Characteristics of diabetes medication-taking in people with mild to moderate intellectual disability compared to those without: a mixed-methods study

Abstract

Aim: This two stage mixed methods study applied social cognitive theory to explore characteristics of diabetic medicines taking in people with diabetes. The aim was to compare frequency and factors associated with medicines taking (depression, perceived side-effects, self-efficacy and social support) in people with mild to moderate intellectual disability without intellectual disability, both with diabetes. Methods: Stage 1 collated information on diabetes medication taking and associated factors in 111 people with diabetes; 33 adults with mild to moderate intellectual disability and 78 adults without intellectual disability. Validated instruments measuring medicine taking, self efficacy, depressive symptoms, perceived level of social support and perceived side effects were administered to both 38 groups. Stage 2 used an abductive qualitative approach to triangulate stage 1 findings with carers (n= 12). Results: The instruments showed good internal reliability (Cα 0.7 – 0.9). Comparisons between people with intellectual disabilities and those without revealed similar frequency of medicines taking (70% vs 62%, p =0.41). People with intellectual disabilities and diabetes had significantly higher depressive symptoms as measured by the Glasgow Depression – LD score (p = 0.04), higher levels of perceived side effects (p = 0.01) and lower confidence levels as measured by the perceived confidence scale (PCS) ( p =0.01). Stage 2 describes how carers of people with intellectual disabilities and diabetes optimised medicines taking yet infrequently discussed medicines side effects. Conclusions: Further investigating medicines taking and side effects may result in development of any evidence informed intervention to improve medicines safety in people with intellectual disabilities.