Study on self care and adherence to therapy among diabetic patients at a tertiary care center in Mysore

Abstract

Background: Adherence to lifestyle modification and self-care are vital elements in the management of diabetes mellitus and the reason for poor adherence and poor self-care could vary from person to person. The study aimed to assess the level of adherence to therapy, the self-care practices and the barriers preventing adherence among diabetic patients attending a tertiary care hospital in Mysore. Methods: A mixed methods study was conducted among an estimated sample of 150 patients attending a tertiary care teaching hospital in Mysore, Karnataka. Diabetes self-care activities was assessed using modified Summary of Diabetes Self-Care Activities (SDSCA) questionnaire. An in depth interview was conducted for 20 subjects for understanding the factors contributing to their level of adherence / non-adherence. The quantitative data was analysed with standard statistical methods and qualitative data through content analysis. Results: The adherence to the drugs was found to be 86.6%.The median number of days during which target diet plan was achieved, at least 30 minutes of physical activity undertaken and foot care was 5.5 and 0 respectively. Lack of awareness and socioeconomic barriers were cited by the patients as the barriers preventing adherence to drug therapy, diet and exercise. Conclusions: Lack of awareness of the disease and cost of the pharmacological therapy are potentially modifiable reasons of poor adherence. Health education is to be provided by the healthcare providers focusing on the importance of adherence to drugs, diet and exercise.