Controlling sugar levels and overcoming diabetes is a global health problem affecting both countries with limited medical resources and developed ones. World Health Organization states that an estimated 422 million adults worldwide had diabetes in 2014, up from 108 million in 1980, increasing from 4.7% to 8.5% of the adult population (Siddiqui, et al., 2019). Despite the deep study of the problem and the availability of scientifically based recommendations, many patients with diabetes do not reach the recommended levels of glycemia, cholesterol and blood pressure. Most of the treatment methods carried out in the framework of primary care give modest results. Understanding what can influence clinical behaviour is crucial when choosing and improving interventions to practice. In this paper, the main barriers preventing the development of the treatment process of diabetic patients at the stage of primary medical treatment are considered. During the implementation of the project, difficulties in the policy of medical workers are identified, which in the future can serve as an incentive and instruction for the development of a treatment plan for diabetic patients.
Contrary to popular belief, the problem of diabetes treatment may be decelerated not only by the patient who is afraid to start treatment at the initial stage. No less contribution is made by poor medical team performance, which cannot properly assess the development of the disease in time and exert sufficient pressure to convince the patient to undergo treatment (Rezaei, et al., 2019). The main problem primary care workers face is uncertainty in the policy of self-organization and great clinical responsibility. Being a complex and changeable disease, diabetes mellitus forces physicians to aim at constantly changing treatment goals in conditions of limited time and resources. In such an environment, it may be difficult for doctors to decide on, for example, the administration of insulin or to promote a change in the patient’s behavioural manner. Changing the boundaries of roles between primary and secondary care, as well as between doctors and nurses within primary care, has created uncertainty and concern about where clinical responsibility lies.
Nevertheless, the patients themselves are also inclined not to comply with the therapeutic regime and refuse to undergo primary care, which accelerates the development of complications. Of the seventeen chronic diseases, diabetes ranks second in terms of low adherence to treatment, making it the second in terms of hospitalization due to non-compliance with the treatment regimen (Ellis, et al., 2018). Patients’ deviation from the agreed prescription is diverse and may be intentional or unintentional. If the patient’s personal beliefs cause the deliberate refusal of treatment, then the unintentional one largely occurs due to the lack of opportunities or resources to undergo treatment offered by the clinic (Siddiqui, et al., 2019). However, the phenomenon of voluntary refusal of treatment is often studied in a particular context and leads researchers to the conclusion that the treatment policy of a medical officer plays an important role in the popularity of this problem.
From all of the above, the treatment of diabetes mellitus as an acute issue nowadays faces barriers both from doctors and patients. Insufficient awareness of both sides leads to a slowdown in the treatment process and the rapid development of complications. Such studies would help draw attention to the problem and create a clearer understanding of how to behave when identifying the final diagnosis. Further ignoring the obstacles will only complicate the fight against diabetes as a global problem and lead to the need to solve it at a deeper level.
References
Ellis, K., Mulnier, H., & Forbes, A. (2018). Perceptions of insulin use in type 2 diabetes in primary care: a thematic synthesis. BMC family practice, 19(1), 1-21.
Rezaei, M., Valiee, S., Tahan, M., Ebtekar, F., & Gheshlagh, R. G. (2019). Barriers of medication adherence in patients with type-2 diabetes: a pilot qualitative study. Diabetes, metabolic syndrome and obesity: targets and therapy, 12, 589.
Siddiqui, M. H., Khan, I. A., Moyeen, F., & Chaudhary, K. A. (2019). Identifying barriers to therapeutic adherence in type 2-diabetes: A complex and multidimensional clinical issue. Asploro Journal of Biomedical and Clinical Case Reports, 2019(1), 22.