Adesão a tratamento medicamentoso e terapias não farmacológicas no controle do diabetes mellitus tipo 2: uma revisão de escopo

Luis Francesquini Júnior; Enoque Fernandes de Araújo; Antonio Carlos Pereira; Andreza Maria Luzia Baldo de Souza

doi:10.5712/rbmfc21(48)4875

Authors

Luis Francesquini Júnior Universidade Estadual de Campinas, Piracicaba School of Dentistry – São Paulo (SP), Brazil https://orcid.org/0000-0002-6344-3488
Enoque Fernandes de Araújo Universidade Estadual de Campinas, Piracicaba School of Dentistry – São Paulo (SP), Brazil https://orcid.org/0000-0003-3239-1467
Antonio Carlos Pereira Universidade Estadual de Campinas, Piracicaba School of Dentistry – São Paulo (SP), Brazil
Andreza Maria Luzia Baldo de Souza Universidade Estadual de Campinas, Piracicaba School of Dentistry – São Paulo (SP), Brazil https://orcid.org/0000-0002-6575-2209

DOI:

https://doi.org/10.5712/rbmfc21(48)4875

Keywords:

Diabetes mellitus, Scoping review, Patient compliance, Public health, Self-care

Abstract

Introduction: Type 2 Diabetes Mellitus (T2DM) represents one of the major global public health challenges, requiring continuous therapeutic strategies that include both pharmacological and non-pharmacological interventions. Treatment adherence is crucial for glycemic control and the prevention of complications, yet it remains hindered by multiple barriers. Objective: To map the available evidence on adherence to pharmacological or non-pharmacological treatments in the management of T2DM, identifying facilitators, barriers, and research gaps. Methods: A scoping review was conducted following guidelines of the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) and the Joanna Briggs Institute, registered with the Open Science Framework. Studies published between 2014 and 2024 were included, sourced from PubMed/MEDLINE, LILACS, and ClinicalTrials.gov, in Portuguese, Spanish, and English. The search strategy combined descriptors related to T2DM, adherence, pharmacological treatment, and non-pharmacological therapies. Clinical trials, observational studies, systematic reviews, and cohort studies were included. Thematic analysis guided the categorization of findings. Results: A total of 16 studies were included. We identified four main thematic categories by the synthesis: (I) barriers to adherence, such as polypharmacy, depressive symptoms, and resistance to insulin use; (II) facilitators, such as social support and health education strategies; (III) digital technologies, including reminders and self-care applications (reported in fewer studies); and (IV) adherence assessment tools such as the Medication Adherence Test. There was a predominance of Brazilian studies, lack of standardized indicators, and a scarcity of longitudinal research. Conclusions: Adherence to T2DM treatment remains a multifactorial phenomenon, requiring interdisciplinary approaches. The use of technologies seems promising, but still lacks validation and standardization. Health education- and social support-based interventions demonstrated greater applicability. Future research should explore diverse populations and adopt consistent indicators, in alignment with the Sustainable Development Goals, particularly regarding equitable access and the promotion of self-care.

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