Beyond prescriptions: an analysis of patient journey, self-management adherence, and unmet needs in type 2 diabetes

As a chronic disease, effective management of Type 2 Diabetes Mellitus (T2DM) heavily relies on people’s continuous self-management adherence. Patient journey mapping provides a powerful perspective for systematically understanding individuals’ complete experiences within the healthcare system, identifying key touchpoints, and uncovering unmet needs. However, research exploring the factors influencing adherence among people with T2DM from this perspective remains insufficient, particularly lacking integrated exploration from the perspective of pharmaceutical services to systematically identify intervention opportunities. This study aims to explore the facilitators and barriers to self-management adherence among people with T2DM through the lens of patient journey mapping and to preliminarily identify potential intervention points for pharmaceutical services throughout the journey. A phenomenological qualitative research method was employed. Through purposive sampling, 15 people with T2DM attending outpatient clinics at Ningbo University Affiliated Lihuili Hospital were recruited for semi-structured in-depth interviews during 2024–2025. The interview guide was designed based on the three stages of the patient journey. Deductive thematic analysis was used to analyze the 15 interview transcripts, with data collection ceasing upon saturation. During the diagnostic phase, facilitators included proactive health awareness and regular screening, while barriers were primarily related to insufficient risk perception, hidden symptoms, and limited healthcare accessibility leading to delayed diagnosis. In the treatment phase, shared decision-making between patients’ and healthcare providers, along with efficient and coherent medical services, significantly enhanced treatment confidence and adherence. Conversely, initial psychological resistance to treatment, poor systemic experiences, and inadequate communication with healthcare providers were major obstacles. In the long-term management phase, family support, financial security, and vigilance against complications were critical sustaining factors, while insufficient health knowledge, practical challenges, stigma, and social influences posed ongoing challenges to daily management. Based on these findings, this study preliminarily identified potential pharmaceutical service intervention points across all journey stages. The patient journey mapping systematically reveals that self-management adherence in T2DM is driven by distinct factors at each stage: health awareness and accessibility in diagnosis, the quality of clinical interaction and system experience in treatment, and the balance of knowledge, support, and motivation in long-term management. These findings underscore the necessity for healthcare providers to adopt a patient-centered, stage-adaptive approach and implement targeted interventions at key journey nodes. This study provides empirical evidence and clear guidance for integrating pharmaceutical services into T2DM management and building a more effective, personalized support system. No patients or members of the public were involved in the design, conduct, or reporting of this research.