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CC BY-NC-ND 4.0 · Journal of Social Health and Diabetes 2019; 7(02): 61-72
DOI: 10.1055/s-0039-3402529
Review Article

Patients’ Experiences of Barriers and Facilitators for Adherence to Type 2 Diabetes Mellitus: A Meta-Ethnography

Subha Gomathy Sridharan
1   Department of Liberal Arts, Indian Institute of Technology Hyderabad, Kandi, Sangareddy District, Telangana, India
,
Mahati Chittem
1   Department of Liberal Arts, Indian Institute of Technology Hyderabad, Kandi, Sangareddy District, Telangana, India
,
Sravannthi Maya
1   Department of Liberal Arts, Indian Institute of Technology Hyderabad, Kandi, Sangareddy District, Telangana, India
› Institutsangaben Funding This research work was funded through a PhD fellowship awarded to the lead author by the Ministry of Human Resource Development, Government of India.
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Abstract

Objectives The main purpose of this article is to synthesize qualitative research exploring experiences of the factors that facilitated and hindered adherence among patients with type 2 diabetes mellitus (T2DM).

Methods Twenty-six qualitative studies were purposefully included in the final sample. The Critical Appraisal Skills Program criteria for quality assessment of the studies was conducted. A meta-ethnographic approach proposed by Noblit and Hare (1988) was employed to analyze the studies. Using the “reciprocal translation” process, the authors searched for and consolidated the common themes.

Results Three major themes were observed: (1) psychological determinants comprising illness beliefs, locus of control, and being forgetful; (2) sociocultural determinants of family and community, culture, and financial aspects; and (3) patients’ relationship with their physicians.

Discussion The meta-ethnography underlines the importance of cultural nuances in the subjective experiences of the barriers and enablers of diabetes adherence. The findings support the need to include qualitative research methods to develop and evaluate interventions to improve T2DM adherence in patients. Clinical implications of this meta-ethnography include engaging in psychoeducation sessions for patients and caregivers, helping set reminders for patients, introducing communication skills training for healthcare providers, and including female caregivers/patients actively in diabetes care.

Keywords

meta-ethnography - adherence - synthesis

1 Search strategy for WoS: Keywords were used to identify publications from 1998 to 2017 through the WoS database. In this way, 42 studies were obtained from WoS. Of these, 31 studies were excluded as they used quantitative methods, mixed methods, and/or used multiple stakeholders (e.g., family, physician, friends) approach. Consequently, 11 qualitative studies were included in the meta-ethnography that were extracted from WoS as they explored patients’ personal accounts of enablers and barriers of T2DM adherence.




