Profile of diabetes patients’ chronic illness care in India and its role in their adherence

Abstract

Background and aims: Negligence of illness care in terms of non-adherence may give rise to serious health outcomes in patients with type 2 diabetes mellitus. Considering the importance of both chronic illness care and adherence, the primary purpose of the study is to explore the profile of diabetic patients’ chronic illness care and examine its role in their clinical adherence. In addition to this, we have also investigated the major confounding variables in understanding the chronic illness care of diabetic patients. Methods: We have conducted this study using a simple retrospective design with one group involving the patients primarily diagnosed with type 2 diabetes (N = 200) in India. Results: The cluster analysis (k-Means) has yielded three clusters on the basis of five domains of chronic illness care—patient activation, delivery system design, goal setting, problem solving, and follow-up/coordination. The findings further reveal that the profile of chronic illness care plays a significant role in deciding the clinical adherence of patients with type 2 diabetes. The three clusters of diabetes patients, however, are confounded by health risk behaviour. Conclusions: These initial findings are suggestive of an association between chronic illness care, clinical adherence, and health risk behaviour of patients with type 2 diabetes. More research on this topic, however, needs to be undertaken involving other important dimensions of health care system like patient-provider relationship and quality of life during hospitalisation. The implications and shortcomings are discussed.