Clarification of Poor Adherence to Treatment Among Patients With Type 2 Diabetes in Iran: The Magnitude of the Problem and the Its Determinants Publisher



Sadeghi D ; Yazdizadeh B ; Ahmadi A ; Zeraatkar A
Source: Journal of Diabetes and Metabolic Disorders Published:2026

Abstract

Background and purpose: Despite the efforts of experts and healthcare providers, poor adherence to treatment in people with type 2 diabetes is still one of the major challenges associated with this disease. However, the rate and associated factors among these patients in Iran are unknown. Therefore, the present study aimed to estimate the level of adherence to treatment and identify its determinant factors among patients with type 2 diabetes in Iran. Methods: In the present study, we conducted a mixed method systematic review of studies related to the adherence to treatment and its causes among patients with type 2 diabetes in Iran, published between 2011 and 2024. Studies were collected from Iranian and international databases and were evaluated using the Oxford University’s critical appraisal tools. A quantitative meta-analysis of the data was performed to determine the prevalence, and attributable risk of each of the identified factors. Results: Of the 57 initial screened studies, 41 eligible studies were identified that provided evidence on the rates and barriers to treatment adherence in different regions of Iran. The level of adherence to treatment was reported in 28 studies, with 14.29% of studies reporting favorable treatment adherence and 85.71% of them reporting poor treatment adherence. Barriers to treatment adherence also included patient-related factors, including patient demographic characteristics, disease awareness and perception, patient self-efficacy, patient concerns about medication side effects, disease-related beliefs, patient social support, and patient psychological characteristics and factors related to the treatment team, which included the performance of the treatment team and the patient’s relationship with the treatment team. Conclusion: The present study showed that the adherence to treatment status in patients with type 2 diabetes in Iran is a lower than recommended standards. Poor adherence to treatment can lead to irreversible side effects in these patients and also impose an additional burden on the patient and healthcare systems. Therefore, further research is needed to clarify the extent of the prevalence rate as well as to determine the factors that influence adherence and can be effective in targeted interventions to promote adherence, optimize diabetes control, and limit diabetes progression. © The Author(s), under exclusive licence to Tehran University of Medical Sciences 2026.