Enablers and Barriers to Medication Self-Management in Patients With Type 2 Diabetes: A Qualitative Study Using the COM-B Model.

IF 2 3区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Patient preference and adherence Pub Date : 2025-03-01 eCollection Date: 2025-01-01 DOI:10.2147/PPA.S503350
Huiqin Li, Ying Li, Jing Wang, Yuyao Zhang, Shiyan Ben
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Abstract

Introduction: Type 2 diabetes mellitus is a chronic disease of global concern. Medication self-management is the process by which an individual actively plans, monitors, evaluates, feeds back, controls, and regulates their medication through their behavior and awareness. Patients' medication self-management is key to glycemic control. A comprehensive understanding of the factors influencing medication self-management and the implementation of effective intervention programs is therefore paramount.

Objective: To examine the enablers and barriers to medication self-management in patients with type 2 diabetes mellitus and to propose a corresponding medication self-management program to improve medication self-management.

Methods: This qualitative study drew up the interview outline with reference to the COM-B model. Sampling was done using purposive sampling method and data collection was done using semi-structured interviews. The interviews mainly included patients' challenges and facilitators in the process of medication self-management. The data were analyzed using a framework analysis method, and themes were generated using the COM-B model.

Results: A total of 20 patients participated in this study. The enablers identified within the COM-B model were the policy support for medical insurance and higher medication self-efficacy. The barriers include low medication literacy, aging of body functions, changes in living habits, the impact of work, limited medical resources, misguided beliefs about medication, and emotional response. The online media applications and the impact of family and friends were mixed factors. Outside of the model, diet and exercise also have an impact. Finally, we propose targeted solutions to improve medication self-management based on the Behavior Change Wheel.

Conclusion: This study proposes targeted medication self-management programs, including education interventions to improve medication literacy and self-efficacy, leveraging mobile smart devices, and improving health insurance policies to promote patient medication management levels. Our findings will contribute to medication self-management for type 2 diabetes and many more chronic diseases.

2型糖尿病患者药物自我管理的促进因素和障碍:一项使用COM-B模型的定性研究
2型糖尿病是一种全球关注的慢性疾病。服药自我管理是个人通过自己的行为和意识主动计划、监测、评估、反馈、控制和调节服药的过程。患者的用药自我管理是血糖控制的关键。因此,全面了解影响药物自我管理和实施有效干预方案的因素是至关重要的。目的:探讨2型糖尿病患者药物自我管理的促进因素和障碍因素,提出相应的药物自我管理方案,提高患者的药物自我管理水平。方法:本定性研究参照COM-B模型编制访谈提纲。抽样采用目的性抽样法,数据收集采用半结构化访谈法。访谈主要包括患者在药物自我管理过程中的挑战和促进因素。数据分析采用框架分析法,主题生成采用COM-B模型。结果:共有20例患者参与了本研究。在COM-B模型中发现的促进因素是医疗保险的政策支持和更高的药物自我效能感。这些障碍包括药物知识水平低、身体功能老化、生活习惯的改变、工作的影响、有限的医疗资源、对药物的错误信念和情绪反应。网络媒体应用和家人朋友的影响是混合因素。在模特之外,饮食和锻炼也有影响。最后,我们提出了基于行为改变轮的药物自我管理改进的针对性解决方案。结论:本研究提出了有针对性的用药自我管理方案,包括提高用药素养和自我效能感的教育干预,利用移动智能设备,完善医疗保险政策,以提高患者的用药管理水平。我们的发现将有助于2型糖尿病和许多其他慢性疾病的药物自我管理。
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来源期刊
Patient preference and adherence
Patient preference and adherence MEDICINE, GENERAL & INTERNAL-
CiteScore
3.60
自引率
4.50%
发文量
354
审稿时长
6-12 weeks
期刊介绍: Patient Preference and Adherence is an international, peer reviewed, open access journal that focuses on the growing importance of patient preference and adherence throughout the therapeutic continuum. The journal is characterized by the rapid reporting of reviews, original research, modeling and clinical studies across all therapeutic areas. Patient satisfaction, acceptability, quality of life, compliance, persistence and their role in developing new therapeutic modalities and compounds to optimize clinical outcomes for existing disease states are major areas of interest for the journal. As of 1st April 2019, Patient Preference and Adherence will no longer consider meta-analyses for publication.
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