Understanding the challenges of participating in self-management educational programmes for adult patients living with diabetes: Evidence from a systematised literature review

Abstract

Background: Diabetes self-management education programmes (DSMEPs) improve the quality of life for individuals with diabetes and empower them to manage their condition. However, there is an ongoing problem with non-attendance at diabetes education. The aim of this review is to determine the main reasons for adult patient’s non-attendance at DSMEPs. Methods: Five databases were searched for articles from 2008 to 2020. The inclusion criteria were peer-reviewed studies that centred on adult patient-reported challenges for non-attendance at DSMEPs. Tow quality assessment tools were used to assess studies quality (Critical Appraisals Skills Programme and Quality Assessment Tool for Quantitative Studies). Results: This review included five qualitative and four quantitative studies of weak to moderate quality. Non-attendees were broadly divided into two categories. The first group included people who did not attend because DSMEPs had not been suggested by their doctor or other medical professional, for medical reasons such as other comorbidities or for logistical reasons such as inappropriate or inconvenient timing. The second group did not attend DSMEPs because they felt that they knew enough already, would get no benefit from attending or had a negative attitude towards education. Conclusion: The inclusion of studies that utilised both qualitative and quantitative approaches with consistent findings indicates that the quality of evidence is robust. To improve DSMEP attendance, clinicians and those involved in public health and health education should explore innovative ways of providing diabetes education. Publishing these review findings in an international journal or conference paper could help improve the DSMEP design.