Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

ACC 2024 Congress

Catch up on all the top stories and latest evidence in cardiology research with our ACC 2024 Congress hub page.
ADVANCED SEARCH
Log in
Top
BMC Endocrine Disorders
Published in: BMC Endocrine Disorders 1/2016

Open Access 01-12-2016 | Research article

Understanding adherence-related beliefs about medicine amongst patients of South Asian origin with diabetes and cardiovascular disease patients: a qualitative synthesis

Authors: Kanta Kumar, Sheila Greenfield, Karim Raza, Paramjit Gill, Rebecca Stack

Published in: BMC Endocrine Disorders | Issue 1/2016

Login to get access

Abstract

Background

Prevalence of diabetes and cardiovascular (CVD) disease amongst UK South Asians is higher than in the general population. Non-adherence to medicines may lead to poor clinical outcomes for South Asian patients with diabetes and CVD. To understand the decision making processes associated with taking medicines, a qualitative systematic meta-synthesis exploring medicine taking behaviours, and beliefs was undertaken.

Methods

Four databases (Medline, Embase, Science Citation Index and CINAHL) were searched to identify qualitative studies of South Asian patients taking diabetic medicines. Data were thematic coded and synthesised.

Results

The following themes were identified: [1] beliefs about the need for and efficacy of medicines; [2] toxicity of medicines and polypharmacy; [3] the necessity of traditional remedies versus “western medicines”; [4] stigma and social support; and [5] communication.

