The adherence of type 2 diabetes patients to their therapeutic regimens: a qualitative study from the patient's perspective

Abstract

AbstractIn chronic diseases such as type 2 diabetes, adherence to treatment is a major public health problem, seriously undercutting the benefits of medical care. Many studies have assessed factors associated with compliance, but the patient perspective is remarkably absent. From these studies, it seems that the patient's role in the process of adhering was to be passive and since the prescriber's view was rational and based on scientific research, it may have been assumed to be superior to the patient's beliefs and wishes. This paper reports on type 2 diabetes patients' health beliefs in relation to their illness, their communication with caregivers and the problems encountered in adhering to treatment regimens.Seven focus groups were held for type 2 diabetes patients recruited by pharmacists in primary care in Flanders, Belgium. These groups focussed on participants' experience of their treatment. Possible explanatory models were generated by qualitative content analysis of the focus group discussions.Forty‐six patients recruited from primary care participated in six semi‐structured group discussions. The data demonstrate that health beliefs, the quality of doctor/patient communication, and the quality of the information patients receive are important factors for patient adherence to treatment. Possible explanatory models for adherence emerged, relating to knowledge of the illness, body awareness and the doctor/patient relationship.This qualitative research identified explanatory models for adhering to medical treatment from the patient's perspective. Interventions designed to enhance adherence should address the patient perspective using these models in order to maximise effectiveness. Copyright © 2003 John Wiley & Sons, Ltd.