Despite receiving treatment at specialised diabetic centres, most of the diabetic patients in Bangladesh have no proper knowledge about controlling the disease and how to use the medication, says a new study of icddr,b.
Principal Investigator Dr Shariful Islam, a senior research investigator from the non-communicable diseases division at icddr,b, and colleagues conducted the study to explore patients’ perspective on medication adherence to diabetes type 2 in Bangladesh.
The researchers conducted in-depth face-to-face interviews with 12 type 2 diabetic patients attending a tertiary hospital in Dhaka city between February and March, 2014. Participants were purposively sampled representing different age groups, education levels, years since diagnosis with diabetes, and glycemic status, to achieve maximum variation sampling.
During the study, the participants were asked about their knowledge and perception about diabetes, including its causes, long-term impact and how diabetes may be controlled.
But, its findings reveal that although patients receive treatment in specialised diabetes centres, they have misconceptions about medication.
It says misconceptions about the disease cause delay in seeking treatment, resulting in long term ill health and negatively impacting the individual, the family and society at large. Moreover, adherence to medically recommended dietary plans and exercise regimens was poor among the majority of participants.
High cost of medications, concerns over medication side-effects and forgetfulness was noted as factors for non-adherence to medication.
According to Dr Shariful Islam, diabetes is a major public health problem in Bangladesh and causes healthcare burden for the patients, society and nation.
It is imperative to understand patients’ perspective on diabetes and its importance to adherence to medications for glycemic control in order to promote optimum diabetes care, he said.
The study observed that participants’ knowledge and perception on diabetes are key factors determining their adherence to medications and, thereby, diabetes management; saying healthcare providers should explore to better understand patients’ perspective on diabetes, medication beliefs, identify psychological stress and provide more effective health education interventions to enhance medication adherence.
This suggested that proper diabetes management requires greater efforts to educate diabetic patients about the disease and ensure that patients carry out proper self-management.
The International Diabetic Federation (IDF) estimates that by 2030, Bangladesh will emerge as one of the countries with largest number of people with type 2 diabetes.
Another recent study conducted on patients with type 2 diabetes attending an urban clinic in the capital city of Dhaka found that almost two-third of the patients had uncontrolled diabetes.
Type 2 diabetes and pre-diabetes are increasing globally and often remain undiagnosed long after onset in low-income settings. Bangladesh has been shown to perform poorly in efforts to reduce NCDs. This rise is due to an increase in sedentary lifestyles, rapid urbanisation and (most importantly) non–adherence to medication.