Psychosocial aspects and contributions of behavioural science to medication‐taking for adults with type 2 diabetes. Issue 3 (27th December 2019)

• Record Type: Journal Article
• Authors: Winkley, K.; Upsher, R.; Polonsky, W. H.; Holmes‐Truscott, E.
• Is Part Of: Diabetic medicine. Volume 37:Issue 3(2020)
• Page Start: 427
• Page End: 435
• Publication Date: 2019-12-27
• Subjects: Diabetes -- Periodicals; 616.462
• DOI: 10.1111/dme.14214
• Languages: English
• ISSNs: 0742-3071

Abstract

Abstract: The aim of this narrative review was to determine the contribution of behavioural and psychosocial research to the field of medication‐taking for adults with type 2 diabetes over the past 25 years. We review the behavioural and psychosocial literature relevant to adults with type 2 diabetes who are treated with oral antidiabetes agents, glucagon‐like peptide‐1 receptor agonists and insulin. Delayed uptake of, omission of and non‐persistence with medications are significant problems among adults with type 2 diabetes. At each stage of the course of diabetes, during which medication to lower blood glucose is initiated or intensified, ~50% of people take less medication than prescribed. Research aimed at increasing optimal medication‐taking behaviour has targeted 'forgetfulness', developing interventions which aid medication‐taking, such as reminder devices, with limited success. In parallel, investigation of beliefs about medication has provided insights into the perceived necessity of and concerns about medication and how these inform medication‐taking decisions. Guidance is available for health professionals to facilitate shared decision‐making, particularly with insulin therapy; however, interventions addressing medication beliefs are limited. Optimal medication‐taking behaviour is essential to prevent hyperglycaemia in adults with type 2 diabetes. Evidence from the past 25 years has demonstrated the association between medication beliefs and medication‐taking behaviour. Health professionals need to address medication concerns, and establish and demonstrate the utility of diabetes medication with the individual within the clinical consultation. There are interventions that may assist diabetes health professionals in the shared decision‐making process, but further development and more robust evaluation of these tools and techniques is required. What's new?: This narrative review synthesizes the research examining the psychosocial contributors of medication‐taking behaviours in type 2 diabetes over the past 25 years. Interventions to date have largely focused on reducing 'forgetfulness'; however, evidence clearly demonstrates that peoples' motivations and associated beliefs about the necessity of the medicine vs their concerns about the medicine, and emotional well‐being are important determinants of medication‐taking behaviours. It is essential that treatment decisions are made in partnership with the person with type 2 diabetes, and that problematic beliefs about diabetes treatment and associated distress are addressed in clinical care. More research is needed to evaluate how this is achieved within clinical settings.