The impact of time and risk preferences and health behaviour on adherence to guidelines for the management of type 2 Diabetes (t2dm): findings from the english longitudinal study of ageing (elsa)

Regular monitoring of key risk factors and lifestyle changes are at the centre of national and international guidelines on T2DM management. However, despite the clear benefit, adherence to these guidelines is often difficult to achieve by the people living with T2DM. This thesis explores the role of time and risk preferences in explaining such behaviour and the associated costs and quality of life implications. Three empirical analyses will be conducted to gain insights into adherence to T2DM-related management behaviour. The first analysis investigates the relationship between time and risk preferences, and adherence to annual routine medical checks for T2DM management. The second analysis quantifies the impact of different time and risk preference rates on the long-term health outcomes and costs of T2DM patients. The third analysis examines whether a new T2DM diagnosis can trigger behaviour change in newly diagnosed individuals. The findings reveal that heterogeneity in individuals’ levels of time and risk preferences was not associated with adherence to the annual care processes recommended by the guidelines for T2DM management. Similarly, preferences did not explain the difference in T2DM related health outcomes and costs. The final analysis found limited evidence of behaviour change following a T2DM diagnosis apart from a reduction in smoking. Healthcare providers are advised to regularly assess patients' willingness and ability to comply with the T2DM guidelines and manage treatment accordingly as a way to improve adherence to T2DM management guidelines.