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

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.