Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BioPsychoSocial Medicine
Published in: BioPsychoSocial Medicine 1/2021

Open Access 01-12-2021 | Type 2 Diabetes | Research

The psychosocial barriers to medication adherence of patients with type 2 diabetes: a qualitative study

Authors: Firoozeh Mostafavi, Fereshteh Zamani Alavijeh, Arash Salahshouri, Behzad Mahaki

Published in: BioPsychoSocial Medicine | Issue 1/2021

Login to get access

Abstract

Background

The adherence of diabetic patients to their medication regimen is associated with many psychosocial factors that are still unknown. Therefore, the present study aims to identify the psychosocial barriers to medication adherence of patients with type2 diabetes (T2D).

Methodology

This descriptive qualitative study was done in Isfahan, Iran by conducting in-depth unstructured interviews with 23 purposively selected patients with T2D and 10 healthcare providers (HCPs). The participants were interviewed face-to-face between November 2017 and June 2018 at the patient’s home, a Health Care Center, or at the diabetes clinic. Data analysis was performed using MAXQDA-10 software and the conventional content analysis.

Results

The analysis of the data led to six categories of perceived psychosocial barriers: 1) fear, concern and distress, 2) exhaustion and burnout, 3) the children’s issues being the priority, 4) poor financial support, 5) communication challenges, and 6) poor work conditions.

