615-P: Identification of Barriers to Medication Adherence in People with Type 2 Diabetes Using Qualitative Interviews and the Theoretical Domains Framework
Authors: VALLIS MICHAEL , JIN SUSIE , KLIMEK-ABERCROMBIE AGNIESZKA , NG GINNIE , BUNKO ANDREAN , KUKASWADIA ATIF A. , NEISH CALUM S. , IVERS NOAH 
Published: May 2022

Despite the availability of many effective medications and management options, many people with type 2 diabetes have low adherence to treatments which can lead to adverse health outcomes. We aimed to better understand the challenges related to type 2 diabetes medication adherence through interviews with people with type 2 diabetes with varying degrees of medication adherence. Phone interviews were conducted in English or French, lasted 45 minutes, and followed a semi-structured discussion guide informed by the Theoretical Domains Framework (TDF) . Eligibility criteria included being diagnosed with type 2 diabetes for at least 2 years and current use of diabetes medication (s) . A total of 30 people with type 2 diabetes were interviewed, with representation across Canada, by gender (14F/16M) , years since diagnosis (12.9±7.9) , types of medication and regimen (n=15 on polypharmacy) , and medication adherence levels (n=for each of the low/medium/high adherence groups) . Themes related to medication adherence identified from interviews mapped to 12 of the 14 TDF domains, with the Knowledge and Skills domain being the exceptions. Compared to people with type 2 diabetes categorized to the high adherence group, those categorized to the low adherence group doubted the appropriateness of their medications; reported less access to healthcare providers; tended not to use organizational tools to help with taking medication; and discussed financial barriers to accessing their medications. In contrast to those in the low adherence category, we found that highly adherent people with type 2 diabetes often viewed taking their medication as an emotionally neutral task. To validate these findings, additional quantitative research is underway to help support people with type 2 diabetes to overcome the psychological and tangible barriers to adherence and impact the perception of taking medication as a task without emotional connotations and stigma.

Disclosure
M. Vallis: Advisory Panel; Bausch Health, Canada, Novo Nordisk Canada Inc. Consultant; Abbott Diabetes, LifeScan. Speaker's Bureau; AbbVie Inc., Bausch Health, Canada, LifeScan, Novo Nordisk, Novo Nordisk A/S. S. Jin: Advisory Panel; Novo Nordisk Canada Inc. Consultant; Abbott Diabetes, Boehringer Ingelheim International GmbH, Dexcom, Inc., HLS Therapeutics Inc., Janssen Pharmaceuticals, Inc., MDBriefcase. Research Support; Novo Nordisk Canada Inc. Speaker's Bureau; Abbott Diabetes, Boehringer Ingelheim International GmbH, Eisai Inc., EOCI Pharmacomm Ltd., Janssen Pharmaceuticals, Inc., Novo Nordisk Canada Inc., Pfizer Inc., Roche Diabetes Care. Other Relationship; Diabetes Canada. A. Klimek-Abercrombie: Employee; Novo Nordisk Canada Inc. G. Ng: Other Relationship; Novo Nordisk Canada Inc. A. Bunko: Other Relationship; Novo Nordisk Canada Inc. A.A. Kukaswadia: Other Relationship; Novo Nordisk. C.S. Neish: Other Relationship; Novo Nordisk Canada Inc.