Modifiable Factors Affect Treatment Adherence in Patients With T2D

Modifiable and nonmodifiable risk factors affected type 2 diabetes (T2D) treatment adherence, according to new study findings publisehd in Journal of Diabetes Research.

The researchers searched many international databases for the studies included in the review (N = 18 studies and 3925 patients). This search took place from October 25, 2021, and November 14, 2021, for articles related to limited health literacy that were published from January 2010 to November 2021. Studies were excluded if they did not specifically address the factors affecting treatment adherence among patients with diabetes or were conducted before January 2010.

The researchers found that economic problems, poor communication from the health care team, socio-individual factors, and limited health literacy were the 4 main areas that acted as barriers to treatment adherence for patients with T2D.

Economic problems were a barrier because of the costs related to a proper diet, physical activity, medication, blood sugar measurements, and proper foot care. Patients with low economic status and patients without health insurance see medical costs as a deterrent to continuing treatment.

Poor health care team communication has led to the discontinuation of treatment in patients with diabetes. Patients in the studies claimed that physicians did not pay attention to their words nor behave well with them. The lack of continuous communication and improper behavior or attitude led patients to become unmotivated or reduce their visits to the doctor.These factors are why it is important to train doctors on proper communication techniques to make sure patients adhere to their treatment, the study authors noted.

For individual and social factors, patients’ negative perceptions about disease, worries about adverse effects (AEs) of drugs, lack of support from family or peers, cultural or religious beliefs, inability to take drugs on a regular basis, and experiencing AEs could all their discontinuation of T2D treatment.

Limited health literacy was the last major barrier to patient adherence. Studies in this review identified a low health literacy in patients with T2D. An increase in health literacy in this population is needed, the authors wrote, and this can be achieved through simplifying instructions or using simple and understandable training.

There were some limitations to this study. Some unpublished studies may have been missed in the search for relevant studies, and it was not possible to determine the quality of some of the studies included, so that may have affected the study results.

The researchers concluded that by pinpointing these 4 factors, education efforts that target treatment adherence can be optimized. In addition, they point to the necessity to train patients' families and health care providers.

Reference

Pourhabibi N, Mohebbi B, Sadeghi R, et al. Determinants of poor treatment adherence among patients with type 2 diabetes and limited health literacy: a scoping review. J Diabetes Res. Published online July 4, 2022. doi:10.1155/2022/2980250