PMID- 32886663
OWN - NLM
STAT- MEDLINE
DCOM- 20201020
LR  - 20240329
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 15
IP  - 9
DP  - 2020
TI  - Barriers and facilitators to successful management of type 2 diabetes mellitus in 
      Latin America and the Caribbean: A systematic review.
PG  - e0237542
LID - 10.1371/journal.pone.0237542 [doi]
LID - e0237542
AB  - BACKGROUND: Given that most evidence-based recommendations for managing type 2 
      diabetes mellitus (T2DM) are generated in high-income settings, significant 
      challenges for their implementation exist in Latin America and the Caribbean 
      region (LAC), where the rates of T2DM and related mortality are increasing. The 
      aim of this study is to identify the facilitators and barriers to successful 
      management of T2DM in LAC, from the perspectives of patients, their families or 
      caregivers, healthcare professionals, and/or other stakeholders. METHODS: We 
      conducted a systematic review in MEDLINE, Web of Science, SciELO, and LILACS. We 
      included studies of disease management, prevention of complications and risk 
      factor management. We qualitatively synthesized the verbatim text referring to 
      barriers and/or facilitators of diabetes management according to the Theoretical 
      Domain Framework and described their relative frequencies. FINDINGS: We included 
      60 studies from 1,595 records identified. 54 studies (90%) identified factors 
      related to the environmental context and resources, highlighting the importance 
      of questions related to health care access or lack of resources in the health 
      system, and the environmental context and living conditions of the patients. 
      Issues related to "social influences" (40 studies) and "social/professional role 
      and identity" (37 studies) were also frequently addressed, indicating the 
      negative impact of lack of support from family and friends and clinicians' 
      paternalistic attitude. 25 studies identified patients beliefs as important 
      barriers, identifying issues such as a lack of patients' trust in the 
      effectiveness of the medication and/or the doctor's advice, or preferences for 
      alternative therapies. CONCLUSIONS: Successful diabetes management in LAC is 
      highly dependent on factors that are beyond the control of the individual 
      patients. Successful disease control will require emphasis on public policies to 
      reinforce health care access and resources, the promotion of a patient-centred 
      care approach, and health promoting infrastructures at environmental level.
FAU - Blasco-Blasco, Mar
AU  - Blasco-Blasco M
AUID- ORCID: 0000-0003-1386-7108
AD  - Department of Public Health, Universidad Miguel Hernandez, Alicante, Spain.
FAU - Puig-Garcia, Marta
AU  - Puig-Garcia M
AD  - Department of Public Health, Universidad Miguel Hernandez, Alicante, Spain.
FAU - Piay, Nora
AU  - Piay N
AD  - Department of Public Health, Universidad Miguel Hernandez, Alicante, Spain.
FAU - Lumbreras, Blanca
AU  - Lumbreras B
AD  - Department of Public Health, Universidad Miguel Hernandez, Alicante, Spain.
AD  - CIBER de Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain.
FAU - Hernandez-Aguado, Ildefonso
AU  - Hernandez-Aguado I
AD  - Department of Public Health, Universidad Miguel Hernandez, Alicante, Spain.
AD  - CIBER de Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain.
FAU - Parker, Lucy Anne
AU  - Parker LA
AUID- ORCID: 0000-0002-2362-4057
AD  - Department of Public Health, Universidad Miguel Hernandez, Alicante, Spain.
AD  - CIBER de Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
DEP - 20200904
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Caribbean Region/epidemiology
MH  - Diabetes Mellitus, Type 2/*epidemiology/prevention & control/*therapy
MH  - Disease Management
MH  - Health Services Accessibility
MH  - Humans
MH  - Latin America/epidemiology
MH  - Patient-Centered Care
MH  - Risk Factors
PMC - PMC7473520
COIS- The authors have declared that no competing interests exist.
EDAT- 2020/09/05 06:00
MHDA- 2020/10/21 06:00
PMCR- 2020/09/04
CRDT- 2020/09/04 17:10
PHST- 2020/05/09 00:00 [received]
PHST- 2020/07/28 00:00 [accepted]
PHST- 2020/09/04 17:10 [entrez]
PHST- 2020/09/05 06:00 [pubmed]
PHST- 2020/10/21 06:00 [medline]
PHST- 2020/09/04 00:00 [pmc-release]
AID - PONE-D-20-13651 [pii]
AID - 10.1371/journal.pone.0237542 [doi]
PST - epublish
SO  - PLoS One. 2020 Sep 4;15(9):e0237542. doi: 10.1371/journal.pone.0237542. 
      eCollection 2020.