Sapkota Sujata, Brien Jo-Anne E, Aslani Parisa
a Faculty of Pharmacy , The University of Sydney , Sydney , Australia.
b St. Vincent's Hospital Clinical School , UNSW , Sydney , Australia.
Ethn Health. 2018 Oct;23(7):718-736. doi: 10.1080/13557858.2017.1294659. Epub 2017 Feb 25.
To explore anti-diabetic medication taking behaviour in Nepalese patients with type 2 diabetes and investigate the factors impacting medication taking in this population.
Face-to-face interviews (n = 48) were conducted with Nepalese patients with type 2 diabetes in Sydney (Australia) and Kathmandu (Nepal). All interviews were audio-recorded, transcribed verbatim and thematically analysed. Participants' medication adherence was also assessed quantitatively using the summary of diabetes self-care activity (SDSCA) questionnaire.
The medication taking behaviour of Nepalese participants aligned with the Stages of Change Model, with some notable patterns of behaviour. Most participants initiated and implemented anti-diabetic medications soon after obtaining their prescription. However, a few, delayed initiation and/or ceased medications after initiation to recommence later. Nonetheless, upon recommencement, participants persisted fairly well with their medications. The self-reported medication adherence was high (97.3%). Although some participants expressed adherence as a challenge at the start of therapy, medication taking on a day-to-day basis was not reported as difficult. Factors such as participants' reluctance towards using medications and preference for natural methods of treatment, together with inadequate understanding about diabetes and treatment resulted in the delay in initiating therapy, and contributed to cessation of therapy. On the other hand, ooccasional non-adherence in daily medication taking was mostly related to inconsistency in meal practices and forgetfulness. Encouragement from doctors and increased awareness about the disease and treatment facilitated medication adherence, including initiation of therapy.
This study demonstrates that Nepalese patients are likely to delay or cease anti-diabetic medications until they fully accept and acknowledge the benefits and necessity of medications for effective diabetes management. Thus, educating patients about the need for medications, as well as implementing strategies to address patients' psychological resistance towards medications will be essential for effective medication management.
探讨尼泊尔2型糖尿病患者的抗糖尿病药物服用行为，并调查影响该人群药物服用的因素。
对悉尼（澳大利亚）和加德满都（尼泊尔）的尼泊尔2型糖尿病患者进行了面对面访谈（n = 48）。所有访谈均进行了录音、逐字转录并进行了主题分析。还使用糖尿病自我护理活动总结（SDSCA）问卷对参与者的药物依从性进行了定量评估。
尼泊尔参与者的药物服用行为与行为改变阶段模型相符，有一些显著的行为模式。大多数参与者在拿到处方后不久就开始并服用抗糖尿病药物。然而，少数人延迟开始服药和/或在开始服药后停药，之后又重新开始。尽管如此，重新开始服药后，参与者对药物的坚持情况相当良好。自我报告的药物依从性很高（97.3%）。虽然一些参与者在治疗开始时表示坚持服药是一项挑战，但日常服药并未被报告为困难。参与者对使用药物的抵触情绪、对自然治疗方法的偏好，以及对糖尿病和治疗的理解不足等因素导致治疗开始延迟，并促成了停药。另一方面，日常服药偶尔出现的不依从大多与饮食不规律和遗忘有关。医生的鼓励以及对疾病和治疗的认识提高促进了药物依从性，包括治疗的开始。
本研究表明，尼泊尔患者可能会延迟或停止服用抗糖尿病药物，直到他们完全接受并认识到药物对有效管理糖尿病的益处和必要性。因此，对患者进行药物必要性教育，以及实施应对患者对药物心理抵触的策略，对于有效的药物管理至关重要。
