<p>Barriers of medication adherence in patients with type-2 diabetes: a pilot qualitative study</p>

Abstract

Background: Patients with type-2 diabetes have poor adherence to the therapeutic regime. It can result in various complications in body systems associated with undesirable metabolic control. Purpose: The present study aimed to explore the inhibitors of medication adherence in patients with type-2 diabetes. Patients and methods: This was a qualitative study using a conventional content analysis method. Participants were 12 patients with type-2 diabetes referred to the diabetes unit in Saghez, Kurdistan Province in 2015. The purposive sampling method was used with a maximum variation in sampling, and data collection was continued until data saturation was achieved. Semi-structured interviews were used for data collection. Interviews were recorded and immediately transcribed verbatim. Results: Data analysis led to the development of four main categories including disbelief in medical explanatory/prescriptive knowledge, lived experiences of the disease, challenges of everyday life, and interactive/economic challenges. The main inhibitors were the patient’s understanding of his/her own physical status and strategies used for maintaining the internal balance. Healthcare providers need to take patients’ perceptions into account when they are prescribing medicinal diets. Another inhibitor was the incidents of everyday life, including economic and social challenges, and interactions to receive education and skills for living with the disease. Conclusion: Beliefs of the medical team and patients should be brought closer to each other, and patients’ trust in the medical team should be increased. Nurses should consider the unique experience of every patient when giving healthcare recommendations, and try to limit the existing challenges as much as possible.

Exploring perceptions, attitudes and beliefs of Thai patients with type 2 diabetes mellitus as they relate to medication adherence at an out-patient primary care clinic in Chiang Mai, Thailand

“…Hence, implications for the Thai context should train health workers and multidisciplinary teams with an explicit focus on eliciting patient's feelings, beliefs and concerns about illness, and involve patients and their families in decision-making [32]. Rezaei et al suggest that gaining the patient's trust can promote the relationship and medical teams should attempt to tailor care programs to each patient based on their lived experiences and unique challenges to increase their adherence to treatment [33]. An easy plan of treatment, specific to each patient's lifestyle, and acknowledging an individual's limitation due to social isolation, age or limited health literacy [28] can help ensure that taking medication is a part of routine, daily activities.…”

Challenges of managing diabetes in Iran: meta-synthesis of qualitative studies

“…Included studies were published between 2009 and 2019. Five articles [17][18][19][20][21] focused on patients, two [22,23] on healthcare providers/experts, and five on mixture of these groups. The total population sample included 188 patients, 2 relatives, and 25 healthcare providers/experts.…”

“…Several patients reported misunderstanding with family members about their situation [24]. Some of them reported that they are being ignored by family members [20]. Moreover, family members were also seen as a barrier to the diabetes related healthy lifestyles.…”

“…Patients have no selfefficacy to change their lifestyle (as a critical selfmanagement dimension) [21] and have difficulties in integrating treatment with their daily activities [26]. Most of participants explained that they do not receive appropriate training on self-control [18,21,24] that may lead to patients' poor knowledge and skill regarding the disease and its management [20,26]. This include insufficient information about appropriate healthy diet [24] normal level of blood sugar [24] and alternative therapies [21].…”

“…The third area in challenges regarding self-management is concerned with the self-medication [19,20,24].…”