Primary caregiver involvement in management of type 2 diabetes mellitus: A community-based observational study from urban Puducherry

Background: Adherence to medication and lifestyle modification is an important predictor of positive outcome of diabetes management among adults in which primary caregiver (PCG) plays an important role. Objectives: The objectives of this study were to describe the involvement of PCG in adherence to the drugs, diets, and lifestyle changes among patients with type 2 diabetes mellitus in an urban area of Puducherry. Methodology: A total of 311 type 2 diabetes patients irrespective of their source of diabetes care were included from the service area of an urban health and training center in an urban area of Puducherry. The PCG for each patient was identified, and the PCG and the patient were interviewed separately to obtain the information on adherence and involvement in various aspects of diabetes management, respectively, using an interview schedule. The information on diabetes control status of the patient was obtained from the records available. Results: About 10% of the patients did not have caregiver. Nearly 90% of the PCGs were involved in either of the lifestyle modification, drug adherence, checking type and frequency of medication, accompanying for consultation, or all. About 80% of the PCGs remind the patient to take medicines when out of station mainly by phone call/short message service. Encouragement toward physical activity was proportionately less compared to diet and drugs, and that was reflected in the patient's level of adherence in those domains. Overall involvement of spouse was more than the nonspouse. PCG involvement was found to be significantly associated with adherence to diet (P = 0.027) but not with drug and physical activity (P > 0.05). Conclusion: The PCG should also be considered while designing health education intervention on various aspects of diabetes management, focusing and highlighting the areas of poor involvement and their importance in disease management. The health system should place special focus on patients without PCG.