Conclusions

This study identified some of the psychosocial barriers to medication adherence of patients with T2D, which will be of great help to researchers and HCPs in designing and implementing effective interventions to overcome these barriers and change patient self-care behaviors and increase their medication adherence.
Literature
1.
Bagonza J, Rutebemberwa E, Bazeyo W. Adherence to anti diabetic medication among patients with diabetes in eastern Uganda; a cross sectional study. BMC Health Serv Res. 2015;15(1):168.CrossRef
2.
Jemal A, Abdela J, Sisay M. Adherence to Oral Antidiabetic Medications among Type 2 Diabetic (T2DM) Patients in Chronic Ambulatory Wards of Hiwot Fana Specialized University Hospital, Harar, Eastern Ethiopia: A Cross Sectional Study. J Diabetes Metab. 8:721. https://​doi.​org/​10.​4172/​2155-6156.​1000721 Page 2 of 8 J Diabetes Metab, an open access journal ISSN: 2155–6156 Volume 8• Issue 1• 1000721. Socio-demographic characteristics frequency% Age. 2017:18–40.
3.
Krass I, Schieback P, Dhippayom T. Adherence to diabetes medication: a systematic review. Diabet Med. 2015;32(6):725–37.CrossRef
4.
Bonn SE, Alexandrou C, Steiner KH, Wiklander K, Östenson C-G, Löf M, et al. App-technology to increase physical activity among patients with diabetes type 2-the DiaCert-study, a randomized controlled trial. BMC Public Health. 2018;18(1):119.CrossRef
5.
Bennich BB, Røder ME, Overgaard D, Egerod I, Munch L, Knop FK, et al. Supportive and non-supportive interactions in families with a type 2 diabetes patient: an integrative review. Diabetol Metab Syndrome. 2017;9(1):57.CrossRef
6.
Buysman EK, Liu F, Hammer M, Langer J. Impact of medication adherence and persistence on clinical and economic outcomes in patients with type 2 diabetes treated with liraglutide: a retrospective cohort study. Adv Ther. 2015;32(4):341–55.CrossRef
7.
Faria HTG, Rodrigues FFL, Zanetti ML, Araújo MFM, Damasceno MMC. Fatores associados à adesão ao tratamento de pacientes com diabetes mellitus. Acta Paulista de Enfermagem. 2013;26(3):231–7.CrossRef
8.
Fadare J, Moshomo T, Godman B, Meyer JC, Gollakota S, Gaenamong M, et al. Antidiabetic medication adherence and associated factors among patients in Botswana; implications for the future. 2017.
9.
Sapkota S, Brien J-a, Greenfield J, Aslani P. A systematic review of interventions addressing adherence to anti-diabetic medications in patients with type 2 diabetes impact on adherence. PloS one. 2015;10(2):e0118296.
10.
Elsous A, Radwan M, Al-Sharif H, Abu MA. Medications adherence and associated factors among patients with type 2 diabetes mellitus in the Gaza strip. Palestine Front Endocrinol. 2017;8:100.CrossRef
11.
Schmieder RE, Ott C, Schmid A, Friedrich S, Kistner I, Ditting T, et al. Adherence to Antihypertensive Medication in Treatment-Resistant Hypertension Undergoing Renal Denervation. J Am Heart Assoc. 2016;5(2):e002343.
12.
Garcia-Perez LE, Álvarez M, Dilla T, Gil-Guillén V, Orozco-Beltrán D. Adherence to therapies in patients with type 2 diabetes. Diabetes Ther. 2013;4(2):175–94.CrossRef
13.
Abebaw M, Messele A, Hailu M, Zewdu F. Adherence and associated factors towards antidiabetic medication among type II diabetic patients on follow-up at University of Gondar Hospital, Northwest Ethiopia. Adv Nurs. 2016;2016.
14.
Mashrouteh M, Khanjani N. Evaluation of oral medication adherence and its related factors in type II diabetic patients in Iran: a systematic review. Int J Diabetes Res. 2017;6(1):24–33.
15.
Hong JS, Kang HC. Relationship between oral antihyperglycemic medication adherence and hospitalization, mortality, and healthcare costs in adult ambulatory care patients with type 2 diabetes in South Korea. Med Care. 2011;1:378–84.CrossRef
16.
Jaam M, Ibrahim MI, Kheir N, Hadi MA, Diab MI, Awaisu A. Assessing prevalence of and barriers to medication adherence in patients with uncontrolled diabetes attending primary healthcare clinics in Qatar. Primary Care Diabetes. 2018;12(2):116–25.CrossRef
17.
Pascal IG, Ofoedu JN, Uchenna NP, Nkwa AA, Uchamma GU. Blood glucose control and medication adherence among adult type 2 diabetic Nigerians attending a primary care clinic in under-resourced environment of eastern Nigeria. N Am J Med Sci. 2012;4(7):310.CrossRef
18.
Gillani SW, Sulaiman SA, Abdul MI, Saad SY. A qualitative study to explore the perception and behavior of patients towards diabetes management with physical disability. Diabetol Metab Syndrome. 2017;9(1):58.CrossRef
19.
Tewahido D, Berhane Y. Self-care practices among diabetes patients in Addis Ababa: a qualitative study. PLoS One. 2017;12(1):e0169062.CrossRef
20.
Rezaei M, Valiee S, Tahan M, Ebtekar F, Gheshlagh RG. Barriers of medication adherence in patients with type-2 diabetes: a pilot qualitative study. Diabetes Metab Syndr Obes. 2019;12:589.CrossRef
