Table 1.

Overview of included studies

First author /year	Setting	Objectives	Study design	Sampling/ participants	Analysis approach	Key emerged themes	CASP score
Molayaghobi [18], 2019	A specialized polyclinic-Isfahan	To implement, determine, and solve the challenges of executing the Chronic Care Model in diabetes management	Action research/ semi-structured interviews	17 patients with type 2 diabetes.	Content analysis	* lack of effective follow-up system * insufficient acre providers * incomplete medical records * limited knowledge of healthcare providers * lack of regular physician visit * lack of commitment to ordered regime	8
Aliasgharpour [24], 2012	A big university affiliated hospitals in Tehran	to clarify the care process for Iranian patients with diabetes suffering from diabetic foot ulcer condition	Grounded Theory /semi-structured interviews	11 diabetic patients with food ulcer, 4 physicians, one head nurse and one nurse	Theoretical analysis	* disease management * disease experience * continuity of care	9
Shakibazadeh [21], 2011	A diabetes clinic in Tehran	to exploreexperience of Iranian diabetic patients regarding barriers to and facilitatingfactors for diabetes self-care	phenomenological study/ focus groups	43 type 2 diabetic patients	Framework analysis	* physical barriers * psychological barriers * educational barriers * social barriers * care system barriers	8
Ravaghi, 2014 [23]	General (health system)	To evaluate the planning and establishing of the specialized care program for diabetic’s patient from the healthcare providers’ perspectives	documents review and face-to-face semi-structured interviews	Program leaders and relevant executive managers of the local medical universities	Thematic analysis	* program planning * program implementation * Program results	7
Abdoli, 2009 [17]	Hospitals, diabetes clinics, physician offices, and health houses	To identify barriers to and facilitators of empowerment in people with diabetes	grounded theory/ in-depth unstructured interviews	11 diabetic patients	Thematic analysis	* negative view about diabetes * ineffective healthcare systems * poverty and illiteracy	8
Nouhjah, 2014 [19]	A diabetes clinic/ Ahwaz	to explore diabetic women’s views about the diabetes and its consequences	Semi-structured interview	40 Diabetic Women’s	Thematic analysis	* unavailability of drugs * high treatment cost * fear and embarrassment of insulin injection * self-treatment	7
Abazari, 2012 [22]	Ministry of health, and officials of the health system in Isfahan	to describe the situation of training of general practitioners who provide diabetes care	unstructured interviews	8 diabetes management planners and six general practitioners workingin diabetes centers	content analysis	* unstructured education of healthcare provides * inadequate physician’s competence * ineffective education	8
Mousavizadeh, 2018 [26]	Hospitals, diabetes associations, physicians’ offices, patients’	to explore how adherence to diabetes treatment process occurs among Iranian patients	grounded theory/ Semi-structured in-depth interviews	21 diabetic patients+ two members of families and healthcare providers	Corbin and Strauss constant comparative analysis	* unperceived threat in diagnosis time * bitter belief * adaptation to treatment	8
Valizadeh, 2017 [27]	Diabetes centers, treatment and health deputies, and health departments	to identify the problems of Type 2 diabetes prevention and control program in Iran	The semi-structured interview	7 diabetes experts, and 10 diabetic patients	Framework analysis	* Referral system issues * human resources issues * Infrastructure issues * cultural problems issues * access issues * intersectoral coordination issues	9
Dehghani Tafti, 2015 [28]	Health network/ Ardakan	to explore the barriers and incentives for diabetes self-care	focus group discussions and interviews	Diabetic patients and health care providers	content analysis	* product issues * place issues * price issues * promotion issues	8
Molayaghobi, 2019 [25]	A specialized poly-clinic/ Isfahan	To identify diabetes management challenges in Iran	semi-structured interviews	4 members of clinic diabetesunit and 21 type 2 diabetic patients	content analysis	* weak care delivery system * Defective diabetes self-care	9
Rezaei, 2019 [20]	A diabetes unit / Kurdistan	To identify barriers of medication adherence in Iranian patients with type-2 diabetes	Semi-structured interviews	12 patients with type-2 diabetes	conventional content analysis	* disbelief in medical explanatory/prescriptive knowledge * lived experiences of the disease * challenges of everyday life * interactive/economic challenges	9