Adherence decision making in the everyday lives of emerging adults with type 1 diabetes

Elizabeth A Pyatak, Daniella Florindez, Marc J Weigensberg, Elizabeth A Pyatak, Daniella Florindez, Marc J Weigensberg

Abstract

Purpose: The purpose of this study was to explore motivations underlying nonadherent treatment decisions made by young adults with type 1 diabetes.

Methods: Eight emerging adults each completed a series of semi-structured interviews concerning their approaches to diabetes care, relationships with clinicians, and everyday activities and routines. A narrative thematic analysis was used to develop initial themes and refine them through continued data collection and review of the research literature.

Results: FIVE THEMES WERE IDENTIFIED AS MOTIVATING NONADHERENCE: (1) efforts to mislead health care providers, (2) adherence to alternative standards, (3) treatment fatigue and burnout, (4) social support problems, and (5) emotional and self-efficacy problems.

Conclusion: Instances of nonadherence generally involved a combination of the five identified themes. Participants reporting nonadherence also described difficulties communicating with care providers regarding their treatment. Nonjudgmental communication between providers and emerging adults may be particularly important in promoting positive health outcomes in this population.

Keywords: compliance; health behavior; motivations; nonadherence.

References

    1. Vermeire E, Hearnshaw H, Van Royen P, Denekens J. Patient adherence to treatment: three decades of research. A comprehensive review. J Clin Pharm Ther. 2001;26(5):331–342.
    1. DiMatteo MR. Variations in patients’ adherence to medical recommendations: a quantitative review of 50 years of research. Med Care. 2004;42(3):200–209.
    1. Morris AD, Boyle DI, McMahon AD, Greene SA, MacDonald TM, Newton RW. Adherence to insulin treatment, glycaemic control, and ketoacidosis in insulin-dependent diabetes mellitus. The DARTS/MEMO Collaboration. Diabetes Audit and Research in Tayside Scotland. Medicines Monitoring Unit. Lancet. 1997;350(9090):1505–1510.
    1. Asche C, LaFleur J, Conner C. A review of diabetes treatment adherence and the association with clinical and economic outcomes. Clin Ther. 2011;33(1):74–109.
    1. Hood KK, Peterson CM, Rohan JM, Drotar D. Association between adherence and glycemic control in pediatric type 1 diabetes: a meta-analysis. Pediatrics. 2009;124(6):e1171–e1179.
    1. McNally K, Rohan J, Pendley JS, Delamater A, Drotar D. Executive functioning, treatment adherence, and glycemic control in children with type 1 diabetes. Diabetes Care. 2010;33(6):1159–1162.
    1. Borus JS, Laffel L. Adherence challenges in the management of type 1 diabetes in adolescents: prevention and intervention. Curr Opin Pediatr. 2010;22(4):405–411.
    1. Pereira MG, Berg-Cross L, Almeida P, Machado JC. Impact of family environment and support on adherence, metabolic control, and quality of life in adolescents with diabetes. Int J Behav Med. 2008;15(3):187–193.
    1. Hsin O, La Greca AM, Valenzuela J, Moine CT, Delamater A. Adherence and glycemic control among Hispanic youth with type 1 diabetes: role of family involvement and acculturation. J Pediatr Psychol. 2010;35(2):156–166.
    1. Hains AA, Berlin KS, Davies WH, Parton EA, Alemzadeh R. Attributions of adolescents with type 1 diabetes in social situations: relationship with expected adherence, diabetes stress, and metabolic control. Diabetes Care. 2006;29(4):818–822.
    1. Smith CB, Choudhary P, Pernet A, Hopkins D, Amiel SA. Hypoglycemia unawareness is associated with reduced adherence to therapeutic decisions in patients with type 1 diabetes: evidence from a clinical audit. Diabetes Care. 2009;32(7):1196–1198.
    1. Katon W, Russo J, Lin EH, et al. Diabetes and poor disease control: is comorbid depression associated with poor medication adherence or lack of treatment intensification? Psychosom Med. 2009;71(9):965–972.
    1. Ahmed AT, Karter AJ, Liu J. Alcohol consumption is inversely associated with adherence to diabetes self-care behaviours. Diabet Med. 2006;23(7):795–802.
    1. Vermeire E, Hearnshaw H, Rätsep A, et al. Obstacles to adherence in living with type-2 diabetes: an international qualitative study using meta-ethnography (EUROBSTACLE) Prim Care Diabetes. 2007;1(1):25–33.
    1. Anderson RM, Funnell MM. Compliance and adherence are dysfunctional concepts in diabetes care. Diabetes Educ. 2000;26(4):597–604.
    1. Anderson RM, Funnell MM. Patient empowerment: myths and misconceptions. Patient Educ Couns. 2010;79(3):277–282.
    1. Vermeire E, Van Royen P, Coenen S, Wens J, Denekens J. The adherence of type 2 diabetes patients to their therapeutic regimens: a qualitative study from the patient’s perspective. Practical Diabetes International. 2003;20(6):209–214.
    1. Hortensius J, Kars MC, Wierenga WS, Kleefstra N, Bilo HJ, van der Bijl JJ. Perspectives of patients with type 1 or insulin-treated type 2 diabetes on self-monitoring of blood glucose: a qualitative study. BMC Public Health. 2012;12:167.