21.
Dalvand H, Dehghan L, Rassafiani M, Hosseini SA. Exploring the process of mothering co-occupations in caring of children with cerebral palsy at home. Int J Pediatr. 2018;6(2):7129–40.
22.
Shen H, Edwards H, Courtney M, McDowell J, Wei J. Barriers and facilitators to diabetes self-management: perspectives of older community dwellers and health professionals in C hina. Int J Nurs Pract. 2013;19(6):627–35.CrossRef
23.
Sweileh WM, Sa’ed HZ, Nab’a RJ, Deleq MI, Enaia MI, Sana’a MN, Al-Jabi SW. Influence of patients’ disease knowledge and beliefs about medicines on medication adherence: findings from a cross-sectional survey among patients with type 2 diabetes mellitus in Palestine. BMC Public Health. 2014;14(1):94.CrossRef
24.
Purnell TS, Lynch TJ, Bone L, Segal JB, Evans C, Longo DR, Bridges JF. Perceived barriers and potential strategies to improve self-management among adults with type 2 diabetes: a community-engaged research approach. Patient. 2016;9(4):349–58.CrossRef
25.
Lin K, Park C, Li M, Wang X, Li X, Li W, Quinn L. Effects of depression, diabetes distress, diabetes self-efficacy, and diabetes self-management on glycemic control among Chinese population with type 2 diabetes mellitus. Diabetes Res Clin Pract. 2017;131:179–86.CrossRef
26.
Díaz EG, Medina DR, López AG, Porras ÓM. Determinants of adherence to hypoglycemic agents and medical visits in patients with type 2 diabetes mellitus. Endocrinol Diabetes Nutr. 2017;64(10):531–8.CrossRef
27.
Rashedi V, Asadi-Lari M, Delbari A, Fadayevatan R, Borhaninejad V, Foroughan M. Prevalence of diabetes type 2 in older adults: findings from a large population-based survey in Tehran, Iran (urban HEART-2). Diabetes Metab Syndr. 2017;11:S347–50.CrossRef
28.
Liu NF, Brown AS, Folias AE, Younge MF, Guzman SJ, Close KL, Wood R. Stigma in people with type 1 or type 2 diabetes. Clin Diabetes. 2017;35(1):27–34.CrossRef
29.
Gredig D, Bartelsen-Raemy A. Diabetes-related stigma affects the quality of life of people living with diabetes mellitus in S witzerland: implications for healthcare providers. Health Soc Care Commun. 2017;25(5):1620–33.CrossRef
30.
Wens J, Nicolucci A, Kalra S, Kulzer B, Benedetti MM, Piana N, et al. Societal discrimination and emotional well-being in people with diabetes: results from DAWN2. In: Diabetologia. New York: Springer; 2013.
31.
Tak-Ying Shiu A, Kwan JJ, Wong RY. Social stigma as a barrier to diabetes self-management: implications for multi-level interventions. J Clin Nurs. 2003;12(1):149–50.CrossRef
32.
Browne JL, Ventura A, Mosely K, Speight J. ‘I call it the blame and shame disease’: a qualitative study about perceptions of social stigma surrounding type 2 diabetes. BMJ open. 2013;3(11):e003384.CrossRef
33.
Anderbro T, Gonder-Frederick L, Bolinder J, Lins PE, Wredling R, Moberg E, Lisspers J, Johansson UB. Fear of hypoglycemia: relationship to hypoglycemic risk and psychological factors. Acta Diabetol. 2015;52(3):581–9.CrossRef
34.
Schopman JE, Geddes J, Frier BM. Frequency of symptomatic and asymptomatic hypoglycaemia in type 1 diabetes: effect of impaired awareness of hypoglycaemia. Diabet Med. 2011;28(3):352–5.PubMed
35.
Fritschi C, Quinn L. Fatigue in patients with diabetes: a review. J Psychosom Res. 2010;69(1):33–41.CrossRef
36.
Rutebemberwa E, Lubega M, Katureebe SK, Oundo A, Kiweewa F, Mukanga D. Use of traditional medicine for the treatment of diabetes in eastern Uganda: a qualitative exploration of reasons for choice. BMC Int Health Hum Rights. 2013;13(1):1.CrossRef
Metadata
Title
The psychosocial barriers to medication adherence of patients with type 2 diabetes: a qualitative study
Authors
Firoozeh Mostafavi
Fereshteh Zamani Alavijeh
Arash Salahshouri
Behzad Mahaki
Publication date
01-12-2021
Publisher
BioMed Central
Keyword
Type 2 Diabetes
Published in
BioPsychoSocial Medicine / Issue 1/2021
Electronic ISSN: 1751-0759
DOI
https://doi.org/10.1186/s13030-020-00202-x

Other articles of this Issue 1/2021

BioPsychoSocial Medicine 1/2021 Go to the issue

Research

Prevalence of autism spectrum disorder and autistic traits in children with anorexia nervosa and avoidant/restrictive food intake disorder

Research

Health-related benefits and adverse events associated with yoga classes among participants that are healthy, in poor health, or with chronic diseases

Review

Cognitive behavioral treatment for irritable bowel syndrome: a recent literature review

Research

A randomized, double-blind, placebo-controlled study to assess efficacy of mirtazapine for the treatment of diarrhea predominant irritable bowel syndrome

Review

A systematic review of the effect of sleep interventions on presenteeism

Review

Cognitive–behavioral therapy for management of mental health and stress-related disorders: Recent advances in techniques and technologies