Published on 29 October 2014

The barriers to positive health outcomes among people with diabetes who do not take their medication as advised and have poor self-management has been highlighted in a new report by a team of health psychology specialists.

Opportunities and challenges around non-adherence and self-management in diabetes, produced by Atlantis Healthcare, recommends collaborative solutions for pharma, health systems and other stakeholders to improve outcomes for people with diabetes.

The recently published report examines the complexities of non-adherence in chronic disease states through the lens of health psychology. In diabetes, a global epidemic impacting nearly 400 million people worldwide, non-adherence involves both medications and diet/lifestyle behaviours, with short and long-term negative health consequences.

Sinead NiMhurchadha, PhD, Health Psychology Specialist, Atlantis Healthcare, said: "In order to identify solutions to improve adherence in diabetes, we first need to understand the many reasons why a patient may not take medication or follow lifestyle changes as prescribed by their physician. In this report, we use a proven health psychology framework, COM-B (capability opportunity motivation – behaviour), to uncover reasons behind non-adherence in diabetes, including factors related to physical and mental capability, motivation and belief systems."

Dr NiMhurchadha noted that factors behind non-adherence varied widely, from people’s perception and acceptance of their condition, beliefs about the effectiveness of their treatment, stigma associated with self-injections, and even the communication style of healthcare professionals.

Recent studies have suggested that non-adherence in diabetes is fairly common, with one-third of people with the condition failing to comply with treatment routines every month. Studies in people with type 2 diabetes showed:

  • Self-reported adherence to insulin is generally in the range of 43% to 86%
  • A third of patients (33%) said they had at least one day of non-adherence in the previous month
  • Only about one-third of patients were adherent to dietary changes for managing their diabetes

Stephen Galt, Managing Director, Atlantis Healthcare, Australia, and co-author of the report believes collaboration across the healthcare spectrum is critical to help patients better self-manage their condition: "Although individual responsibility sits ultimately with the patient, there are broader responsibilities for anyone who provides healthcare support in order to help them implement change. All stakeholders need to align on a common approach that is firmly grounded in understanding patient beliefs, recognising that no single intervention will change behaviours across the patient population."

For more information on non-adherence in diabetes, and to download the report, visit: http://www.atlantishealthcare.com/therapeutic-focus-on-diabetes
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