Conclusions

South Asians described cultural social stigma associated with diabetes and reported fears about drug toxicity as barriers to taking medicines. Cultural beliefs about traditional remedies and interactions with healthcare professionals also appeared to play a role in the way people made decisions about medicines. Advice should be tailored provided to South Asian patients highlighting the long term consequences of diabetes and CVD.
Literature
1.
2.
Matthews DR, Pramming S. Diabetes and the global burden of non-communicable disease. Lancet. 2003;362:1763–4.CrossRefPubMed
3.
Beaglehole R, Yach D. Globalisation and the prevention and control of non-communicable disease: the neglected chronic diseases of adults. Lancet. 2003;362:903–8.CrossRefPubMed
4.
5.
6.
Gill PS, Kai J, Bhopal RS, Wild S. Health care needs assessment: black and minority ethnic groups. In: Raftery J, Stevens A, Mant J, editors. Health care needs assessment, The epidemiologigically based needs assessment reviews, vol. 3rd. Abindon: Radcliffe; 2007. p. 227–399.
7.
World Health Organization. Adherence to long-term therapies-Evidence for action. Geneva: World Health Organisation; 2003. ISBN:924154992
8.
Dimatteo MR. Variations in patients’ adherence to medical recommendations: a quantitative review of 50 years of research. Med Care. 2004;42:200–9.CrossRefPubMed
9.
Ho PM, Rumsfeld JS, Masoudi FA, McClure DL, Plomondon ME, Steiner JF, et al. Effect of medication nonadherence on hospitalization and mortality among patients with diabetes mellitus. Arch Intern Med. 2006;166:1836–41.CrossRefPubMed
10.
Muszbek N, Brixner D, Benedict A, Keskinaslan A, Khan ZM. The economic consequences of noncompliance in cardiovascular disease and related conditions: a literature review. Int J Clin Pract. 2008;62:338–51.CrossRefPubMedPubMedCentral
11.
Horne R, Chapman SC, Parham R, Freemantle N, Forbes A, Cooper V. Understanding patients’ adherence-related beliefs about medicines prescribed for long-term conditions: a meta-analytic review of the necessity-concerns framework. PLoS One. 2013;8:80633.CrossRef
12.
Horne R, Clatworthy J, Polmear A, Weinman J. Do hypertensive patients’ beliefs about their illness and treatment influence medication adherence and quality of life? J Hum Hypertens. 2001;15 Suppl 1:S65–8.PubMed
13.
Centre for Reviews and Dissemination. Systematic Reviews: CRD’s guidance for undertaking reviews in health care. York: University of York; 2008. p. 1–277
14.
15.
Walsh D, Downe S. Meta-synthesis method for qualitative research: a literature review. J Adv Nurs. 2005;50:204–11.CrossRefPubMed
16.
Dixon-Woods M, Fitzpatrick R, Roberts K. Including qualitative research in systematic reviews: opportunities and problems. J Eval Clin Pract. 2001;7:125–33.CrossRefPubMed
17.
Dixon-Woods M, Agarwal S, Jones D, Young B, Sutton A. Synthesising qualitative and quantitative evidence: a review of possible methods. J Health Serv Res Policy. 2005;10:45–53.CrossRefPubMed
18.
Bissell P, May CR, Noyce PR. From compliance to concordance: barriers to accomplishing a re-framed model of health care interactions. Soc Sci Med. 2004;58:851–62.CrossRefPubMed
19.
Keval H. Cultural negotiations in health and illness:the experience of type 2 diabetes among Gujarati-speaking South Asians in England. Divers Health Care. 2009;3:255–65.
20.
Lawton J, Ahmad N, Hallowell N, Hanna L, Douglas M. Perceptions and experiences of taking oral hypoglycaemic agents among people of Pakistani and Indian origin: qualitative study. BMJ. 2005;330:1247.CrossRefPubMedPubMedCentral
21.
Lawton J, Parry O, Peel E, Douglas M. Diabetes service provision: a qualitative study of newly diagnosed Type 2 diabetes patients’ experiences and views. Diabet Med. 2005;22:1246–51.CrossRefPubMed
22.
Lawton J, Ahmad N, Hanna L, Douglas M, Hallowell N. ‘I can’t do any serious exercise’: barriers to physical activity amongst people of Pakistani and Indian origin with Type 2 diabetes. Health Educ Res. 2006;21:43–54.CrossRefPubMed
23.
Lawton J, Ahmad N, Peel E, Hallowell N. Contextualising accounts of illness: notions of responsibility and blame in white and South Asian respondents’ accounts of diabetes causation. Sociol Health Illn. 2007;29:891–906.CrossRefPubMed
24.
Lewis C. Healthcare beliefs of Indian patients living with leg and foot ulcers. Br J Nurs. 2007;16:S22–6.CrossRefPubMed
25.
Meetoo D. Dietary pattern of self-care among Asian and Caucasian diabetic patients. Br J Nurs. 2004;13:1074–8.CrossRefPubMed
26.
Meetoo D, Meetoo L. Explanatory models of diabetes among Asian and Caucasian participants. Br J Nurs. 2005;14:154–9.CrossRefPubMed
27.
Rhodes P, Nocon A. A problem of communication? Diabetes care among Bangladeshi people in Bradford. Health Soc Care Community. 2003;11:45–54.CrossRefPubMed
28.
Rhodes P, Nocon A, Wright J. Access to diabetes services: the experiences of Bangladeshi people in Bradford, UK. Ethn Health. 2003;8:171–88.CrossRefPubMed
29.
Singh H, Cinnirella M, Bradley C. Support systems for and barriers to diabetes management in South Asians and Whites in the UK: qualitative study of patients’ perspectives. BMJ Open. 2012;2(6). doi: 10.1136/bmjopen-2012-001459.
30.
Stack RJ, Elliott RA, Noyce PR, Bundy C. A qualitative exploration of multiple medicines beliefs in co-morbid diabetes and cardiovascular disease. Diabet Med. 2008;25(10):1204–10.CrossRefPubMed
31.
Stone M, Pound E, Pancholi A, Farooqi A, Khunti K. Empowering patients with diabetes: a qualitative primary care study focusing on South Asians in Leicester, UK. Fam Pract. 2005;22:647–52.CrossRefPubMed
32.
Wilkinson E, Randhawa G, Feehally J, Farrington K, Greenwood R, Choi P, et al. A multi-centre qualitative study exploring the experiences of UK South Asian and White diabetic patients referred for renal care. BMC Nephrol. 2012;13:157.CrossRefPubMedPubMedCentral
33.
