Socio-cognitive determinants affecting insulin adherence/non-adherence in late adolescents and young adults with type 1 diabetes: a systematic review protocol

Abstract

Objective This systematic review aims to investigate the key socio-cognitive determinants associated with adherence/non-adherence to insulin treatment in late adolescents and young adults in the age range of 17–24 years with T1D. Methods A pre-specified search strategy will be used to search for studies in the electronic databases and citation indexes: PubMed, EMBASE, Web of Science, and PsycINFO. Two researchers will screen the title and the abstract independently, then will read and critically appraise the full text of each included study. A third independent reviewer will resolve disagreements in data extraction until consensus. Data will be extracted using the Population, Exposure, Outcomes, Study characteristics framework. Study selection will follow the updated guideline for reporting systematic reviews (PRISMA 2020) and will take place from 15 October 2021 to 1 January 2022. The methodological quality and risk of bias of the observational studies will be assessed by the JBI Critical Appraisal Checklist for Cohort and JBI Critical Appraisal Checklist for Analytical Cross Sectional Studies. Results A qualitative narrative synthesis will present the characteristics and the quality of studies and the outcomes of concern. Conclusion Based on the contemporary literature, this review will synthesize the evidence on the socio-cognitive determinants associated with adherence/non-adherence to insulin treatment in late adolescents and young adults in the age range of 17–24 years with T1D. The findings will help design patient-centered interventions to promote adherence to insulin in this age group, guide patients’ consultations and diabetes self-management education (DSME) programs. Protocol registration: PROSPERO ID: CRD42021233074.

Improving Adherence to Treatment in Patients With Diabetes: Practical Strategies

“…Social problems of patients with diabetes include feelings of fear, embarrassment, blame, guilt, anxiety and decreased selfconfidence, which may lead to a feeling of social stigma in the patient. For this reason, these patients may resort to strategies such as hiding the disease, not performing therapeutic activities in public, avoiding social relations and finally not adherence to treatment of their disease [5,6]. Meanwhile, family support, as one of the most important sources of social support, plays a significant role in increasing self-confidence and adaptation to the disease in people with diabetes.…”

“…Patients with diabetes always need consultation and interaction with their treatment team to get the necessary recommendations for disease management and the motivation to adherence to their treatment plan. Therefore, the strong performance of the treatment team in terms of responding appropriately to the needs of patients, providing complete information and away from contradictions based on the defined protocols, as well as trying to accompany patients in care plans, can gain their trust and satisfaction and provide them with the opportunity to refer again and adherence to treatment [6]. Another effective strategy to improving adherence to treatment is to adopt a collaborative approach in the behaviour of health personnel with clients.…”