A phenomenological study on barriers of adherence to medical advice among type 2 diabetic patients

Abstract

Background More than three decades of research and study for overcoming the problem of “non-acceptance/non-compliance” of patients has neither resolved nor reduced the severity of this problem. This phenomenological study aimed to identify barriers of adherence to medical advice among type 2 diabetic patients. Methods This study was a qualitative research using phenomenology approach, and the data were analyzed using content analysis approach. Participants were 69 type 2 diabetic patients covered by the diabetes unit of West and East Community Health Centers of Ahvaz, Iran. The views and attitudes of patients about the barriers of adherence to medical advice were elicited by conducting 20–45 min sessions of semi-structured interviews. Data analysis was performed following Colaizzi’s seven-step method. Results Barriers of adherence to medical advice were classified into systemic and individual barriers. Individual barriers included 11 codes and 5 categories, and systemic barriers contained within 5 codes and 3 categories. Physiologic and physical factors, financial problems, occupational factors, attitudinal problems and lack of knowledge, and social and family problems were identified as individual barriers. Systemic barriers included inadequate publicizing and limited notification, inadequate equipment and facilities, and poor inter-sectional coordination. Conclusions Generally, problems stated by diabetic patients at the individual level can partly be solved by training patients and the people around them. However, as for the systemic problems, it seems that solving the barriers of adherence to medical advice requires coordination with other organizations as well as intersection coordination. Overall, these problems require not only comprehensive health service efforts, but also the support of policymakers to resolve barriers at infrastructure level.

Treatment noncompliance level among patients with type 2 diabetes mellitus: A hospital based cross-sectional study in Bangladesh

“…Several studies have shown that attitudinal issues such as carelessness, a lack of knowledge, financial problems, physiologic and physical factors, as well as social and family problems, can frequently act as a barrier to drug adherence in type 2 diabetes mellitus patients [7,8]. Mann et al (2009) conducted a cross-sectional study to identify potentially modifiable patient conditions and drug beliefs associated with poor medication adherence among people with diabetes [9].…”

Prevention and control of diabetes mellitus complications in productive population in rural

“…Data analysis using thematic analysis [23], [28], [29]. Data were analyzed using a thematic analysis approach [30], [31], by specifying coding [32], [33], make a similar patterns (pattern mathing), drawing and make major deductions [34], [35]. Peer-d briefings were also conducted to maintain the consistency of the informant's answers [36].…”

“…In addition, the socio-demographic picture in the three villages is very supportive considering the characteristics of the productive population of people with diabetes mellitus and providers to explore implementation programs. Saturation in qualitative studies is carried out when the answers from informants are saturated or conditions when all informants answer in the same pattern [24], [31]. This research was approved by the research ethics committee of the Faculty of Medicine, Universitas Sebelas Maret with number 99/UN27.06.11/KEP/EC/2022.…”

BMC Endocrine Disorders’ collection of articles on “Reducing inequalities in the Management of Endocrine Disorders”

“…Regarding the treatment of diabetes mellitus, evidence-based approaches, notably systematic reviews and meta-analyses, have confirmed diabetes-related health education’s major role (through institutionally provided training, self-learning or peer education) on glycemic control [ 7 ], and the importance of quality of care improvement approaches in reducing diabetes-associated complications in socially disadvantaged populations [ 8 ]. Undeniably, several barriers exist, including social and family issues, lack of adequate financial resources, and others (e.g., social security officers) [ 9 ]. Nonetheless, sophisticated digital health-based diabetes management tools (e.g.., remote blood glucose monitoring through wearable devices) could address these barriers through an equity lens [ 10 ].…”