Reasons for diabetes patients attending Bishop Lavis Community Health Centre being non-adherent to diabetes care

摘要

Background: Non-adherence to diabetes care is a concern at Bishop Lavis Community Health Centre (BLCHC) as it results in many diabetes complications that could have been avoided. The aim was to explore the reasons for people with diabetes in the Bishop Lavis area being non-adherent to diabetes care. Methods: A qualitative study was undertaken. Focus groups and in-depth interviews were conducted with patients who had uncontrolled blood sugar and non-compliance. The framework method was used to analyse the data. Results: The main findings in this study were that the following had a negative impact on compliance with diabetes care: (1) poor knowledge of diabetes mellitus; (2) drug treatment barriers such as shift work and not knowing the importance of taking medication regularly; (3) lifestyle adjustment barriers: dietary barriers and lack of exercise; (4) staff and clinic visit problems, for example over-burdened public health-care facilities; and (5) poor support structures including support from family, the community and financially as well as poor infrastructure. Conclusion: The main findings in this study were consistent with many of the previous studies done on adherence, i.e. patient barriers, disease and drug-regime barriers and doctor–patient relationship barriers. However, in this poverty-stricken area these participants also face other constraints that influence their compliance behaviour. These include (1) over-burdened public health care facilities, (2) insufficient education, (3) poor support structures, (4) infrastructure that is not wheelchair-friendly, (5) unsafe communities, (6) low income and unemployment.