Treatment Adherence in Diabetic Individuals in Rural India and Variables Influencing it: A Review of Studies Conducted in India and Recommendations for Future Research

Abstract

Diabetes is one of the leading causes of morbidity and mortality in the world and India accommodates one in seven adults living with diabetes. Poor adherence to prescribed therapy is a growing concern among diabetics where they skip, adjust, or miss medication doses or refuse treatment entirely, subverting the benefits of medical care.The objectives were to review the prevalence of diabetes in India and LMICs, treatment adherence among diabetics in India and factors that contribute to non-adherence to treatment for diabetes in adults. The narrative review includes 56 articles published through PubMed, ResearchGate and Google Scholar during the period 2011-2022, and has been analysed to meet the research objectives. An increasing and alarming trend of diabetes prevalence is seen in India with diabetes control among patients far from ideal. The studies indicate low to moderate treatment adherence among diabetics in India. Treatment adherence was reported to be lower in rural areas as compared to urban areas and lesser in illiterates as compared to literates. The factors influencing adherence to prescribed diabetes management regimen can be attributed to various socio-demographic variables, health system factors, nature of the condition and treatment, associated distress and quality of life. Early detection and treatment with a continuum of care is critical in reducing the burden of diabetes. The need of the hour is a strengthened and resilient capacity at state, district, and subdistrict levels, with an emphasis on promotive and preventive care and its two-way continuity with curative care.