Publikationsverlauf

Artikel online veröffentlicht:
30. März 2020

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  • References

  • 1 Shultz JA, Sprague MA, Branen LJ, Lambeth S. A comparison of views of individuals with type 2 diabetes mellitus and diabetes educators about barriers to diet and exercise. J Health Commun 2001; 6 (02) 99-115
    CrossrefPubMedGoogle Scholar
  • 2 Castro-Sánchez AE, Ávila-Ortíz MN. Changing dietary habits in persons living with type 2 diabetes. J Nutr Educ Behav 2013; 45 (06) 761-766
    CrossrefPubMedGoogle Scholar
  • 3 Praet SFE, van Rooij ES, Wijtvliet A. et al. Brisk walking compared with an individualised medical fitness programme for patients with type 2 diabetes: a randomised controlled trial. Diabetologia 2008; 51 (05) 736-746
    CrossrefPubMedGoogle Scholar
  • 4 Vermeire E, Royen PV, Coenen S. et al. The adherence of type 2 diabetes patients to their therapeutic regimen: a qualitative study. Pract Diabetes Int 2003; 20 (06) 209-214
    CrossrefGoogle Scholar
  • 5 Vinter-Repalust N, Petricek G, Katić M. Obstacles which patients with type 2 diabetes meet while adhering to the therapeutic regimen in everyday life: qualitative study. Croat Med J 2004; 45 (05) 630-636
    PubMedGoogle Scholar
  • 6 Vermeire E, Hearnshaw H, Rätsep A. et al. Obstacles to adherence in living with type-2 diabetes: an international qualitative study using meta-ethnography (EUROBSTACLE). Prim Care Diabetes 2007; 1 (01) 25-33
    CrossrefPubMedGoogle Scholar
  • 7 Sohal T, Sohal P, King-Shier KM, Khan NA. Barriers and facilitators for type-2 diabetes management in South Asian: a systematic review. PLoS One 2015; 10 (09) e0136202
    CrossrefPubMedGoogle Scholar
  • 8 Gomersall T, Madill A, Summers LK. A meta-synthesis of the self-management of type 2 diabetes. Qual Health Res 2011; 21 (06) 853-871
    CrossrefPubMedGoogle Scholar
  • 9 Gask L, Macdonald W, Bower P. What is the relationship between diabetes and depression? A qualitative meta-synthesis of patient experience of co-morbidity. Chronic Illn 2011; 7 (03) 239-252
    CrossrefPubMedGoogle Scholar
  • 10 Fleming E, Gillibrand W. An exploration of culture, diabetes, and nursing in the South Asian community: a meta-synthesis of qualitative studies. J Transcult Nurs 2009; 20 (02) 146-155
    CrossrefPubMedGoogle Scholar
  • 11 Chen CM, Chang Yeh M. The experiences of diabetics on self-monitoring of blood glucose: a qualitative meta-synthesis. J Clin Nurs 2015; 24 (5-6) 614-626
    CrossrefPubMedGoogle Scholar
  • 12 Noblit GW, Hare RD. Meta-Ethnography: Synthesizing Qualitative Studies. Neubury Park, California: Sage Publication; 1988
    Google Scholar
  • 13 Britten N, Campbell R, Pope C, Donovan J, Morgan M, Pill R. Using meta ethnography to synthesise qualitative research: a worked example. J Health Serv Res Policy 2002; 7 (04) 209-215
    CrossrefPubMedGoogle Scholar
  • 14 Campbell R, Pound P, Pope C. et al. Evaluating meta-ethnography: a synthesis of qualitative research on lay experiences of diabetes and diabetes care. Soc Sci Med 2003; 56 (04) 671-684
    CrossrefPubMedGoogle Scholar
  • 15 Atkins S, Lewin S, Smith H, Engel M, Fretheim A, Volmink J. Conducting a meta-ethnography of qualitative literature: lessons learnt. BMC Med Res Methodol 2008; 8: 21
    CrossrefPubMedGoogle Scholar
  • 16 Tan PSX, Chen HC, Taylor BJ, Hegney DG. Exploring the meaning of hypoglycaemia to community-dwelling Singaporean Chinese adults living with type 2 diabetes mellitus. Int J Nurs Pract 2012; 18 (03) 252-259
    CrossrefPubMedGoogle Scholar
  • 17 Greenhalgh T, Helman C, Chowdhury AM. Health beliefs and folk models of diabetes in British Bangladeshis: a qualitative study. BMJ 1998; 316 7136 978-983
