Adherence to Antidiabetic Medications among Women with Gestational Diabetes
Date
2021
Journal Title
Journal ISSN
Volume Title
Publisher
Hindawi
Abstract
Background. Optimal adherence to prescribed medications in women with gestational diabetes is relevant for perinatal
outcomes. Objective. To summarize available information on the prevalence and factors contributing to medication
adherence in women with gestational diabetes from the biological and psychosocial perspectives. Methods. A literature
search on adherence in gestational diabetes was conducted in PubMed/MEDLINE, CINAHL, Scopus, and the Directory of
Open Access Journals for studies published on the topic. The Arksey and O’Malley framework for scoping reviews was
used to explore and summarize the evidence. Results. A total of 2395 studies were retrieved of which 13 fully met the
eligibility criteria. The studies were reported in Zimbabwe (n = 5), Iran (n = 1), Mexico (n = 1), South India (n = 1), the
United States of America (n = 4), and one multinational study covering Australia, Europe, North and South America. The
main types of antidiabetic medications used were insulin (n = 6), metformin (n = 4), and glyburide (n = 2). The prevalence
of adherence ranged from 35.6% to 97%, with the assessment tool being self-report measures (n = 8). The main factors
associated with nonadherence included worsening pregnancy symptoms, side effects of medications, perceived risks, mental
health symptoms, poor social support, and socioeconomic status. Recommendations that evolved from the studies to
improve adherence included education, counselling, improved support networks, and social interventions, while the main
reported interventional study employed continuous education on the impact of adherence on perinatal outcomes.
Conclusion. Medication nonadherence in gestational diabetes seems to be influenced by multiple factors with some
educational interventions positively impacting adherence behaviours. Thus, future research in women with gestational
diabetes could consider interventions from a multifactorial perspective to improve therapeutic outcomes.
Description
Research Article