Patient and provider’s perspective on barriers and facilitators for medication adherence among adult patients with cardiovascular diseases and diabetes mellitus in India: a qualitative evidence synthesis

Abstract

ObjectiveTo explore the various stakeholders’ perspectives on barriers and facilitators for medication adherence among patients with cardiovascular diseases (CVDs) and diabetes mellitus (DM)in India.DesignSystematic review of qualitative studies.Data sourcesA comprehensive systematic search was conducted in Medline, Cochrane Library, Science Direct and Google Scholar from January 2010 to July 2020. We included all qualitative peer-reviewed studies, reporting barriers and facilitators of medication adherence, from India, for our current review.Data extraction and synthesisData extraction was performed by two independent authors who also assessed the quality of included studies using the Critical Appraisal Skills Programme criteria. This qualitative evidence synthesis adhered to the enhancing transparency in reporting the synthesis of qualitative research checklistResultsIn total, 18 studies were included. Major barriers reported were lack of understanding about the disease, complications related to non-adherence, followed by forgetfulness, lack of family support and risk communication. Health system-related barriers such as accessibility, affordability and acceptability were also reported by majority of the studies. Creation of peer support groups, digital reminder systems, integration of native Indian systems of India, physiotherapy and geriatric clinics at the primary healthcare level and innovations in patient care were suggested to counter these barriers in medication adherence.ConclusionSuch patient-specific targeted interventions need to be developed to achieve better control among patients with CVD and DM.PROSPERO registration numberCRD42020199529.

Determinants of Adherence to Treatment in Type 2 Diabetic Patients: A Directed Qualitative Content Analysis Based on Pender’s Health Promotion Model

“…This study found many barriers to successful treatment adherence. Individual and contextual barriers included the physical problems to do regular physical activity, complications of diabetes, forgetting to take medicines, high cost and low insurance coverage of medicines, doctor visits and lab tests, and low availability of drugs especially insulin, and this is consistent with international studies (Huang & Shiyanbola, 2021;Krishnamoorthy et al, 2022;Rezaei et al, 2019). In Iran, as suggested by the NPPCD and the NGOs, such as the Iranian Diabetes Society, there are different ways to promote the perceived benefits of treatment adherence and overcome the potential barriers.…”

Medication adherence and environmental barriers to self-care practice among people with diabetes: A cross-sectional study in a lifestyle clinic in eastern India

“… 21 , 22 , 23 , 24 , 25 Lack of dietary control, regular physical exercise, glucose testing, and medication adherence are common in India. 26 , 27 , 28 , 29 We found that environmental barriers were common in our setting, particularly among people with low levels of formal education. Most of the prior Indian studies have identified similar findings coupled with inadequate counselling from the health care system.…”

Comparing Medication Non-adherence in Cardiovascular Disease Patients at Public and Private Hospitals in Peshawar: A Cross-Sectional Study of Prevalence and Contributing Factors

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