Determinants of Non-Adherence to Diabetes Treatment and Health Care Seeking Behaviour Before and During COVID-19 in Tamil Nadu: Mixed Methods Study

Abstract

Non-adherence to medication is common among type 2 diabetes mellitus patients. Non-adherence leads to increased morbidity and mortality as well as increased rates of hospital admission. Hence, this study was carried out to determine the factors affecting the non-adherence to medication among patients attending Non-CommunicableDisease(NCD) clinic at RuralHealthTraining Centre (RHTC)in South India and to explore the reasons and possible solutions for treatment non-adherence among diabetes patients and treatment seeking behaviour among patient during covid-19 pandemic. A mixed method study was employed with quantitative being a secondary data collection and qualitative as In-depth interview (IDI) technique. IEC clearance was obtained. The descriptive and analytical data were analyzed using SPSS (Version_24.0) while Smith’s salience index was calculated with Visual Anthropac (version_1.0) softwareto determine the most salient items.Manual content analysis was done for IDI.The overall prevalence of non-adherence to diabetes medication was seen in 438 patients (73.8%) out of 593 patients. Among the non-adherent patients, 277 (63.2%) patients were ≥ 50 years, 231 (52.7%) were females, 183 (41.7%) were illiterate, 213 (48.6%) were physical inactive, 372 (84.9%) were belongs to APL, 360 (82.1%) were having history of Diabetes mellitus, 93 (21.2%) were addicted to tobacco and alcohol usage and 270 (61.6%) were overweight and obese. Forgetfulness and fear of side effects were ranked first among the reasons of diabetes adherence to medication. Important barriers affecting quality of life of diabetes patient during COVID-19 lockdown were diet, exercise adherence and monitoring of blood glucose and blood pressure. Thus, this study has explored some barriers and solutions for medication adherence faced by the patients and their quality of life during COVID-19 pandemic.