Download or read book A Mixed Methods Investigation of the Barriers and Facilitators to Medication Adherence in Patients with Type 2 Diabetes Across Different Health Literacy Levels written by Yen-Ming Huang (Ph.D.) and published by . This book was released on 2019 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Background: Type 2 diabetes (T2D) is the leading cause of death in the U.S., and it incurs tremendous health expenditures associated with various complications due to poor diabetes control. Medication adherence, which is correlated with patients' health literacy, should be consistently practiced in order to achieve optimal diabetes control. However, no literature has systematically explored the multiple psychosocial and communication barriers and facilitators at the individual level that mediate the linkage between health literacy and medication adherence. A deeper understanding of the specific communication and psychosocial factors related to medication-taking behaviors across different levels of health literacy among people with T2D will guide the development of effective interventions and customized strategies to enhance medication adherence. Objectives: (1) To examine whether the barriers and facilitators associated with medication adherence differ among people with T2D across different levels of health literacy. (2) To explore patients' perceptions of the barriers and facilitators of medication adherence across different levels of health literacy. (3) To understand how the qualitative interview data complement the quantitative survey results about the barriers and facilitators of medication adherence. Methods: This mixed-methods study used an explanatory sequential design, including a quantitative study with a survey questionnaire followed by a qualitative study with semi-structured interviews. The Health Literacy Pathway Model was used to identify the psychosocial and communication factors that may influence medication adherence. The target population was patients who were 20 years of age or above, were diagnosed with T2D, understood English, and were prescribed at least one oral diabetes medicine daily. Analysis of covariance and direct content analysis were used respectively in quantitative and qualitative analysis. A joint display was used to present the integrated findings from quantitative and qualitative data. Results: In the quantitative phase, 205 participants provided complete information in the survey questionnaire. In the qualitative phase, 23 participants completed semi-structured interviews. Confirmed by quantitative and qualitative data, holding stronger self-efficacy, having fewer concern beliefs about medication, and possessing fewer perceived barriers to medication-taking are necessary for better medication adherence. Linking medication-taking to daily routine and focusing on the internal locus of control is an imperative approach to foster self-efficacy of medication use. Addressing patients' life experience and clarifying medication misinformation may help participants cope with their concerns with medications. Solving the high cost of medications and therapy-related problems could lessen participants' perception of barriers to medication-taking. Conclusion: To optimally support patients' diabetes care, practitioners should address concern beliefs among non-adherent patients with low health literacy, as well as emphasize self-efficacy and perceived barriers to medication adherence among all non-adherent patients with T2D.