DOI: http://dx.doi.org/10.18203/2349-3933.ijam20173239

A qualitative study on non-adherence to oral hypoglycemic agents in type 2 diabetics

Sourav Agarwala, Md. Asif Ansari, Uttam Kumar Paul, Arup Bandyopadhyay

Abstract


Background: Non-adherence to oral hypoglycaemic agents is both a global and ubiquitous problem during treatment of type 2 diabetes mellitus. This leads to unwanted persistence and aggregation of hyperglycemia as well as many of the complications of diabetes mellitus and even to early death. However, there have been quite a few studies on this issue but different studies have shown different reasons of non-adherence because of this confusion and also because no studies have been done in Bihar and North Bengal, the present authors decided to go for a qualitative study on this issue.

Methods: This study was conducted in the medicine OPD of two medical colleges one in Bihar and another in north Bengal. The study method was one of the qualitative descriptive nature in which open interviews are conducted on non-compliant diabetic patients. Audio recording was taken in each case after taking written permission from the patients as well as from the institutional ethical committee. A transcript in English was made manually of each audio recording and then transcript analysis was done using categories and codes.

Results: The results showed existence for four broad categories, viz, adverse effect, economic issues, availability and alternative treatment. Each category was divided into several codes like - adverse effects into weakness, hypoglycemia, organ damage, vertigo and fear; economic issues into high cost, low income, lifelong high expenditure and family crisis; availability into total non-availability, local non-availability, travel expenses and problems to buy from distance and brand non-availability; lastly alternative treatment included Ayurveda, Homeopathy and jori-buti. The last two categories, viz, non-availability and alternative therapy are very much unique in our study.

Conclusions: It can be concluded that non-adherence is very much a problem in our places as it is in other places, nationally and globally. But it is slightly different here. We must find out solutions for this problem and start interventions immediately.


Keywords


Oral hypoglycaemic agents, Qualitative study, Type 2 diabetes

Full Text:

PDF

References


Muhammad C, Jibril UN, Dauda S. Non-compliant with treatment regimens among clients with diabetes mellitus in University of Maiduguri Teach Hospital, North Eastern Nigeria. JRNM. (ISSN: 2315-568). 2016;5(1):11-20.

Famakinwa TT. Diabetes Mellitus in Textbook of medico-surgical Nursing (2nd Edition) Agbar: Bayosoye Printing Services; Nigeria; 2002.

Christopher JLM, Evans DB, Acharya A, Baltussen RMPM. Development of WHO guidelines on generalized cost-effectiveness analysis. Health Econ. 2000;9:235-51.

Al Maskari, El Sadig M, Al Kaabi JMi, Afandi B, Nagel Kerke N, Yeatts KB. Knowledge attitude and practices of diabetic patients in the United Arab Emirates. PLoS One. 2013;8(1):e52857.

Roglic G, Verghese C, Thamarangi T. Diabetes in South-East Asia: burden, gaps, challenges and ways forward. WHO. Special issues on Diabetes. 2016;5(1):1-4.

Ataur RK, Zaki NA, Mohammad AA, Montaser AB, Ibrahim A, Shabbir AK. Factors contributing to non-compliance among diabetics attending Primary Health centres in the Al Hasa district of Saudi Arabia. J Family Comm Med. 2012;19(1):26-32.

Nahala KRI, Saeid GA, Sunny AS, Ebtisam MF, Fatihey E, Physicians' therapeutic practice and compliance of diabetic clients attending rural primary health care units in Alexandria, Egypt. Egy J Fam Comm Med. 2010;17(3):201-7.

Garcia-Perez LE, Alvarez M, Dilla T, Gil Guillen V, Orozco-Beltran D. Adherence to therapies with type 2 diabetes. Diabetes Ther. 2013;4:175-94.

Gibson TB, Song X, Alemayahu B, Wang SS, Wadell JL, Bouchard JR, et al. Cost sharing, adherence and health outcomes in patients with diabetes. Am J Manag Care. 2012;16:589-600.

Mukherjee S, Sharmasarkar B, Das KK, Bhattacharyya A. Deb. Compliance to antidiabetic drugs: Observations from the diabetic clinic of a medical college in Kolkata. Ind J Clin Diagnostic Res. 2013;7(4):661-5.