ReviewBarriers to diabetes management: Patient and provider factors
Section snippets
Methods
We searched the PubMed, CINAHL, ERIC, and PsycINFO for the years January 1, 1990–June 1, 2009 using the key words: type 2 diabetes; diabetes mellitus; barriers; diabetes self-management; treatment guidelines; adherence; and diabetes care. Reference lists of relevant studies were also hand searched for additional sources. The goal of this review was not to perform a meta-analysis. Thus, a search for systematic review included cross-sectional studies; randomized clinical trials (RCTs);
Patient factors
Adherence: Better adherence to a self-care regimen, a characteristic of active patient self-management, can reduce mortality and disability, improve quality of life, and reduce health care costs [5], [6], [7]. Glycemic control is affected by poor patient adherence to treatment regimens, for example, failure to keep appointments or take medications as recommended [8]. Several studies compared cohorts with different medication adherence regimens. Once-daily regimens had higher rates of adherence
Discussion and conclusions
Effective type 2 diabetes management is widely acknowledged as challenging for both patients and their health care providers.
Several patient factors may contribute to type 2 diabetes management: adherence, beliefs, attitudes, knowledge, ethnicity/culture, language ability, financial resources, co-morbidities, and social support. Seven studies found that adherence to self-management are influenced by an individual's financial resources, beliefs and attitudes about the disease, and effectiveness
Conflict of interest
The authors declare that they have no conflict of interest.
Acknowledgements
Acknowledgment of financial and/or other support: California Endowment and American Association of Colleges of Nursing (AACN), Nurse Faculty Program, 2007–2009.
References (75)
- et al.
Treatment adherence and risk of death after a myocardial infarction
Lancet
(1990) - et al.
Patient compliance and persistence with antihyperglycemic drug regimens: evaluation of a medicaid patient population with type 2 diabetes mellitus
Clin Ther
(2001) - et al.
Medication compliance in type 2 diabetes patients: retrospective data analysis
Value Health
(2003) - et al.
Lay perceptions of type 2 diabetes in Scotland: bringing health services back in
Soc Sci Med
(2005) - et al.
Measuring the attitudes of patients towards diabetes and its treatment
Patient Educ Couns
(1990) - et al.
Determinants of active self-care behavior of insulin treated patients with diabetes: implications for diabetes education
Soc Sci Med
(1990) Rethinking the models and modes of diabetes education
Patient Educ Couns
(1990)- et al.
Importance of attitude evaluation in diabetes patient education
Diabetes Res Clin Pract
(1990) - et al.
Injection related anxiety in insulin-treated diabetes
Diabetes Res Clin Pract
(1999) - et al.
Is cardiovascular risk factor knowledge sufficient to influence behavior?
Am J Prev Med
(1990)