Issues Affecting Medication-Taking Behavior of People with Type 2 Diabetes in Indonesia: A Qualitative Study

Overview

Journal Patient Prefer Adherence

Date 2021 May 27

PMID 34040353

Citations 1

Authors

Anna Wahyuni Widayanti

Kristian Kalvin Sigalingging

Furi Patriana Dewi

Niken Nur Widyakusuma

Affiliations

Soon will be listed here.

Abstract

Purpose: It has been widely acknowledged that non-adherence to medication among people with type 2 diabetes is a significant problem worldwide. Studies have suggested that non-adherence to medication may be caused by the complexity of issues surrounding medication use which further created burdens related to medication. However, studies on this topic in the Indonesian context were still limited. This study aimed to understand the experiences of people with type 2 diabetes in medication-taking and explore any practical issues that potentially affect their behavior when taking medication.

Methods: Qualitative phenomenological study with semi-structured interviews was applied. The participants were purposefully recruited and selected from some primary healthcare facilities in Yogyakarta Province. The eligibility criteria included: diagnosed with type 2 diabetes by healthcare professionals for at least six months and were able to comprehend information. Information about the study was explained, and written informed consent was collected. The interviews were recorded, transcribed verbatim, and analyzed with a deductive qualitative content analysis method.

Results: Fifty-one people with type 2 diabetes were involved in this study. Most of the participants were between 40 and 59 years old, and many of them were female and housewives. The thematic analysis found some practical issues that affected people's behavior in taking type 2 diabetes medication. These included individual's mealtime, characteristics of the medications, accessibility of healthcare services, experiences of side effects and social activities.

Conclusion: The practical issues identified in this study can be resolved by improving the role of healthcare providers in managing people with diabetes. Future research needs to be conducted to evaluate the effectiveness of interventions developed based on understanding of the practical factors identified.

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References

Viswanathan M, Kahwati L, Golin C, Blalock S, Coker-Schwimmer E, Posey R . Medication therapy management interventions in outpatient settings: a systematic review and meta-analysis. JAMA Intern Med. 2014; 175(1):76-87. DOI: 10.1001/jamainternmed.2014.5841. View

Gellad W, Grenard J, Marcum Z . A systematic review of barriers to medication adherence in the elderly: looking beyond cost and regimen complexity. Am J Geriatr Pharmacother. 2011; 9(1):11-23. PMC: 3084587. DOI: 10.1016/j.amjopharm.2011.02.004. View

Williams P, Prabandari Y, Burfeind C, Lefebvre R, LaBresh K . Impact of a Pilot Intervention to Increase Physician-Patient Communication About Stroke Risk in Indonesia. Health Commun. 2016; 31(12):1573-8. DOI: 10.1080/10410236.2015.1082456. View

Guerci B, Chanan N, Kaur S, Jasso-Mosqueda J, Lew E . Lack of Treatment Persistence and Treatment Nonadherence as Barriers to Glycaemic Control in Patients with Type 2 Diabetes. Diabetes Ther. 2019; 10(2):437-449. PMC: 6437240. DOI: 10.1007/s13300-019-0590-x. View

Huang Y, Pecanac K, Shiyanbola O . "Why Am I Not Taking Medications?" Barriers and Facilitators of Diabetes Medication Adherence Across Different Health Literacy Levels. Qual Health Res. 2020; 30(14):2331-2342. DOI: 10.1177/1049732320945296. View

Sapkota S, Brien J, Aslani P . Nepalese patients' perceptions of treatment modalities for type 2 diabetes. Patient Prefer Adherence. 2016; 10:1777-1786. PMC: 5028164. DOI: 10.2147/PPA.S113467. View

Saunders B, Sim J, Kingstone T, Baker S, Waterfield J, Bartlam B . Saturation in qualitative research: exploring its conceptualization and operationalization. Qual Quant. 2018; 52(4):1893-1907. PMC: 5993836. DOI: 10.1007/s11135-017-0574-8. View

Newman T, San-Juan-Rodriguez A, Parekh N, Swart E, Klein-Fedyshin M, Shrank W . Impact of community pharmacist-led interventions in chronic disease management on clinical, utilization, and economic outcomes: An umbrella review. Res Social Adm Pharm. 2020; 16(9):1155-1165. DOI: 10.1016/j.sapharm.2019.12.016. View

Clifford S, Barber N, Horne R . Understanding different beliefs held by adherers, unintentional nonadherers, and intentional nonadherers: application of the Necessity-Concerns Framework. J Psychosom Res. 2007; 64(1):41-6. DOI: 10.1016/j.jpsychores.2007.05.004. View

10.

