Treatment adherence and associated factors in older people with type 2 diabetes: A qualitative study.
Zahra Maghsoudi, Amir Sadeghi, Khodayar Oshvandi and 2 others
PMID 37196154WHAT IT FOUND
Older adults with type 2 diabetes described adherence as depending on three things: understanding their disease, having family and community support, and taking personal responsibility.
They struggled with complex written instructions and relied heavily on family reminders to maintain their new lifestyle.
Key findings
01Participants identified three main factors influencing adherence: health literacy, support from family and systems, and personal responsibility.
02Family monitoring and emotional or financial support were described as critical for maintaining diet and medication routines, especially for those with less support.
03Patients reported difficulty using written educational materials provided by clinicians, with some stating they could not read the pamphlets given to them.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was conducted in only two provinces in Iran, so the findings may not apply to older adults with type 2 diabetes in other cultural or healthcare settings. The sample size was small (20 participants), which is typical for qualitative work but limits the breadth of perspectives. Participants may have reported what they thought researchers wanted to hear (social acceptance bias) regarding their adherence levels. The study excluded patients with other chronic diseases or cognitive impairment, so it does not reflect the experience of the majority of older adults with diabetes who have multiple conditions.
Declared interests
The authors declared no conflicts of interest. The study was supported by Hamadan University of Medical Sciences.
The easy way to misread this
Do not interpret these themes as evidence that specific interventions, such as family education programs or simplified pamphlets, will improve adherence rates. This study describes the patients' experiences and perceived barriers; it did not test whether addressing these factors actually changes clinical outcomes.