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基于2型糖尿病患者经历的抗糖尿病药物依从性的决定因素

The determinants of anti-diabetic medication adherence based on the experiences of patients with type 2 diabetes.

作者信息

Dehdari Laleh, Dehdari Tahereh

机构信息

1Department of Statistics, School of Mathematics Sciences, Yazd University, Yazd, Iran.

2Department of Health Education and Health Promotion, School of Public Health, Iran University of Medical Sciences, Shahid Hemmat Highway, Tehran, Iran.

出版信息

Arch Public Health. 2019 May 16;77:21. doi: 10.1186/s13690-019-0347-z. eCollection 2019.

Abstract

BACKGROUND

The purpose of this study is to explain the experiences of patients with type 2 diabetes (T2DM) about medication adherence.

METHOD

A qualitative content analysis study was conducted at the Institute of Endocrinology and Metabolism Research and Training Center of Firoozgar Academic Hospital, affiliated to Iran University of Medical Sciences in Tehran, Iran during April-June 2017. Twenty-six semi-structured in-depth interviews were conducted with diabetic patients and their families. The participants were asked about their experiences of medication adherence. After the first round of the interviews, content analysis of data started and continued up to the data saturation.

RESULTS

Four main themes including perceived barriers (with 6 subthemes including inadequate knowledge, situational influences, inadequate perceived threat about diabetes, treatment characteristics, personality traits and medication cost), perceived social support (with 3 subthemes including family, doctor and community supports), medication beliefs (with 3 subthemes including belief in the effectiveness of treatment, belief in the more effectiveness of complementary therapies than medication use and prioritizing the use of the pills instead of the insulin injection) and cues to action (with 2 subthemes including internal and external cues to action) emerged as the experiences of the participants in terms of anti-diabetic medications adherence which should be considered in developing medication adherence interventions for the patients with T2DM.

CONCLUSION

The patients with T2DM had more barriers for regular drugs consumption. They had incorrect beliefs about anti-diabetic drugs. In addition, they were in need of abroad support community, surroundings and also health professionals. Health systems should consider medication adherence training to be added to the treatment protocols of the diabetic patients.

摘要

背景

本研究旨在阐释2型糖尿病(T2DM)患者在药物依从性方面的经历。

方法

2017年4月至6月期间,在伊朗德黑兰伊朗医科大学附属菲罗兹加尔学术医院内分泌与代谢研究及培训中心开展了一项定性内容分析研究。对糖尿病患者及其家属进行了26次半结构化深度访谈。询问参与者关于他们药物依从性的经历。第一轮访谈后,开始对数据进行内容分析,并持续至数据饱和。

结果

出现了四个主要主题,包括感知到的障碍(有6个子主题,包括知识不足、情境影响、对糖尿病的感知威胁不足、治疗特征、个性特质和药物成本)、感知到的社会支持(有3个子主题,包括家庭、医生和社区支持)、用药信念(有3个子主题,包括对治疗效果的信念、对补充疗法比药物使用更有效的信念以及优先使用药片而非注射胰岛素)和行动线索(有2个子主题,包括内部和外部行动线索),这些是参与者在抗糖尿病药物依从性方面的经历,在为T2DM患者制定药物依从性干预措施时应予以考虑。

结论

T2DM患者在规律用药方面存在更多障碍。他们对降糖药物有错误认知。此外,他们需要广泛的支持群体、周围环境以及医疗专业人员。卫生系统应考虑在糖尿病患者的治疗方案中增加药物依从性培训。

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