A Comprehensive Review on Determinants of Poor Treatment Adherence among Type 2 Diabetes Patients and Low Health Literacy

Subject Areas : Journal of Chemical Health Risks

Helen  Williams ¹ (Assistant Professor, Department of Pharmacy Practice, Faculty of Pharmacy, Bharath Institute of Higher Education and Research, Chennai, Tamil Nadu, India)
Srinivasan  Ranganathan ² (Research Guide, Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Bharath Institute of Higher Education and Research (BIHER), Chennai, Tamil Nadu, India)

Received: 2022-11-22 Accepted : 2023-10-11 Published : 2024-03-16

Keywords: Type 2 diabetes, Systematic Review, Poor treatment adherence, Low health literacy,

Abstract :

Both preventive and therapeutic interventions are necessary for good diabetes management and the prevention of complications. There are serious therapeutic and financial repercussions when patients don't follow their doctors' orders about medicine, nutrition, and healthcare procedures. The current comprehensive review aims to determine factors that have been observed in patients with type 2 diabetes and low health literacy, contribute to poor treatment adherence in 2022. Five steps were taken to complete this review: creating a research question, looking for and extracting relevant papers, choosing relevant studies, tabulating data, and reporting findings. Using the terms "Type 2 diabetes", "obstacles", "determinants", "factors", "barriers", "treatment", "medication", "therapy" "adherence", "non-adherence", "poor adherence", and "low health literacy" was gathered from six electronic databases (Scopus, Web of Science, Embase, Science Direct, PubMed and Google Scholar) from January 2018 to January 2022. Twelve were able to be reviewed from the initial 140 articles. In this review, ten studies have been selected involving 1497 patients with type 2 diabetes. The range of nonadherence prevalence was from 42% to 74.3%. Economic difficulties, inadequate communication with the medical staff, an absence of family support, ignorance, misinterpretation, and low health literacy were major barriers to treatment adherence in the publications. The findings of this study identified both modifiable and non-modifiable factors influencing medication adherence in type 2 diabetes patients. Modifiable factors must be addressed by suitable interventions carried out with the target population and healthcare experts.

References:

1. Barati S., Sadeghipour P., Ghaemmaghami Z., 2021. Warning signals of elevated prediabetes prevalence in the modern Iranian urban population. Primary Care Diabetes. 15(3), 472–479.


2. Barman P., Das M., Verma M., 2023. Epidemiology of type 2 diabetes mellitus and treatment utilization patterns among the elderly from the first wave of Longitudinal Aging study in India (2017-18) using a Heckman selection model. BMC Public Health. 23, 699.


3. Mousavizadeh S.N., Ashktorab T., Ahmadi F., Zandi M., 2016. Evaluation of barriers to adherence to therapy in patients with diabetes. Journal of Diabetes Nursing. 4(3), 94–108.


4. Gholamaliei B., Karimi-Shahanjarini A., Roshanaei G., Rezapour-Shahkolaei F., 2016. Medication Adherence and its Factors in Patients with Type II Diabetes. Journal of Education and Community Health. 2(4), 3–12.


5. Osicka T., Kothe E., Ricciardelli L., 2015. A systematic review of adherence to restricted diets in people with functional bowel disorders. Appetite. 92, 143–155.


6. Kavookjian J., Wittayanukorn S., 2015. Interventions for adherence with oral chemotherapy in hematological malignancies: a systematic review. Research in Social and Administrative Pharmacy. 11(3), 303–314.


7. Epakchipoor F., Bastani F., Pashaei S.F., 2021. Self-management and medication adherence in older adults with type II diabetes referring to the endocrinology clinics of the teaching hospital affiliated to Iran University of Medical Sciences. Iran Journal of Nursing. 34(129), 1–14.


8. Liu C., Wang D., Liu C., 2020. What is the meaning of health literacy? A systematic review and qualitative synthesis. Family Medicine and Community Health. 8(2), 351.


9. Arbabi H., Mansouri A., Nooshirvani S., Arbab A., 2017. The relationship between health literacy and general health in patients with type II diabetes referring to diabetes clinic of Zabol in 2016. Journal of Diabetes Nursing. 5(1), 29–39.


10. Goli Roshan A., Hosseinkhani S., Norouzadeh R., 2021. The relationship between health literacy of elderly diabetics and adherence to treatment. Qom University of Medical Sciences Journal. 14(12), 70–80.


11. Khosravi A., Kh A., Sh A., Tahmasbi R., 2015. Health Literacy Levels of Diabetic Patients Referred to Shiraz Health Centers and Its Effective Factors. Health Information Management. 12(2), 205.


12. Pashaki M.S., Eghbali T., Niksima S.H., Albatineh A.N., Gheshlagh R.G., 2019. Health literacy among iranian patients with type 2 diabetes: A systematic review and meta-analysis. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 13(2), 1341–1345.


13. Mohammad A.Z.B., Mehdi K., 2018. Relationship between health literacy and self-care behaviors in diabetic patients type II referred to the center of diabetes control and prevention in zabol. Journal of Health Literacy. 3(1), 10–19.


14. Charoghchian Khorasani E., Peyman N., Sahebkar M., Moghzi M., 2017. Investigating health literacy in patients with type2 diabets referring to the health houses of chenaran in 2016. Journal of North Khorasan University of Medical Sciences. 9(2), 183–191.


