Older adults with type 2 diabetes mellitus: Contributions to understanding medication regimen management
DOI:
https://doi.org/10.12707/RV21029Keywords:
medication adherence, diabetes mellitus, aged, qualitative research, interviewAbstract
Background: Due to the population’s aging, the prevalence of chronic illnesses, including diabetes mellitus, is increasing, and nurses have to face the challenges arising from the complexity of older adults’ medication regimens and their optimal management.
Objective: To understand how older adults with diabetes mellitus manage their medication regimens.
Methodology: This is a descriptive qualitative study using an inductive approach. Twelve semi-structured interviews were conducted with older adults diagnosed with diabetes mellitus. The interviews were transcribed and analyzed using content analysis.
Results: Therapeutic success relates to how patients deal with the need to adhere to a medication regimen. Despite patients recognizing the need to take medication, intrinsic factors (such as gender and age) and extrinsic factors (treatment duration, underdeveloped health systems, and others) influence therapeutic success.
Conclusion: The study allowed understanding how patients manage their medication regimens. It confirmed that low adherence rates compromised therapeutic success and identified the urgent need for interventions that address the specific needs of chronically-ill patients.
Downloads
References
Al-Musawe, L., Martins, A. P., Raposo, J. F., & Torre, C. (2019). The association between polypharmacy and adverse health consequences in elderly type 2 diabetes mellitus patients: A systematic review and meta-analysis. Diabetes Research and Clinical Practice, 155, 107804. https://doi.org/10.1016/j.diabres.2019.107804
Aminde, L. N., Tindong, M., Ngwasiri, C. A., Aminde, J. A., Njim, T., Fondong, A. A., & Takah, N. F. (2019). Adherence to antidiabetic medication and factors associated with non-adherence among patients with type-2 diabetes mellitus in two regional hospitals in Cameroon. BMC Endocrine Disorders, 19(1), 35. https://doi.org/10.1186/s12902-019-0360-9
Atinga, R. A., Yarney, L., & Gavu, N. M. (2018). Factors influencing long-term medication non-adherence among diabetes and hypertensive patients in Ghana: A qualitative investigation. PLoS One, 13(3), e0193995. https://doi.org/10.1371/journal.pone.0193995
Brown, M. T., Bussell, J., Dutta, S., Davis, K., Strong, S., & Mathew, S. (2016). Medication adherence: Truth and consequences. The American Journal of the Medical Sciences, 351(4), 387-399. https://doi.org/10.1016/j.amjms.2016.01.010
Fundação Francisco Manuel dos Santos. (2019). População residente, estimativas a 31 de Dezembro: Total e por grupo etário. PORDATA.
Gast, A., & Mathes, T. (2019). Medication adherence influencing factors-an (updated) overview of systematic reviews. Systematic Reviews, 8(1), 112. https://doi.org/10.1186/s13643-019-1014-8
Gonçalves, S. P., Gonçalves, J. P., & Marques, C. G. (2021). Manual de investigação qualitativa: Conceção, análise e aplicações. Pactor.
González-Bueno, J., Calvo-Cidoncha, E., Nieto-Martín, M. D., Ollero-Baturone, M., & Santos-Ramos, B. (2019). Selection of interventions aimed at improving medication adherence in patients with multimorbidity. European Journal of Hospital Pharmacy, 26(1), 39-45. https://doi.org/10.1136/ejhpharm-2017-001240
Karam, S. L., Dendy, J., Polu, S., & Blonde, L. (2020). Overview of therapeutic inertia in diabetes: Prevalence, causes, and consequences. Diabetes Spectrum, 33(1), 8-15. https://doi.org/10.2337/ds19-0029
Kyngäs, H., Kääriäinen, M., & Elo, S. (2020). The trustworthiness of content analysis. In H. Kyngäs, K. Mikkonen & M. Kääriäinen (Eds.), The application of content analysis in nursing science research (pp. 41-48). Springer.
Leelakanok, N., Holcombe, A. L., Lund, B. C., Gu, X., & Schweizer, M. L. (2017). Association between polypharmacy and death: A systematic review and meta-analysis. Journal of the American Pharmacists Association, 57(6), 729-738. https://doi.org/10.1016/j.japh.2017.06.002
Littlejohns, B. L., & Wilson, A. (2019). Strengthening complex systems for chronic disease prevention: A systematic review. BMC Public Health, 19(1), 729. https://doi.org/10.1186/s12889-019-7021-9
Midão, L., Giardini, A., Menditto, E., Kardas, P., & Costa, E. (2018). Polypharmacy prevalence among older adults based on the survey of health, ageing and retirement in Europe. Archives of Gerontology and Geriatrics, 78, 213-220. https://doi.org/10.1016/j.archger.2018.06.018
Morin, L., Johnell, K., Laroche, M. L., Fastbom, J., & Wastesson, J. W. (2018). The epidemiology of polypharmacy in older adults: Register-based prospective cohort study. Clinical Epidemiology, 10, 289-298. https://doi.org/10.2147/CLEP.S153458
Sociedade Portuguesa de Diabetologia, Observatório Nacional da Diabetes. (2019). Diabetes: Factos e números: O ano de 2016, 2017 e 2018: Relatório anual do Observatório da Diabetes. https://www.spd.pt/images/uploads/20210304-200808/DF&N-2019_Final.pdf
Tavares, N. U., Bertoldi, A. D., Mengue, S. S., Arrais, P. S., Luiza, V. L., Oliveira, M. A., Ramos, L. R., Farías, M. R., & Pizzol, T. D. (2016). Factors associated with low adherence to medicine treatment for chronic diseases in Brazil. Revista de Saúde Pública, 50(Suppl. 2), 10s. https://doi.org/10.1590/S1518-8787.2016050006150
Tavares, N. U., Bertoldi, A. D., Thume, E., Facchini, L. A., França, G. V., & Mengue, S. S. (2013). Factors associated with low adherence to medication in older adults. Revista de Saúde Pública, 47(6), 1092-1101. https://doi.org/10.1590/s0034-8910.2013047004834
World Health Organization. (2003). Adherence to long-term therapies: Evidence for action. https://www.who.int/chp/knowledge/publications/adherence_full_report.pdf
World Health Organization. (2019). Medication safety in polypharmacy. https://apps.who.int/iris/handle/10665/325454
World Health Organization. (2020). World health statistics 2020: Monitoring health for the SDGs sustainable development goals. https://www.who.int/publications/i/item/9789240005105