    CrossrefPubMedGoogle Scholar
  • 18 Peel E, Douglas M, Lawton J. Self monitoring of blood glucose in type 2 diabetes: longitudinal qualitative study of patients’ perspectives. BMJ 2007; 335 7618 493-498
    CrossrefPubMedGoogle Scholar
  • 19 Al-Qazaz HK, Hassali MA, Shafie AA. Syed Sulaiman SA, Sundram S. Perception and knowledge of patients with type 2 diabetes in Malaysia about their disease and medication: a qualitative study. Res Social Adm Pharm 2011; 7 (02) 180-191
    CrossrefPubMedGoogle Scholar
  • 20 Lawton J, Ahmad N, Hallowell N, Hanna L, Douglas M. Perceptions and experiences of taking oral hypoglycaemic agents among people of Pakistani and Indian origin: qualitative study. BMJ 2005; 330 7502 1247
    CrossrefPubMedGoogle Scholar
  • 21 Lai WA, Chie WC, Lew-Ting CY. How diabetic patients’ ideas of illness course affect non-adherent behaviour: a qualitative study. Br J Gen Pract 2007; 57 (537) 296-302
    PubMedGoogle Scholar
  • 22 Sherman LD, McKyer ELJ, Singer JN. et al. Understanding the essence and lived experience of self-care management among African-American men living with type 2 diabetes. J SocHealth Diabetes. 2014; 2 (02) 96
    Google Scholar
  • 23 Lawton J, Peel E, Parry O, Douglas M. Patients’ perceptions and experiences of taking oral glucose-lowering agents: a longitudinal qualitative study. Diabet Med 2008; 25 (04) 491-495
    CrossrefPubMedGoogle Scholar
  • 24 Brown K, Avis M, Hubbard M. Health beliefs of African-Caribbean people with type 2 diabetes: a qualitative study. Br J Gen Pract 2007; 57 (539) 461-469
    PubMedGoogle Scholar
  • 25 Washington G, Wang-Letzkus MF. Self-care practices, health beliefs, and attitudes of older diabetic Chinese Americans. J Health Hum Serv Adm 2009; 32 (03) 305-323
    PubMedGoogle Scholar
  • 26 He W, Zhang Y, Zhao F. Factors influencing exercises in Chinese people with type 2 diabetes. Int Nurs Rev 2013; 60 (04) 494-500
    CrossrefPubMedGoogle Scholar
  • 27 Agarwala S, Ansari A, Paul UK. et al. A qualitative study on non-adherence to oral hypoglycemic agents in type 2 diabetics. IntJ Adv Med. 2017; 4 (04) 1099-1102
    Google Scholar
  • 28 Lawton J, Ahmad N, Hanna L, Douglas M, Hallowell N. ‘I can’t do any serious exercise’: barriers to physical activity amongst people of Pakistani and Indian origin with Type 2 diabetes. Health Educ Res 2006; 21 (01) 43-54
    CrossrefPubMedGoogle Scholar
  • 29 Shakibazadeh E, Larijani B, Shojaeezadeh D, Rashidian A, Forouzanfar M, Bartholomew L. Patients’ perspectives on factors that influence diabetes self-care. Iran J Public Health 2011; 40 (04) 146-158
    PubMedGoogle Scholar
  • 30 Peel E, Parry O, Douglas M, Lawton J. Blood glucose self-monitoring in non-insulin-treated type 2 diabetes: a qualitative study of patients’ perspectives. Br J Gen Pract 2004; 54 (500) 183-188
    PubMedGoogle Scholar
  • 31 Kokanovic R, Manderson L. Exploring doctor-patient communication in immigrant Australians with type 2 diabetes: a qualitative study. J Gen Intern Med 2007; 22 (04) 459-463
    CrossrefPubMedGoogle Scholar
  • 32 Matthews SM, Peden AR, Rowles GD. Patient-provider communication: understanding diabetes management among adult females. Patient Educ Couns 2009; 76 (01) 31-37
    CrossrefPubMedGoogle Scholar
  • 33 Rustveld LO, Pavlik VN, Jibaja-Weiss ML, Kline KN, Gossey JT, Volk RJ. Adherence to diabetes self-care behaviors in English- and Spanish-speaking Hispanic men. Patient Prefer Adherence 2009; 3: 123-130
    PubMedGoogle Scholar
  • 34 Islam SMS, Biswas T, Bhuiyan FA, Mustafa K, Islam A. Patients’ perspective of disease and medication adherence for type 2 diabetes in an urban area in Bangladesh: a qualitative study. BMC Res Notes 2017; 10 (01) 131-139
