Abstract
Background Patients’ perspective of diabetes and adherence to its prescribed medications is a significant predictor of glycemic control and overall management of the disease. However, there is a paucity of such information in Bangladesh. This study aimed to explore patients’ perspective of diabetes, their experience of taking oral hypoglycemic medications and explore factors that contribute to medication adherence in patients with type 2 diabetes in Bangladesh.Methods We conducted in-depth face-to-face interviews with 12 type 2 diabetes patients attending a tertiary hospital in Dhaka city between February and March, 2014. Participants were purposively sampled representing different age groups, education levels, years since diagnosis with diabetes, and glycemic status, to achieve maximum variation sampling. All interviews were conducted using a topic guide and were audio-recorded, transcribed verbatim, checked for errors, coded and analyzed by means of a qualitative content analysis framework.ResultsThe data analysis generated rich information on the participants’ knowledge and perception on diabetes, its causes, self-management, medication use, adverse effects of medication use, medication adherence, and impact of diabetes, Although most of the participants demonstrated substantive knowledge on diabetes and its consequences, they also reported numerous misconceptions about the disease. Knowledge on diabetes medication, their appropriate use and side effects was rather poor. Respondents also reported non-compliance to dietary and physical activity advice by their physicians and concerns on diabetes diabetes-induced psychological stress. High cost of medications, concerns over medication side effects and forgetfulness was noted as factors for non-adherence to medication.ConclusionParticipants’ knowledge and perception on diabetes are key factors determining their adherence to medications and, thereby, diabetes management. Healthcare providers should explore to better understand patients’ perspective on diabetes, medication beliefs, identify psychological stress and provide more effective health education interventions to enhance medication adherence.
Highlights
Patients’ perspective of diabetes and adherence to its prescribed medications is a significant predictor of glycemic control and overall management of the disease
Location and participants We conducted a qualitative study based on in-depth interviews with patients with type 2 diabetes attending the outpatient department of the Bangladesh Institute of Health Science (BIHS) hospital in Dhaka, Bangladesh between February and March, 2014
The BIHS hospital is affiliated with the Diabetes Association of Bangladesh (DAB)—the prime agency providing comprehensive diabetes care throughout the country using specialized clinics and hospitals [19]
Summary
Patients’ perspective of diabetes and adherence to its prescribed medications is a significant predictor of glycemic control and overall management of the disease. A recent study conducted on patients with type 2 diabetes attending an urban clinic in the capital city of Dhaka found that almost two-third of the patients had uncontrolled diabetes [10]. Most of these patients were newly diagnosed cases with several co-morbidity. The present study, was designed to address some of these paucity of data issues and aimed at better understanding patients’ perspective on type 2 diabetes and factors underscoring their adherence to diabetes medications in an urban area in Bangladesh
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