    1. Hunt LM, Arar NH. An analytical framework for contrasting patient and provider views of the process of chronic disease management. Med Anthropol Q. 2001;15(3):347–367.
    1. Davidson M, Penney ED, Muller B, Grey M. Stressors and self-care challenges faced by adolescents living with type 1 diabetes. Appl Nurs Res. 2004;17(2):72–80.
    1. Wagner EH, Austin BT, VonKorff M. Organizing care for patients with chronic illness. Milbank Q. 1996;74(4):511–544.
    1. Matthews SM, Peden AR, Rowles GD. Patient-provider communication: understanding diabetes management among adult females. Patient Educ Couns. 2009;76(1):31–37.
    1. Hunt LM, Arar NH, Larme AC. Contrasting patient and practitioner perspectives in type 2 diabetes management. West J Nurs Res. 1998;20(6):656–676. discussion 677–682.
    1. Wens J, Vermeire E, Royen PV, Sabbe B, Denekens J. GPs’ perspectives of type 2 diabetes patients’ adherence to treatment: a qualitative analysis of barriers and solutions. BMC Fam Pract. 2005;6(1):20.
    1. Arnett JJ. Emerging adulthood. A theory of development from the late teens through the twenties. Am Psychol. 2000;55(5):469–480.
    1. Anderson BJ, Wolpert HA. A developmental perspective on the challenges of diabetes education and care during the young adult period. Patient Educ Couns. 2004;53(3):347–352.
    1. Peters A, Laffel L, American Diabetes Association Transitions Working Group Diabetes care for emerging adults: recommendations for transition from pediatric to adult diabetes care systems: a position statement of the American Diabetes Association, with representation by the American College of Osteopathic Family Physicians, the American Academy of Pediatrics, the American Association of Clinical Endocrinologists, the American Osteopathic Association, the Centers for Disease Control and Prevention, Children with Diabetes, The Endocrine Society, the International Society for Pediatric and Adolescent Diabetes, Juvenile Diabetes Research Foundation International, the National Diabetes Education Program, and the Pediatric Endocrine Society (formerly Lawson Wilkins Pediatric Endocrine Society) Diabetes Care. 2011;34(11):2477–2485.
    1. Wibell L, Nyström L, Ostman J, et al. Increased mortality in diabetes during the first 10 years of the disease. A population-based study (DISS) in Swedish adults 15–34 years old at diagnosis. J Intern Med. 2001;249(3):263–270.
    1. Bryden KS, Dunger DB, Mayou RA, Peveler RC, Neil HA. Poor prognosis of young adults with type 1 diabetes: a longitudinal study. Diabetes Care. 2003;26(4):1052–1057.
    1. Hislop AL, Fegan PG, Schlaeppi MJ, Duck M, Yeap BB. Prevalence and associations of psychological distress in young adults with type 1 diabetes. Diabet Med. 2008;25(1):91–96.
    1. Bryden KS, Peveler RC, Stein A, Neil A, Mayou RA, Dunger DB. Clinical and psychological course of diabetes from adolescence to young adulthood: a longitudinal cohort study. Diabetes Care. 2001;24(9):1536–1540.
    1. Riessman CK. Narrative Methods for the Human Sciences. Thousand Oaks, CA: Sage; 2008.
    1. Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Research Group. Nathan DM, Zinman B, et al. Modern-day clinical course of type 1 diabetes mellitus after 30 years’ duration: the diabetes control and complications trial/epidemiology of diabetes interventions and complications and Pittsburgh epidemiology of diabetes complications experience (1983–2005) Arch Intern Med. 2005;169(14):1307–1316.
    1. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. The Diabetes Control and Complications Trial Research Group. N Engl J Med. 1993;329(14):977–986.
    1. American Diabetes Association Standards of medical care in diabetes – 2012. Diabetes Care. 2012;35(Suppl 1):S11–S63.
    1. Wysocki T, Greco P. Social support and diabetes management in childhood and adolescence: influence of parents and friends. Curr Diab Rep. 2006;6(2):117–122.
    1. Aljasem LI, Peyrot M, Wissow L, Rubin RR. The impact of barriers and self-efficacy on self-care behaviors in type 2 diabetes. Diabetes Educ. 2001;27(3):393–404.
    1. Sarkar U, Fisher L, Schillinger D. Is self-efficacy associated with diabetes self-management across race/ethnicity and health literacy? Diabetes Care. 2006;29(4):823–829.
    1. Buckloh LM, Lochrie AS, Antal H, et al. Diabetes complications in youth: qualitative analysis of parents’ perspectives of family learning and knowledge. Diabetes Care. 2008;31(8):1516–1520.
    1. Kondryn HJ, Edmondson CL, Hill J, Eden TO. Treatment non-adherence in teenage and young adult patients with cancer. Lancet Oncol. 2011;12(1):100–108.
    1. Rao D, Kekwaletswe TC, Hosek S, Martinez J, Rodriguez F. Stigma and social barriers to medication adherence with urban youth living with HIV. AIDS Care. 2007;19(1):28–33.
    1. Ferzacca S. “Actually, I don’t feel that bad”: managing diabetes and the clinical encounter. Med Anthropol Q. 2000;14(1):28–50.
    1. Naemiratch B, Manderson L. Control and adherence: living with diabetes in Bangkok, Thailand. Soc Sci Med. 2006;63(5):1147–1157.

Source: PubMed

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