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      Exploring patient’s perspective of barriers to diabetic medication adherence in Jazan, Saudi Arabia, using the social determinants of health model

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          Abstract

          Background:

          Type 2 diabetes mellitus is usually associated with long-term macrovascular and microvascular complications that negatively impact the patient’s quality of life and add economic burden to the healthcare system. Understanding patients’ perspectives on medication nonadherence is essential for planning the appropriate methods and strategies to improve medication adherence among patients with uncontrolled diabetes.

          Aim:

          Therefore, this study aims to explore patients’ perceptions of the barriers to medication adherence through the Social Health determinants framework.

          Method:

          After obtaining ethical approval, qualitative face-to-face interviews with a sample of patients with type 2 diabetes mellitus (uncontrolled diabetes) were conducted. Interviews were audio-recorded, and then the data were analyzed using thematic analysis to identify essential themes related to the patient’s views.

          Results:

          Fifteen patients with type 2 diabetes mellitus were interviewed. Potential barriers to antidiabetic medications were identified and categorized based on the Social Determinants of Health domains. The patient’s health perceptions and behaviors were found to positively or negatively impact medication adherence. Beliefs toward antidiabetic medications, polypharmacy, medication-related problems, and the relationship between patients and their healthcare providers that related to healthcare access and quality domains were also reported as potential barriers to medications. Financial constraints, social stigma, and family support were other social health determinants factors that were found to have either positive or negative impacts on adherence. Nevertheless, using mobile health applications was suggested to facilitate medication adherence.

          Conclusion:

          Social Determinants of Health, such as education about type 2 diabetes mellitus, quality and access to healthcare, and social stigma and support, might significantly affect medication adherence among type 2 diabetes mellitus patients. This study’s findings can aid the development of suitable patient-specific tools and strategies to enhance medication adherence.

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          Most cited references40

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          Patient medication adherence: measures in daily practice.

          Adherence to therapies is a primary determinant of treatment success. Failure to adherence is a serious problem which not only affects the patient but also the health care system. Medication non adherence in patients leads to substantial worsening of disease, death and increased health care costs. A variety of factors are likely to affect adherence. Barriers to adherence could be addressed as patient, provider and health system factors, with interactions among them. Identifying specific barriers for each patient and adopting suitable techniques to overcome them will be necessary to improve medication adherence. Health care professionals such as physicians, pharmacists and nurses have significant role in their daily practice to improve patient medication adherence.
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            • Record: found
            • Abstract: found
            • Article: not found

            Mobile Telephone Text Messaging for Medication Adherence in Chronic Disease: A Meta-analysis.

            Adherence to long-term therapies in chronic disease is poor. Traditional interventions to improve adherence are complex and not widely effective. Mobile telephone text messaging may be a scalable means to support medication adherence.
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              • Record: found
              • Abstract: found
              • Article: found
              Is Open Access

              Medical Management of Hyperglycemia in Type 2 Diabetes: A Consensus Algorithm for the Initiation and Adjustment of Therapy

              The consensus algorithm for the medical management of type 2 diabetes was published in August 2006 with the expectation that it would be updated, based on the availability of new interventions and new evidence to establish their clinical role. The authors continue to endorse the principles used to develop the algorithm and its major features. We are sensitive to the risks of changing the algorithm cavalierly or too frequently, without compelling new information. An update to the consensus algorithm published in January 2008 specifically addressed safety issues surrounding the thiazolidinediones. In this revision, we focus on the new classes of medications that now have more clinical data and experience.
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                Author and article information

                Journal
                SAGE Open Med
                SAGE Open Med
                SMO
                spsmo
                SAGE Open Medicine
                SAGE Publications (Sage UK: London, England )
                2050-3121
                18 August 2024
                2024
                : 12
                : 20503121241271820
                Affiliations
                [1 ]Department of Clinical Pharmacy, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
                [2 ]Pharmacy Practice Research Unit, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
                [3 ]Department of Pharmacy Practice, College of Pharmacy, Taibah University, Madinah, Saudi Arabia
                [4 ]Department of Pharmaceutics, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
                [5 ]Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
                [6 ]Department of Pharmacology and Toxicology, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
                [7 ]Inflammation Pharmacology and Drug Discovery Unit, Medical Research Center, Jazan University, Jazan, Saudi Arabia
                [8 ]Jazan Endocrinology and Diabetes Center, Ministry of Health, Jizan, Saudi Arabia
                Author notes
                [*]Amani Khardali, Pharmacy Practice Research Unit, Department of Clinical Pharmacy, College of Pharmacy, Jazan University, Jazan 45142, Kingdom of Saudi Arabia. Email: aakherdeli@ 123456jazanu.edu.sa
                Author information
                https://orcid.org/0000-0002-5611-4782
                Article
                10.1177_20503121241271820
                10.1177/20503121241271820
                11331575
                39161401
                6a1e4e1a-a5c2-40e6-9130-216cd11ca5aa
                © The Author(s) 2024

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 2 March 2024
                : 4 July 2024
                Funding
                Funded by: The authors extend their appreciation to the Deputyship for Research & Innovation, Ministry of Education in Saudi Arabia, ;
                Award ID: ISP23-72
                Categories
                Original Article
                Custom metadata
                January-December 2024
                ts1

                type-ii diabetes mellitus,medication adherence,barriers,qualitative

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