Patient and provider’s perspective on barriers and facilitators for medication adherence among adult patients with cardiovascular diseases and diabetes mellitus in India: a qualitative evidence synthesis
Authors
Yuvaraj Krishnamoorthy
Department of Preventive and Social Medicine, JIPMER PSM, Chennai, India
Sathish Rajaa
Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education, Puducherry, India
Tanveer Rehman
Department of Preventive and Social Medicine, PGIMER, Chandigarh, Chandigarh, India
Mahalakshmi Thulasingam
Department of Preventive and Social Medicine, JIPMER, Puducherry, Tamil Nadu, India
Objective
To explore the various stakeholders’ perspectives on barriers and facilitators for medication adherence among patients with cardiovascular diseases (CVDs) and diabetes mellitus (DM)in India.
Design
Systematic review of qualitative studies.
Data sources
A comprehensive systematic search was conducted in Medline, Cochrane Library, Science Direct and Google Scholar from January 2010 to July 2020. We included all qualitative peer-reviewed studies, reporting barriers and facilitators of medication adherence, from India, for our current review.
Data extraction and synthesis
Data extraction was performed by two independent authors who also assessed the quality of included studies using the Critical Appraisal Skills Programme criteria. This qualitative evidence synthesis adhered to the enhancing transparency in reporting the synthesis of qualitative research checklist
Results
In total, 18 studies were included. Major barriers reported were lack of understanding about the disease, complications related to non-adherence, followed by forgetfulness, lack of family support and risk communication. Health system-related barriers such as accessibility, affordability and acceptability were also reported by majority of the studies. Creation of peer support groups, digital reminder systems, integration of native Indian systems of India, physiotherapy and geriatric clinics at the primary healthcare level and innovations in patient care were suggested to counter these barriers in medication adherence.
Conclusion
Such patient-specific targeted interventions need to be developed to achieve better control among patients with CVD and DM.
PROSPERO registration number
CRD42020199529.
Keywords: qualitative research, preventive medicine, primary care, coronary heart disease, diabetes & endocrinology
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