Carlson O, Martin B, Stote K, Golden E, Maudsley S, Najjar S . Impact of reduced meal frequency without caloric restriction on glucose regulation in healthy, normal-weight middle-aged men and women. Metabolism. 2007; 56(12):1729-34. PMC: 2121099. DOI: 10.1016/j.metabol.2007.07.018. View

11.

Elo S, Kyngas H . The qualitative content analysis process. J Adv Nurs. 2008; 62(1):107-15. DOI: 10.1111/j.1365-2648.2007.04569.x. View

12.

Mohammed M, Moles R, Chen T . Medication-related burden and patients' lived experience with medicine: a systematic review and metasynthesis of qualitative studies. BMJ Open. 2016; 6(2):e010035. PMC: 4746464. DOI: 10.1136/bmjopen-2015-010035. View

13.

Aminde L, Tindong M, Ngwasiri C, Aminde J, Njim T, Fondong A . Adherence to antidiabetic medication and factors associated with non-adherence among patients with type-2 diabetes mellitus in two regional hospitals in Cameroon. BMC Endocr Disord. 2019; 19(1):35. PMC: 6446302. DOI: 10.1186/s12902-019-0360-9. View

14.

Chan A, Cooper V, Lycett H, Horne R . Practical Barriers to Medication Adherence: What Do Current Self- or Observer-Reported Instruments Assess?. Front Pharmacol. 2020; 11:572. PMC: 7237632. DOI: 10.3389/fphar.2020.00572. View

15.

Krass I, Schieback P, Dhippayom T . Adherence to diabetes medication: a systematic review. Diabet Med. 2014; 32(6):725-37. DOI: 10.1111/dme.12651. View

16.

Alqarni A, Alrahbeni T, Qarni A, Qarni H . Adherence to diabetes medication among diabetic patients in the Bisha governorate of Saudi Arabia - a cross-sectional survey. Patient Prefer Adherence. 2019; 13:63-71. PMC: 6309134. DOI: 10.2147/PPA.S176355. View

17.

Roborel de Climens A, Pain E, Boss A, Shaunik A . Understanding Reasons for Treatment Discontinuation, Attitudes and Education Needs Among People Who Discontinue Type 2 Diabetes Treatment: Results from an Online Patient Survey in the USA and UK. Diabetes Ther. 2020; 11(8):1873-1881. PMC: 7376801. DOI: 10.1007/s13300-020-00843-9. View

18.

Aljuraiban G, Chan Q, Oude Griep L, Brown I, Daviglus M, Stamler J . The impact of eating frequency and time of intake on nutrient quality and Body Mass Index: the INTERMAP Study, a Population-Based Study. J Acad Nutr Diet. 2015; 115(4):528-36.e1. PMC: 4380646. DOI: 10.1016/j.jand.2014.11.017. View

19.

Hashimoto K, Urata K, Yoshida A, Horiuchi R, Yamaaki N, Yagi K . The relationship between patients' perception of type 2 diabetes and medication adherence: a cross-sectional study in Japan. J Pharm Health Care Sci. 2019; 5:2. PMC: 6341584. DOI: 10.1186/s40780-019-0132-8. View

20.

Al-Qazaz H, Sulaiman S, Hassali M, Shafie A, Sundram S, Al-Nuri R . Diabetes knowledge, medication adherence and glycemic control among patients with type 2 diabetes. Int J Clin Pharm. 2011; 33(6):1028-35. DOI: 10.1007/s11096-011-9582-2. View