Widayanti Anna Wahyuni, Norris Pauline, Heydon Susan, Green James A
School of Pharmacy, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
Faculty of Pharmacy, Universitas Gadjah Mada, Sekip Utara, Yogyakarta, Indonesia.
Int J Clin Pharm. 2020 Feb;42(1):31-39. doi: 10.1007/s11096-019-00933-0. Epub 2019 Nov 7.
Background Medicine-taking behaviour of people in Indonesia is particularly complex because of Indonesia's pluralistic health system, in which public and private medical services co-exist with traditional and alternative treatments. Objective This study aimed to explore medicine-taking behaviours of people with type 2 diabetes in Indonesia. Setting Rural and urban communities in East Nusa Tenggara and West Sumatera Provinces. Method Qualitative study with focus group discussions. Six focus groups, involving 45 diabetes patients, were conducted. The discussions were recorded and transcribed verbatim in the original language. The transcripts were translated into English and analysed for common themes. Main outcome measure People's medicine-taking behaviours after being diagnosed with diabetes. Results Medicine-taking behaviours of diabetes participants aligned with the concept of resistance to medicine taking and a therapeutic decision model. It varied based on individual lay evaluation processes. After being diagnosed, participants commonly took the prescribed medicines for some period. They then self-evaluated the effectiveness of the prescribed medicines. Based on the self-evaluation, patients either continued to take the prescribed medicines or made a variety of changes: they discontinued taking the prescribed medicines, combined or alternated prescribed medicines with traditional medicines, or occasionally took medicines they bought without prescription. Reasons mentioned by participants for choosing traditional medicines including perceived ineffectiveness or side effect of the prescribed-medicines. Long-term medicine taking burdened the participants as the notion of being fed up with taking medicines was frequently mentioned. Problems of inaccessibility of the prescribed-medicines also emerged. Conclusion Diabetes patients' medicine-taking behaviours and their reasons for decision-making need to be acknowledged to improve adherence to medicine. Health professionals should assist patients on how to evaluate effectiveness, manage side effects, and reduce the medicine-related burden.
背景 由于印度尼西亚多元化的卫生系统，该国人们的用药行为尤为复杂，在这一系统中，公共和私人医疗服务与传统及替代疗法并存。目的 本研究旨在探索印度尼西亚2型糖尿病患者的用药行为。地点 东努沙登加拉省和西苏门答腊省的农村和城市社区。方法 采用焦点小组讨论的定性研究方法。开展了6个焦点小组讨论，涉及45名糖尿病患者。讨论内容进行了录音，并逐字逐句转录为原始语言。转录内容被翻译成英文，并分析其中的共同主题。主要观察指标 人们被诊断患有糖尿病后的用药行为。结果 糖尿病参与者的用药行为符合抵制用药观念和治疗决策模型。其行为因个体的外行评估过程而异。被诊断后，参与者通常会在一段时间内服用 prescribed medicines。然后他们会自我评估 prescribed medicines 的疗效。基于自我评估，患者要么继续服用 prescribed medicines，要么做出各种改变：他们停止服用 prescribed medicines，将 prescribed medicines 与传统药物联合或交替使用，或者偶尔服用他们自行购买的非处方药物。参与者提到选择传统药物的原因包括认为 prescribed medicines 无效或有副作用。长期服药给参与者带来负担，因为经常提到厌烦服药的观念。还出现了 prescribed medicines 难以获取的问题。结论 需要认识到糖尿病患者的用药行为及其决策原因，以提高用药依从性。卫生专业人员应协助患者如何评估疗效、管理副作用并减轻与药物相关的负担。
