Treatment‐Seeking Behavior and Compliance of Diabetic Patients in a Rural Area of South India

Abstract

India, being a rural country, has unique problems regarding the treatment compliance of diabetic patients. This community‐based study was undertaken in a rural primary health center area near Chennai (Madras) in order to better understand treatment‐seeking behavior, compliance patterns, and reasons for noncompliance among rural diabetics. Compliance was indirectly measured through patient interviews and drug use charts. Of the 112 patients interviewed, 72% had some symptoms at the time of diagnosis, and the majority of them were diagnosed in government health centers. Noncompliance was seen in 57% of the 112 patients interviewed, and reasons were elicited. Interruption of treatment was significantly associated with lack of education. The study identified the lack of a patient‐friendly, flexible health care system as the primary reason for noncompliance.

Self Care and Medication Adherence among Type 2 Diabetics in Puducherry, Southern India: A Hospital Based Study

“…Similarly, a study done in rural south India reported that lack of family cooperation was one of the reasons for non adherence [12]. Hence, in addition to individual counseling, family counseling should also be an essential component in the care of DM.…”

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“…Cooperation with social workers should be undertaken to assist with adequate support [30]. Further, it is of the utmost importance to assess patients’ use of herbal remedies, particularly if used as an alternative to allopathic medicine [28, 29], to avoid a switch between different caregivers that might interrupt compliance and glycaemic control, negatively affecting health [31]. Nurses need to elicit information about use from patients in a sensitive and non-judgemental manner, as many users believe that health care providers would admonish them for it and thus do not inform about the treatments used [28].…”

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“…Hypertension was also very prevalent, which, in association with diabetes, increases the risk of complications and morbidity. [14]…”

“…[13] All patients with diabetes require access to education on how to manage the condition; medication, particularly for blood glucose and blood pressure lowering, frequent monitoring of blood glucose and blood pressure, regular monitoring of feet, eyes and kidneys function for potential complications, and access to care in order to both prevent and treat complications when they occur. [14] Compliance and adherence to medication is crucial in diabetics and poses a challenge to caregivers around the world. Factors shown to influence patient compliance include ease of access to facilities, cost of medication(s), patient's cultural or family factors, and patients’ perception and knowledge about their illness.…”