Barriers and Facilitators in Access to Diabetes, Hypertension, and Dyslipidemia Medicines: A Scoping Review

Castillo-Laborde, Carla; Hirmas-Adauy, Macarena; Matute, Isabel; Jasmen, Anita; Urrejola, Oscar; Molina, Xaviera; Awad, Camila; Frey-Moreno, Catalina; Pumarino-Lira, Sofia; Descalzi-Rojas, Fernando; Ruiz, Tomás José; Plass, Barbara

doi:10.3389/phrs.2022.1604796

Cited by 8 publications

(9 citation statements)

References 199 publications

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“…The existence of unfavorable waiting areas compounded the unpleasant experiences faced by the patients at their respective facilities therefore minimizing the possibility of complete engagement of patients in various aspects of their care and predicting both compliance and utilization of the facility services. Consistent findings of unfavourable facility environments have been elucidated by other relevant studies [ 15 , 21 , 37 , 38 ]. A systematic and qualitative meta-synthesis study revealed significant service delivery network problems, particularly among low-middle-income countries where most of the diabetes health services are provided by public clinics established within hospitals in district and regional capitals [ 39 ].…”

Section: Discussionsupporting

confidence: 83%

Barriers and facilitators to satisfaction with diabetes care: The perspectives of patients attending public diabetic clinics in Dar es Salaam, Tanzania

Chona,

Kayange,

Iseselo

2024

PLoS ONE

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Background The prevalence of diabetes has been increasing steadily over the past decade in low- and middle-income countries (LMICs) with about three-quarters of people living with the disease globally residing in these countries. Patient satisfaction can be used as a proxy measure of overall facility performance, and its use has been recommended for determining the quality of services provided by healthcare centres and organizations. This study aimed to explore barriers and facilitators towards satisfaction with diabetes care among patients attending public diabetic clinics in Dar es Salaam, Tanzania. Methods A qualitative descriptive study was carried out among people with diabetes attending public diabetic clinics in Dar es Salaam, Tanzania. Using a purposeful sampling technique, 35 people with diabetes were interviewed from May 2023 to July 2023 with the principles of saturation guiding sample size determination. A semi-structured face-to-face interview guide was employed in data collection. The audio-recorded interviews were transcribed and analyzed using a conventional content analysis approach after translation. NVivo 12.0 computer software was employed to organize and code the data. Results A total of 35 participants were enrolled in this study with a mean (±SD) age of 58.5 (±13.76) years. Four predominant themes and 12 categories were identified after data analysis including two barriers and two facilitators toward patients’ satisfaction with diabetes care. Financial constraints and unfavourable clinic environments were identified as barriers. Furthermore, good provider-patient relationships and continuity of care emerged as facilitators. Conclusion Barriers and facilitators to patients’ satisfaction with diabetes identified in this study are greatly determined by socio-economic and cultural conditions, highlighting the role of the healthcare delivery systems and allied stakeholders in regulatory and policy development to address the existing barriers and consolidate the proven facilitators.

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Section: Discussionsupporting

confidence: 83%

Barriers and facilitators to satisfaction with diabetes care: The perspectives of patients attending public diabetic clinics in Dar es Salaam, Tanzania

Chona,

Kayange,

Iseselo

2024

PLoS ONE

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“…The presentation of the results is divided into three subsections: 1) Description of the participants; 2) General perceptions on access to health, and the barriers and facilitators depending on the dimensions of access (3–5); and 3) the differences between the perceptions of the FONASA and ISAPRE beneficiaries regarding access to medicines.…”

Section: Resultsmentioning

confidence: 99%

“…In other words, access to medicines implies their availability at a reasonable distance, their acceptance by patients and physicians and the real possibility of financing. These dimensions, as well as multiple barriers and facilitators associated with each of them, were also identified globally by a scope review on medications associated with three chronic conditions of high prevalence (5), finding that the most reported dimension, in countries of all regions and income levels, is affordability, and among the most relevant barriers, the availability of medications, long distances, cost, professional support and cultural aspects (5). Despite the therapeutic importance of pharmaceutical drugs, the lack of access to essential medicines, defined as those that meet the priority health care needs of the 5 population, is one of the most serious public health problems globally, affecting one third of the world's population, with consequences for loss of life and deterioration of health (6).…”

Section: Introductionmentioning

confidence: 99%

Access to medicines for the treatment of chronic diseases in Chile: qualitative analysis of perceived patient barriers and facilitators in five regions of the country

