Identifying Barriers to Therapeutic Adherence in Type 2-Diabetes: A Complex and Multidimensional Clinical Issue

Abstract

The problem of therapeutic non-adherence is a serious issue adversely affecting the adequate control and management of Type2 Diabetes (T2D).This unwelcoming situation has been studied well on various spots on the globe, with diverse results. The present study, aimed at identifying the barriers to therapeutic adherence, was conducted on a set of proven cases of T2D, managed by primary healthcare providers. The adherence rate to medication alone was 42% while to medication plus lifestyle recommendations 27%. Whereas sub-optimal health literacy, complexity of prescription and socioeconomic aspects were the main determinants, lapse on the part of healthcare system cannot be underscored. The present qualitative study was a preliminary investigation on a small sample .The magnitude of the problem necessitates that a large scale multi-centre in-depth quantitative study in 5 dimensions (recommended by WHO): socio-economic factors, health care team and system related factors, condition related factors , therapy related factors and patient related factors, be done on priority basis. This would pave the way for planning a well-designed intervention programme.