OBJECTIVES: Non-adherence with diabetes medicines is a challenge. Approximately 38% of patients on insulin and 64% on oral antidiabetics are non-adherent. The objective of this study was to understand the patient’s preferences when addressing non-adherence based on the 3S framework – strategies (what approaches can be used in addressing non-adherence), settings (when and where should the intervention happen), and sources (who should provide the intervention).

METHODS: A focus group research design was used among patients who were non-adherent with diabetes medicines from an integrated healthcare system in the US. The focus group guide was based on the Medication Adherence Reasons Scale that has nineteen specific reasons for non-adherence across the domains of forgetfulness, beliefs, logistics, and long-term concern issues. For each item in the scale, the patients were asked their experiences, strategies that can be used in addressing that issue, the setting in which the interventions should be provided, and the source from which the interventions should come from. Content analysis was used to analyze the data.

RESULTS : Two focus group interviews, each group having seven patients, were conducted. The major strategies identified were patient education, self-responsibility of patients, family support, reminders, and societal support. The key educational needs were dealing with side effects and learning to use insulin properly, while utilizing different learning styles. For the setting, the patients preferred continuity of patient education throughout the disease journey. For the source, the physicians and pharmacists were considered key players who needed to have a continuous dialogue about the disease and medicines, and individuality in managing the disease. Respondents also recommended using a peer support group among patients.

CONCLUSIONS : Patients with diabetes identified various preferred strategies for addressing the reasons for non-adherence. Educational strategies were identified as the foremost approach coming from physicians and pharmacists throughout their disease journey.