15. Salehi F., Ahmadian L., Ansari R., Sabahi A., 2016. The role of information resources used by diabetic patients on the management of their disease. Medical Journal of Mashhad University of Medical Sciences. 59(1), 17–25.


16. Mohebbi B., Sabouri M., Tol A., 2021. Application of health education and promotion theory-based interventions on patients with cardiovascular disease: A systematic review. Journal of Education and Health Promotion. 10, 236.


17. Arksey H., Malley L.O., 2005. Scoping Studies: Towards a Methodological Framework. International Journal of Social Research Methodology. 8(1), 19–32.


18. Kooshyar H., Shoorvazi M., Dalir Z., Hosseini M., 2014. Health literacy and its relationship with medical adherence and health-related quality of life in diabetic community residing elderly. Journal of Mazandaran University of Medical Sciences. 24(1), 134–143.


19. Mehrtak M., Hemmati A., Bakhshzade A., 2018. Health Literacy and its Relationship with the medical, dietary Adherence and exercise in Patients with Type II Diabetes mellitus. Journal of Health Literacy. 3(2), 137–144.


20. Mukona D., Munjanja S., Zvinavashe M., Stray-Pederson B., 2017. Barriers of adherence and possible solutions to nonadherence to antidiabetic therapy in women with diabetes in pregnancy: patients’ perspective. Journal of Diabetes Research. 17, 10.


21. Dehvan F., Baghi V., Lotfi A., Ghanei Gheshlagh R., 2018. Medication adherence inhibitors and facilitators in type 2 diabetic patients: an integrative review. Scientific Journal of Nursing, Midwifery and Paramedical Faculty. 3(1), 1–17.


22. Açıl D., Bahar Z., 2019. Perceived barriers to diabetes management at home: a qualitative study. Turkish Journal of Biochemistry. 44 (5), 621–629.


23. Nelson L., Wallston K., Kripalani S., Lestourgeon L., Williamson S.E., Mayberry L.S., 2018. Assessing barriers to diabetes medication adherence using the information- motivation behavioral skills model. Diabetes Research and Clinical Practice. 142, 374–384.


24. Rezaei M., Valiee S., Tahan M., Ebtekar F., Ghanei G.R., 2019. Barriers of medication adherence in patients with type-2 diabetes: a pilot qualitative study. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy. 12, 589–599.


25. Habte B.M., Kebede T., Fenta T.G., Boon H., 2017. Barriers and facilitators to adherence to anti-diabetic medications: Ethiopian patients' perspectives. African journal of primary health care & family medicine. 9(1), 1–9.


26. Hussain N., Said A., Khan Z., 2020. Influence of health literacy on medication adherence among elderly females with type 2 diabetes in Pakistan. Health Education. 41(1), 35–44.


27. Alwazae M., Al Adel F., Alhumud A., Almutairi A., Alhumidan A., Elmorshed H., 2019. Barriers for Adherence to Diabetic Retinopathy Screening among Saudi Adults. Cureus. 11(12), 6454.


28. Abdullah A., Liew S.M., Salim H., Ng C.G., Chinna K., 2019. Prevalence of limited health literacy among patients with type 2 diabetes mellitus: A systematic review. PloS one. 14(5), 216.


29. Huang Y.M., Shiyanbola O., 2021. Investigation of barriers and facilitators to medication adherence in patients with type 2 diabetes across different health literacy levels: an explanatory sequential mixed methods study. Frontiers in Pharmacology. 12(1), 745749.


30. Fan J., Lyons S., Goodman M., Blanchard M., Kaphingst K., 2016. Relationship between health literacy and unintentional and intentional medication nonadherence in medically underserved patients with type 2 diabetes. The Diabetes Educator. 42(2), 199–208.


31. Mostafavi F., Zamani Alavijeh F., Salahshouri A., Mahaki B., 2021. The psychosocial barriers to medication adherence of patients with type 2 diabetes: a qualitative study. BioPsycho Social Medicine. 15(1), 1-2.


32. Hashemi S.M., Bouya S., 2018. Treatment adherence in diabetic patients: an important but forgotten issue. Journal of Diabetes Nursing. 6(1), 341–351.


33. Bauer A.M., Schillinger D., Parker M.M., 2013. Health literacy and antidepressant medication adherence among adults with diabetes: the diabetes study of Northern California (DISTANCE). Journal of General Internal Medicine. 28(9), 1181–1187.


34. Brundisini F., Vanstone M., Hulan D., DeJean D., Giacomini M., 2015. Type 2 diabetes patients and providers differing perspectives on medication nonadherence: a qualitative meta-synthesis. BMC Health Services Research. 15(1), 516.


35. Lewis C.P., Newell J.N., 2014. Patients perspectives of care for type 2 diabetes in Bangladesh–a qualitative study. BMC Public Health. 14(1), 737.


36. Miller T., DiMatteo R., 2013. Importance of Family/Social Support and Impact on Adherence to Diabetic Therapy. Diabetes Metabolic Syndrome and Obesity: Targets and Therapy. 6(1), 421–426.


37. Rezaee Esfahrood Z., Haerian Ardekani A., Rahmanian M., Ghaffari Targhi M., 2015. A Survey on Health Literacy of Referred Diabetic Patients Yazd Diabetes Research Center. Toloo E Behdasht. 15(3), 176–186.

38. Davoodi M., Dindamal B., Dargahi H., Faraji-Khiavi F., 2022. A phenomenological study on barriers of adherence to medical advice among type 2 diabetic patients. BMC Endocr Disord. 22(1), 18.