BMJ open · 2025
Psychosocial factors and patient experience associated with diabetes treatment discontinuation: a cross-sectional study in Japan.
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Kuwabara Yuki, Taniguchi Shin-Ichi, Hosoda-Urban Tamaki, Son Daisuke, Kinjo Aya, Kim Hongja, Kaneda Yukiko, Osaki Yoneatsu
Аннотация
OBJECTIVES: The prevention of treatment discontinuation is crucial in mitigating the adverse consequences of diabetes. This study aimed to identify the psychosocial factors and patient experiences associated with the discontinuation of diabetes treatment.
DESIGN: A cross-sectional study was conducted.
SETTING: A nationwide online survey with convenience sampling.
PARTICIPANTS: Participants, aged 40-79 years, who reported living with diabetes, were included.
PRIMARY AND SECONDARY OUTCOME MEASURES: Treatment continuation status was the outcome variable. Participants who previously received regular treatment but were not currently under medical care were classified as the treatment discontinuation group. Psychological factors (mood and anxiety disorders, self-esteem, procrastination), social factors (loneliness, economic difficulties, adverse childhood experiences) and patient experiences and opinions regarding diabetes were assessed.
RESULTS: A total of 4715 individuals were included in the analysis. After adjusting for confounders, psychological distress (adjusted OR (AOR)=1.87, 95% CI (1.06 to 3.30), p=0.032) and higher procrastination (AOR=2.64, 95% CI (1.25 to 5.56), p=0.011) were significantly associated with treatment discontinuation. Overall, 9.7% of participants reported financial hardship, and 12.1% reported diabetes burnout during their course of treatment. Financial hardships (p=0.002), difficulty with child or older adult care (p<0.001) and diabetes burnout (p=0.001) were significantly more common in the treatment discontinuation group than in the continuation group.
CONCLUSIONS: Psychological distress and higher procrastination levels were significantly associated with diabetes treatment discontinuation, after adjusting for potential confounders. The treatment discontinuation group reported significantly more psychosocial challenges than the continuation group. Healthcare providers and systems should prioritise addressing the psychosocial characteristics, experiences and challenges faced by individuals with diabetes.
DESIGN: A cross-sectional study was conducted.
SETTING: A nationwide online survey with convenience sampling.
PARTICIPANTS: Participants, aged 40-79 years, who reported living with diabetes, were included.
PRIMARY AND SECONDARY OUTCOME MEASURES: Treatment continuation status was the outcome variable. Participants who previously received regular treatment but were not currently under medical care were classified as the treatment discontinuation group. Psychological factors (mood and anxiety disorders, self-esteem, procrastination), social factors (loneliness, economic difficulties, adverse childhood experiences) and patient experiences and opinions regarding diabetes were assessed.
RESULTS: A total of 4715 individuals were included in the analysis. After adjusting for confounders, psychological distress (adjusted OR (AOR)=1.87, 95% CI (1.06 to 3.30), p=0.032) and higher procrastination (AOR=2.64, 95% CI (1.25 to 5.56), p=0.011) were significantly associated with treatment discontinuation. Overall, 9.7% of participants reported financial hardship, and 12.1% reported diabetes burnout during their course of treatment. Financial hardships (p=0.002), difficulty with child or older adult care (p<0.001) and diabetes burnout (p=0.001) were significantly more common in the treatment discontinuation group than in the continuation group.
CONCLUSIONS: Psychological distress and higher procrastination levels were significantly associated with diabetes treatment discontinuation, after adjusting for potential confounders. The treatment discontinuation group reported significantly more psychosocial challenges than the continuation group. Healthcare providers and systems should prioritise addressing the psychosocial characteristics, experiences and challenges faced by individuals with diabetes.