Determinants of Poor Treatment Adherence among Patients with Type 2 Diabetes and Limited Health Literacy: A Scoping Review

Abstract

Prevention of complications and successful control of diabetes require preventive and therapeutic measures. Patients’ nonadherence to medication and diet regimens and healthcare protocols is associated with significant therapeutic and economic consequences. The present scoping review aims to identify determinants of poor treatment adherence among patients with type 2 diabetes and limited health literacy in 2021. This scoping review was conducted in five stages: designing a research question, searching and extracting related studies, selecting related studies, tabulating information, and reporting results. Data were collected from six foreign electronic databases (Embase, Science Direct, PubMed, Google Scholar, Scopus, and Web of Science) and four Iranian electronic databases (MagIran, SID, IranDoc, and IranMedex) using keywords “Type 2 diabetes”, “barriers”, “treatment”, “medication”, “adherence”, “non-adherence”, “limited adherence”, and “limited health literacy” from January 2010 to November 2021. From an initial 146 articles, 18 articles were eligible for review. Eighteen studies involving 3925 patients with T2DM from eight countries were included. The prevalence of nonadherence ranged from 42% to 74.3%. Barriers to treatment adherence, which were common among the articles, included economic problems, poor communication with healthcare team, lack of family support, lack of knowledge, misconceptions, and limited health literacy. The results of the present study provided modifiable and nonmodifiable factors affecting treatment adherence among patients with type 2 diabetes. Modifiable factors are essential by performing appropriate interventions with the target group and health professionals.

Adherencia a las medidas higiénico dietéticas de adultos con diabetes mellitus de Asunción en 2022

“…La misma tiene una (6) relación directa con el conocimiento que tiene el paciente sobre la medicación antidiabética . Otras causas de escasa adherencia son los problemas económicos, la mala comunicación con el equipo de salud, la falta de apoyo familiar, el bajo nivel de conocimientos, la presencia de conceptos erróneos y (13,16) la alfabetización limitada en salud . En Chile se ha visto que los adultos mayores con diabetes (1) tienen mala adherencia en relación al bajo nivel socioeconómico y educativo .…”

“…Los datos obtenidos de esta investigación permiten conocer aspectos del tratamiento de una enfermedad crónica prevalentes en el país y aplicar medidas correctivas pues muchos de esos (13) resultados son modificables . Los estudios demuestran que las mejores estrategias para mejorar el cumplimiento terapéutico tienen que ser mixtas.…”

“…. La falta de cumplimiento de todas estas medidas conlleva importantes consecuencias (13) clínicas y económicas .…”

“…(9) El control metabólico de la diabetes es multifactorial . La falta de adherencia al tratamiento (13) oscila entre 42 y 74% a nivel mundial, según una revisión del año 2022 . En el Paraguay, la diabetes mellitus afecta a 10% de la población y existe poca información sobre la adherencia al tratamiento de (14,15) enfermedades crónicas, sobre todo en áreas urbanas y en pacientes de la comunidad .…”

Dietary Management Tools Improve the Dietary Skills of Patients with T2DM in Communities

“…This includes cultural and conceptual knowledge; the ability to listen and speak (for example, following verbal directions); the ability to write and read (for example, reading and understanding labels on pill bottles, medical directions, education brochures, and other T2DM-related information), and the ability to understand and use numbers (for example, comprehending and following medication dosing, test results, food intake, and exercise levels) [ 59 ]. Previous research has shown the relationship between T2DM health literacy, self-management behaviors, and diabetes-related outcomes, such as medication adherence [ 60 ], physical activity [ 61 , 62 ], healthy diet [ 63 ], self-monitoring of blood glucose [ 64 ], and glycemic control [ 59 , 61 , 62 ]. As a part of T2DM health literacy, improving dietary knowledge and skills may change eating patterns, which in turn can affect glycemic control [ 65 , 66 , 67 ].…”