Determinants of adherence to insulin and blood glucose monitoring among adolescents and young adults with type 1 diabetes in Qatar: a qualitative study

Abstract

Background: Adherence to insulin and blood glucose monitoring (BGM) is insufficient in adolescents and young adults (AYAs) with type 1 diabetes (T1D) worldwide and in Qatar. Little is known about the factors related to being aware of non-adherence and the beliefs related to non-adherence in this group. This qualitative study investigated factors related to awareness of, and beliefs about non-adherence, as well as the existence of specific action plans to combat non-adherence using the I-Change model. Methods: The target group was comprised of 20 Arab AYAs (17–24 years of age) with T1D living in Qatar. Participants were interviewed via semi-structured, face-to-face individual interviews, which were audio-recorded, transcribed verbatim, and analyzed using the Framework Method. Results: Suboptimal adherence to insulin, and particularly to BGM, in AYAs with T1D was identified. Some AYAs reported to have little awareness about the consequences of their non-adherence and how this can adversely affect optimal diabetes management. Participants also associated various disadvantages to adherence (e.g., hypoglycemia, pain, among others) and reported low self-efficacy in being adherent (e.g., when outside home, in a bad mood, among others). Additionally, goal setting and action-planning often appeared to be lacking. Factors facilitating adherence were receiving support from family and healthcare providers, being motivated, and high self-efficacy.  Conclusions: Interventions that increase awareness concerning the risks of non-adherence of AYAs with T1D are needed, that increase motivation to adhere by stressing the advantages, creating support and increasing self-efficacy, and that address action planning and goal parameters.