Abstract
BackgroundMore than three decades of research and study for overcoming the problem of “non-acceptance/non-compliance” of patients has neither resolved nor reduced the severity of this problem. This phenomenological study aimed to identify barriers of adherence to medical advice among type 2 diabetic patients.MethodsThis study was a qualitative research using phenomenology approach, and the data were analyzed using content analysis approach. Participants were 69 type 2 diabetic patients covered by the diabetes unit of West and East Community Health Centers of Ahvaz, Iran. The views and attitudes of patients about the barriers of adherence to medical advice were elicited by conducting 20–45 min sessions of semi-structured interviews. Data analysis was performed following Colaizzi’s seven-step method.ResultsBarriers of adherence to medical advice were classified into systemic and individual barriers. Individual barriers included 11 codes and 5 categories, and systemic barriers contained within 5 codes and 3 categories. Physiologic and physical factors, financial problems, occupational factors, attitudinal problems and lack of knowledge, and social and family problems were identified as individual barriers. Systemic barriers included inadequate publicizing and limited notification, inadequate equipment and facilities, and poor inter-sectional coordination.ConclusionsGenerally, problems stated by diabetic patients at the individual level can partly be solved by training patients and the people around them. However, as for the systemic problems, it seems that solving the barriers of adherence to medical advice requires coordination with other organizations as well as intersection coordination. Overall, these problems require not only comprehensive health service efforts, but also the support of policymakers to resolve barriers at infrastructure level.
Highlights
More than three decades of research and study for overcoming the problem of “non-acceptance/ non-compliance” of patients has neither resolved nor reduced the severity of this problem
The patients had been diagnosed with T2DM for a duration of one to 30 years
According to Worlming et al.’s results, comorbidity in diabetic patients with diseases such as arthritis, stroke, cardiovascular disease, respiratory diseases, and myocardial infarction was associated with a reduction in physical health, and an increase in the number of comorbid diseases led to a decline in the quality of life, indicating the more pronounced role of doctors in the treatment and health behaviors of diabetic patients [17]
Summary
More than three decades of research and study for overcoming the problem of “non-acceptance/ non-compliance” of patients has neither resolved nor reduced the severity of this problem. This phenomenological study aimed to identify barriers of adherence to medical advice among type 2 diabetic patients. More than three decades of research and study for overcoming the problem of “non-acceptance/noncompliance” of patients has neither resolved nor reduced the severity of this problem [9]. The same figures for Germany, Denmark and Kenya are 40%, 51% and 61%, respectively These high rates indicate lack of patient adherence to medical advice [12]
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