Castillo-Laborde

Matute

Sgombich³

et al. 2023

Preprint

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Purpose: To know patients' perceptions of barriers and facilitators in access to medicines in general, and those associated with the treatment of three chronic conditions of high prevalence in Chile: diabetes, dyslipidemia and hypertension. Methods: Ten focus groups of patients with these diseases, diagnosed for at least six months and prescribed medication, were included. These were carried out in five regions of Chile: Arica, in the north, Aysén, in the south, and Valparaíso, Metropolitan, and Maule, in the central zone. The criteria for the formation of groups were region, age, health system (public or private) and socioeconomic level (residence commune). Sessions were recorded, transcribed, and analyzed by categories. Results: The experience of access to medicines is determined by the insurance system, the experience of care with public or private providers, and geographical-administrative difference between capital and other regions. Beneficiaries of public sector, despite their greater socioeconomic vulnerability, perceive greater protection in access: access conditions, delivery reliability and adherence to pharmacological treatment are met. The main problem observed is the financing of treatments not covered by the health system. Policyholders in private sector perceive that they have access to medicines of better quality than those provided free of charge by public sector, but raise fears associated with the inability to afford them and distrust in the process, linked to alliances between laboratories and physicians. Public sector beneficiaries value territorial coverage of primary care, which guarantees access in isolated areas. Regarding the type of provider, public sector shows greater capacity for user loyalty, which is expressed in regular visits and follow-up; unlike discontinuous examinations among private sector beneficiaries. Conclusions: Different access conditions both at the territorial level and in the health subsystems are evident. It is necessary to make progress in addressing the problem of access to medicines in a comprehensive manner.

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“…Equitable access to medicines for hypertension and diabetes is crucial for reducing the burden of NCD41 42; providing medicines at the PHC level has shown a practical approach to reducing blood pressure-related deaths 43. Moreover, the Sustainable Development Goal for universal health coverage requires access to safe, adequate quality and affordable medicine 44.…”

Section: Discussionmentioning

confidence: 99%

Lived experiences of people living with HIV and hypertension or diabetes access to care in Ethiopia: a phenomenological study

Badacho,

Mahomed

2024

BMJ Open

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BackgroundPeople living with HIV (PLWH) are more likely to develop hypertension and diabetes than people without HIV. Previous studies have shown that HIV stigma, discrimination and exclusion make it difficult for PLWH to access care for hypertension and diabetes.ObjectivesThis study aimed to explore the lived experiences of PLWH with comorbid hypertension or diabetes to access hypertension and diabetes care in southern Ethiopia.DesignWe conducted a qualitative study using a semistructured interview guide for an in-depth, in-person interview.SettingsFrom 5 August to 25 September 2022, PLWH with comorbid hypertension or diabetes were purposefully selected from five primary healthcare (PHC) facilities in the Wolaita zone of southern Ethiopia.ParticipantsA total of 14 PLWH with comorbid hypertension or diabetes who were receiving antiretroviral therapy from PHC were interviewed. Among them, 10 were women, and 4 were men.MethodsIn-person, in-depth interviews were conducted. Qualitative data analysis software (NVivo V.12) was used to assist with the data organisation, and Colaizzi’s (1978) inductive thematic analyses were conducted to explore key concepts.ResultThis study yielded two main themes: Theme 1: barriers to accessing care as individual barriers to access (low awareness of non-communicable diseases, misperceptions, lack of health insurance and cost of treatment); healthcare system barriers (shortage of supplies, drugs and equipment; long wait times; lack of integrated services; absence of routine screening and lack of respect from providers); community barriers (lack of support from families, friends and the community) and stigma and discrimination access to hypertension and diabetes. Theme 2: accessibility facilitators (support from family, friends and organisations; health insurance coverage).ConclusionPLWH recommended that access to services can be improved by service integration, awareness-raising activities, no user fee charges for hypertension and diabetes care and routine screening.

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Barriers and Facilitators in Access to Diabetes, Hypertension, and Dyslipidemia Medicines: A Scoping Review

Cited by 8 publications

References 199 publications

Barriers and facilitators to satisfaction with diabetes care: The perspectives of patients attending public diabetic clinics in Dar es Salaam, Tanzania

Barriers and facilitators to satisfaction with diabetes care: The perspectives of patients attending public diabetic clinics in Dar es Salaam, Tanzania

Access to medicines for the treatment of chronic diseases in Chile: qualitative analysis of perceived patient barriers and facilitators in five regions of the country

Lived experiences of people living with HIV and hypertension or diabetes access to care in Ethiopia: a phenomenological study

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