Galdas PM, Kang HB. Punjabi Sikh patients’ cardiac rehabilitation experiences following myocardial infarction: a qualitative analysis. J Clin Nurs. 2010;19:3134–42.CrossRefPubMed
34.
King KM, Leblanc P, Sanguins J, Mather C. Gender-based challenges faced by older Sikh women as immigrants: recognizing and acting on the risk of coronary artery disease. Can J Nurs Res. 2006;38:16–40.PubMed
35.
Oliffe JL, Grewal S, Bottorff JL, Dhesi J, Bindy H, Kang K, et al. Masculinities, diet and senior Punjabi Sikh immigrant men: food for Western thought? Sociol Health Illn. 2010;32:761–76.CrossRefPubMed
36.
Fagerli RA, Lien ME, Wandel M. Experience of dietary advice among Pakistani-born persons with type 2 diabetes in Oslo. Appetite. 2005;45:295–304.CrossRefPubMed
37.
Rafique G, Shaikh F. Identifying needs and barriers to diabetes education in patients with diabetes. J Pak Med Assoc. 2006;56:347–52.PubMed
38.
Fleming E, Carter B, Pettigrew J. The influence of culture on diabetes self-management: perspectives of Gujarati Muslim men who reside in northwest England. J Clin Nurs. 2008;17:51–9.CrossRefPubMed
39.
Kishore J, Ahmad I, Kaur R, PKM. Beliefs and perceptions about cancers among patients attending radiotherapy OPD in Delhi, India. Asian Pac J Cancer Prev. 2008;9:155–8.PubMed
40.
Bottorff JL, Johnson JL, Bhagat R, Grewal S, Balneaves LG, Clarke H, et al. Beliefs related to breast health practices: the perceptions of South Asian women living in Canada. Soc Sci Med. 1998;47:2075–85.CrossRefPubMed
41.
Bottorff JL, Johnson JL, Bhagat R, Grewal S, Balneaves LG, Hilton BA, et al. Breast health practices and South Asian women. Can Nurse. 1999;95:24–7.PubMed
42.
Griffiths C, Kaur G, Gantley M, Feder G, Hillier S, Goddard J, et al. Influences on hospital admission for asthma in south Asian and white adults: qualitative interview study. BMJ. 2001;323:962–6.CrossRefPubMedPubMedCentral
43.
Jha V, Rathi M, Rathi M. Natural medicines causing acute kidney injury. Semin Nephrol. 2008;28:416–28.CrossRefPubMed
44.
45.
Kumar K, Gordon C, Toescu V, Buckley CD, Horn R, Nightingale PG, et al. Beliefs about medicines in patients with RA and SLE: a comparison between patients of South Asian and White British origin. Rheumatology. 2008;47:690–7.CrossRefPubMed
46.
Kumar K, Raza K, Nightingale P, Horne R, Chapman S, Greenfield S, et al. Determinants of adherence to disease modifying anti-rheumatic drugs in White British and South Asian patients with rheumatoid arthritis: a cross sectional study. BMC Musculoskelet Disord. 2015;16:396.CrossRefPubMedPubMedCentral
47.
Chaturvedi P, Chaturvedi U, Sanyal B. Alternative medicine and cancer patients in less developed countries. Lancet Oncol. 2002;3:10.CrossRefPubMed
48.
Qidwai W, Alim SR, Dhanani RH, Jehangir S, Nasrullah A, Raza A. Use of folk remedies among patients in Karachi Pakistan. J Ayub Med Coll Abbottabad. 2003;15:31–3.PubMed
49.
Ashing-Giwa KT, Padilla G, Tejero J, Kraemer J, Wright K, Coscarelli A, et al. Understanding the breast cancer experience of women: a qualitative study of African American, Asian American, Latina and Caucasian cancer survivors. Psychooncology. 2004;13:408–28.CrossRefPubMedPubMedCentral
50.
Marshall IJ, Wolfe CD, McKevitt C. Lay perspectives on hypertension and drug adherence: systematic review of qualitative research. BMJ. 2012;345:3953.CrossRef
51.
52.
Horne R, Weinman J. Patients’ beliefs about prescribed medicines and their role in adherence to treatment in chronic physical illness. J Psychosom Res. 1999;47:555–67.CrossRefPubMed
53.
Horne R, Weinman J. Self regulation and self management in asthma: exploring the role of illness perceptions and treatment beliefs in explaining non-adherence to preventor medication. Psychol Health. 2002;17:17–32.CrossRef
54.
Cooper V, Gellaitry G, Hankins M, Fisher M, Horne R. The influence of symptom experiences and attributions on adherence to highly active anti-retroviral therapy (HAART): a six-month prospective, follow-up study. AIDS Care. 2009;21:520–8.CrossRefPubMed
55.
Horne R, Parham R, Driscoll R, Robinson A. Patients’ attitudes to medicines and adherence to maintenance treatment in inflammatory bowel disease. Inflamm Bowel Dis. 2009;15:837–44.CrossRefPubMed
Metadata
Title
Understanding adherence-related beliefs about medicine amongst patients of South Asian origin with diabetes and cardiovascular disease patients: a qualitative synthesis
Authors
Kanta Kumar
Sheila Greenfield
Karim Raza
Paramjit Gill
Rebecca Stack
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Endocrine Disorders / Issue 1/2016
Electronic ISSN: 1472-6823
DOI
https://doi.org/10.1186/s12902-016-0103-0

Other articles of this Issue 1/2016

BMC Endocrine Disorders 1/2016 Go to the issue

Reviewer acknowledgement

BMC Endocrine Disorders reviewer acknowledgement 2015

Research article

Obesity and diabetes mellitus association in rural community of Katana, South Kivu, in Eastern Democratic Republic of Congo: Bukavu Observ Cohort Study Results

Case report

Successful every-other-day liothyronine therapy for severe resistance to thyroid hormone beta with a novel THRB mutation; case report

Research article

Pro inflammatory interleukins and thyroid function in Naswar (dipping tobacco) users: a case control study

Research article

The predictive value of sonographic images of follicular lesions – a comparison with nodules unequivocal in FNA – single centre prospective study

Research article

Sulfonylurea use and the risk of hospital readmission in patients with type 2 diabetes

ACC 2024 Congress Coverage

Cardiology Video

Highlights from the ACC 2024 Congress

Watch now

Watch official videos from the ACC congress summarizing key highlights from the last year in heart failure, cardiomyopathies, valvular disease, pulmonary vascular disease, and pediatric cardiology.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits