Identifying barriers to glycemic control in patients with type 2 diabetes after completion of an accredited education program

ObjectivesThe objective of this study was to identify patient-perceived barriers to achieving A1C targets after receiving instruction in an accredited diabetes education program.DesignQualitative research using semistructured interviews and thematic analyses.SettingOne pharmacist-run diabetes center located within an independent community pharmacy in a suburban region of southern Indiana.ParticipantsA total of 17 participants between the ages of 41-78 were interviewed in March and April 2016.InterventionNot applicable.Main outcome measuresPatient-perceived barriers to attaining glycemic control after completion of a pharmacist-taught diabetes self-management education (DSME) program accredited by the American Association of Diabetes Educators.ResultsParticipants reported a variety of perceived barriers to glycemic control subsequent to the receipt of structured education. Seven major themes emerged: 1) health care provider factors; 2) self-identified indiscretions; 3) psychological barriers and poor social support; 4) knowledge deficits; 5) personal injury or adverse drug events; 6) time constraints and competing life demands; and 7) financial constraints.ConclusionParticipants reported a variety of perceived barriers to achieving A1C targets after completing DSME. Incorporation of solutions and coping mechanisms to these barriers into diabetes education programs may help patients attain glycemic control. Other factors may require individualized attention outside of DSME in follow-up episodes of diabetes care.