Adherence difficulties have many causes, all of which stem from the level of personal control and the perceived complexity of the regimen (pp. 44-46).
Inadequacy of knowledge about the condition and its management as well as lack of skills in the approximation of normal glucose levels may cause patients to underestimate the effects of non-adherence or if not, commit errors that may soon prove to be fatal. Feelings as basis for determining blood glucose levels, instead of data gathered through proper self-monitoring are of course unreliable. The health care providers’ failure to comply with international guidelines regarding patient-focused aspects of care may contribute to this barrier (pp. 44-46).
Low self-efficacy may contribute to non-adherence to recommendations and poor management of the condition if glycemic control remains poor despite their diligent efforts. A vicious cycle is created the moment a patient starts to feel that his or her efforts in effectively managing his or her condition appear to be futile (pp. 44-46).
While social support may be generally viewed as positive factors that can contribute to adherence to recommendations and effective management of blood sugar, the effects the patient’s gender may bring about some exceptions. Support from others can help people with diabetes in effecting a change in behavior but when support involve influences that encourage a lifestyle that is inconsistent with good diabetes management, such support or influence may instead, serve as a barrier to adherence. Men of course have more social contacts that promote or tolerate non-adherence (pp. 44-46).
Daily monitoring of blood glucose levels, taking insulin shots, calorie-management, regular exercise and regular health care appointments are all activities that are not regular parts of the routine of normal people. Just the thought of these additional new activities, combined with the fact that this list of activities will now become part of the patient’s regular routine may overwhelm the patient resulting to the dismissal of the treatment procedures as inconveniences. Most likely, the patient has been used to other concerns, and adding diabetic management to the list of his or her activities will surely take significant amounts of time and money that used to be allocated for other things that the patient enjoys or deems more deserving of concern (pp. 44-46).
Lastly, the patient’s relationship with his or her attending health care professional greatly contributes to his or her adherence and to the effectiveness of the management plan. A health care professional must not only be able to set realistic goals so as not to increase the risk of failure but also ensure that such goals are adequately understood by the patient.
Patients generally have limited or no knowledge about the technicalities of their condition and may thus be easily overwhelmed by the complexity of their condition. That said, instructions that are too general may only contribute to non-adherence. In addition, health care professionals who are too focused on the medical aspect of the condition may cause patients to feel that other concerns that they feel should be considered are taken for granted. This may possibly reduce the effectiveness of plans (pp. 44-46).