    CrossrefPubMedGoogle Scholar
  • 35 Mousavizadeh SN, Ashktorab T, Ahmadi F, Zandi M. From negligence to perception of complexities in adherence to treatment process in people with diabetes: A grounded theory Study. Iran J Med Sci 2018; 43 (02) 150-157
    PubMedGoogle Scholar
  • 36 Boonsatean W, Dychawy Rosner I, Carlsson A, Östman M. Women of low socioeconomic status living with diabetes: becoming adept at handling a disease. SAGE Open Med 2015; 3: 2050312115621312
    Google Scholar
  • 37 Paduch A, Kuske S, Schiereck T. et al; Joint Action on Chronic Diseases and Promoting Healthy Ageing across the Life Cycle (JA-CHRODIS). Psychosocial barriers to healthcare use among individuals with diabetes mellitus: a systematic review. Prim Care Diabetes 2017; 11 (06) 495-514
    CrossrefPubMedGoogle Scholar
  • 38 Leventhal H, Brissette I, Leventhal EA. The common-sense model of self-regulation of health and illness. The self-regulation of health and illness behavior 2003; 1: 42-65
    Google Scholar
  • 39 Harvey JN, Lawson VL. The importance of health belief models in determining self-care behaviour in diabetes. Diabet Med 2009; 26 (01) 5-13
    CrossrefPubMedGoogle Scholar
  • 40 Breland JY, McAndrew LM, Burns E, Leventhal EA, Leventhal H. Using the Common Sense Model of Self-regulation to review the effects of self-monitoring of blood glucose on glycemic control for non-insulin-treated adults with type 2 diabetes. Diabetes Educ 2013; 39 (04) 541-559
    CrossrefPubMedGoogle Scholar
  • 41 Phillips LA, Leventhal H, Leventhal EA. Physicians’ communication of the common-sense self-regulation model results in greater reported adherence than physicians’ use of interpersonal skills. Br J Health Psychol 2012; 17 (02) 244-257
    CrossrefPubMedGoogle Scholar
  • 42 Tillotson LM, Smith MS. Locus of control, social support, and adherence to the diabetes regimen. Diabetes Educ 1996; 22 (02) 133-139
    CrossrefPubMedGoogle Scholar
  • 43 Shrestha SS, Shakya R, Karmacharya BM, Thapa P. Medication adherence to oral hypoglycemic agents among type II diabetic patients and their clinical outcomes with special reference to fasting blood glucose and glycosylated hemoglobin levels. Kathmandu Univ Med J (KUMJ) 2013; 11 (43) 226-232
    PubMedGoogle Scholar
  • 44 Jackson IL, Adibe MO, Okonta MJ, Ukwe CV. Medication adherence in type 2 diabetes patients in Nigeria. Diabetes Technol Ther 2015; 17 (06) 398-404
    CrossrefPubMedGoogle Scholar
  • 45 Irvine AA, Saunders JT, Blank MB, Carter WR. Validation of scale measuring environmental barriers to diabetes-regimen adherence. Diabetes Care 1990; 13 (07) 705-711
    PubMedGoogle Scholar
  • 46 Wen LK, Shepherd MD, Parchman ML. Family support, diet, and exercise among older Mexican Americans with type 2 diabetes. Diabetes Educ 2004; 30 (06) 980-993
    CrossrefPubMedGoogle Scholar
  • 47 Ngo-Metzger Q, Sorkin DH, Billimek J, Greenfield S, Kaplan SH. The effects of financial pressures on adherence and glucose control among racial/ethnically diverse patients with diabetes. J Gen Intern Med 2012; 27 (04) 432-437
    CrossrefPubMedGoogle Scholar
  • 48 Schillinger D, Piette J, Grumbach K. et al. Closing the loop: physician communication with diabetic patients who have low health literacy. Arch Intern Med 2003; 163 (01) 83-90
    CrossrefPubMedGoogle Scholar
  • 49 Sridharan SG, Chittem M, Muppavaram N. A review of literature on diabetes self-management: Scope for research and practice in India. J Soc Health Diabetes. 2016; 4 (02) 108-114
    Artikel in Thieme ConnectGoogle Scholar
  • 50 Zamzam S, Anoosheh M, Ahmadi F. Barriers to diabetes control from Syrian women’s perspectives. Jpn J Nurs Sci 2013; 10 (01) 121-129
    CrossrefPubMedGoogle Scholar