Experiences and Barriers of Medication Adherence in Older People with Uncontrolled Type 2 Diabetes Mellitus A Qualitative Study

Abstract

Diabetes mellitus is one of the most prevalent non-communicable diseases worldwide. The presence of diabetes among the older population is increasing and is associated with a higher risk of diabetes-related complications. Medication non-adherence is an essential clinical and resource-intensive concern and older people are at an increased risk. This study aimed to explore the experiences and barriers of medication adherence among older patients with uncontrolled type 2 diabetes mellitus attending government healthcare centres in Sri Lanka. A qualitative, descriptive, exploratory study was conducted through in‐depth telephone interviews with a purposive sample of 14 older people with uncontrolled type 2 diabetes mellitus. A semi‐structured interview guide was used for data collection. The study included patients from the Diabetes Clinic at Teaching Hospital, Peradeniya, as well as community members through snowball sampling. Interviews were audiotaped with the participants’ consent and transcribed verbatim. The thematic analysis method was used in data analysis. In reporting results, the consolidated criteria for reporting qualitative research guidelines were followed. Six themes were emerged: (a) Impact of knowledge, practices, and attitudes on medication adherence, (b) Treatment-related barriers for medication adherence, (c) Impact of age-related changes on medication adherence, (d) Person-related barriers for medication adherence, (e) Impact of COVID-19 on medication adherence and, (f) Role of support system in medication adherence. In addition to the barriers common for the general population, age-related physical and psychological changes interfere in medication adherence of older people with diabetes mellitus. Furthermore, complementary and alternative medicine is used increasingly by older people, giving it a priority, which consequently leads to poor adherence when taking western medicines. Implementing individualized patient teaching and provision and strengthening of additional support systems, especially during the COVID-19 pandemic, are essential to improve medication adherence levels among older people with diabetes mellitus.