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Medicine taking behaviours of people with type 2 diabetes in Indonesia: a qualitative study

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Abstract

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.

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Acknowledgements

This work was supported by New Zealand ASEAN Scholars Awards, and was undertaken within the School of Pharmacy, University of Otago. The authors wish to acknowledge the participants, the health professionals in Puskesmas in study locations, research assistants, and translators.

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There was no specific funding source for this study.

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Authors and Affiliations

  1. School of Pharmacy, University of Otago, PO Box 56, Dunedin, 9054, New Zealand

    Anna Wahyuni Widayanti, Pauline Norris, Susan Heydon & James A. Green

  2. Faculty of Pharmacy, Universitas Gadjah Mada, Sekip Utara, Yogyakarta, Indonesia

    Anna Wahyuni Widayanti

  3. School of Allied Health and Physical Activity for Health Cluster, University of Limerick, Limerick, V94 T9PX, Ireland

    James A. Green

  4. Health Research Institute (HRI), University of Limerick, Limerick, Ireland

    James A. Green

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  1. Anna Wahyuni Widayanti
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Correspondence to Anna Wahyuni Widayanti.

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Widayanti, A.W., Norris, P., Heydon, S. et al. Medicine taking behaviours of people with type 2 diabetes in Indonesia: a qualitative study. Int J Clin Pharm 42, 31–39 (2020). https://doi.org/10.1007/s11096-019-00933-0

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