Medication adherence and environmental barriers to self-care practice among people with diabetes: A cross-sectional study in a lifestyle clinic in eastern India.

Objective: The study was conducted to estimate the prevalence of non-adherence to medications among patients with type 2 diabetes attending a lifestyle clinic in a tertiary care hospital in West Bengal, India; to identify the environmental barriers to self-care practices, including diet, exercise, glucose testing and medication; and to identify the socio-demographic and environmental determinants of medication non-adherence. Methods: A cross-sectional study was performed among the patients with type 2 diabetes taking oral hypoglycemic drugs and attending a lifestyle clinic of a teaching hospital in 2021. The participants were interviewed in clinical settings via a structured questionnaire in the local language. Medication adherence was assessed with Morisky Medication Adherence Scale-8 (MMAS), and environmental barriers were assessed with the Environmental Barrier Assessment Scale (EBAS). Results: Among 178 participants, a high level of adherence (MMAS score 8.0) was found among 3 (1.7%) participants, and moderate adherence (MMAS score 6.0 to 7.75) was found among 67 (37.6%; 95% CI 30.3%, 44.9%) participants. The prevalence of non-adherence was 60.7% (95% CI: 53.4%, 68.0%). The overall mean barrier score was 134 (SD 13). All environmental barrier components were distributed equally among the predictor variables except the diet score, which was lower among men (mean difference 1.3; 95% CI: 0.04, 2.5) and people with higher education (mean difference 1.8; 95% CI: 0.6, 3.1). Conclusion: The study indicated poor adherence to OHA in this population. Barriers to self-care practice and medication adherence were observed acrross all socio-economic strata. Poor medication adherence poses a major challenge to clinicians and public health experts in achieving treatment goals.

Breastfeeding practices and infant feeding pattern of a tribal population region of eastern India.

BACKGROUND: Regular vigilance over infant feeding practices in the community is necessary for assessment of optimal growth and development and the intervention if needed. OBJECTIVE: To illustrate infant feeding practices, and socio-demographically correlated time like when weaning starts, the challenges met by mothers, and the types of complementary feeding adopted. METHODS: A structured pretested and predesigned questionnaire was used to collect information regarding sociodemographic, detail information regarding initiation and duration of breastfeeding, age of complementary feeding and type of food given during complementary feeding, minimum dietary diversity and minimum meal frequency, and also advice given during child feeding session. RESULTS: The study revealed that it was a predominantly Hindu tribal community where majority of infant were female and belong to joint families. Most of the mother had completed high secondary school and were housewives and belong to upper lower social class. Majority of women had more than two children, and rate of delivery at government institution was more than private institution and home delivery. Exclusive breastfeeding was practiced among 78% of infants, 46% had started breastfeeding within 1 h of birth. In total, 48% of infants were given prelacteal feed, and colostrum feeding was practiced among 62% of infants. Complementary feeding was given by 82% of infants and minimum dietary diversity, and minimum meal frequency was found among 77 and 85%, respectively. CONCLUSION: This community-based study carried out among tribal population of Kalyani showed that exclusive breastfeeding and other domains like complementary feeding and minimum dietary diversity are almost satisfactory.