Top

Published in:

Open Access 01-10-2018 | Review

Patients’ Perspectives of Oral and Injectable Type 2 Diabetes Medicines, Their Body Weight and Medicine-Taking Behavior in the UK: A Systematic Review and Meta-Ethnography

Authors: Aikaterini Psarou, Helen Cooper, John P. H. Wilding

Published in: Diabetes Therapy | Issue 5/2018

Abstract

The aim of this review is to identify peoples’ perspectives of their glucose-lowering and anti-obesity drugs in relation to diabetes and weight control and to explore how these views affect medication adherence. Theoretical perspectives associated with medicine-taking behavior are also explored. The systematic review was based on a meta-ethnography of qualitative studies identified through a search of 12 medical and social science databases and subsequent citation searches. The quality of all studies was assessed. Sixteen studies were included with data from 360 UK individuals. No relevant studies were identified which focused on anti-obesity and non-insulin injectable drugs. The review revealed that the patients’ perspectives and emotional state were influenced by starting and/or changing to a new glucose-lowering medicine. These were also influenced by prior medication experience, disease perceptions and interactions with clinicians. Despite reports of positive experiences with and positive perceptions of medicines, and of participation in strategies to regain life control, medication non-adherence was common. Accepting glucose-lowering medicines impacted on the individual’s perception of lifestyle changes, and it was notable that weight loss was not perceived as a strategy to support diabetes management. Synthesis revealed that more than one theory is required to explain medicine-taking behavior. New insights into the underlying factors of poor adherence and the specific practical issues identified in this review can help in the development of patient-centered interventions.

Funding: Diabetes UK.

Available only for authorised users

Diabetes UK. Type 2 diabetes and obesity: a heavy burden. London: Diabetes UK; 2005.

Philippe J, Raccah D. Treating type 2 diabetes: how safe are current therapeutic agents? Int J Clin Pract. 2009;63(2):321–32.CrossRefPubMed

Cramer JA. A systematic review of adherence with medications for diabetes. Diabetes Care. 2004;27(5):1218–24. https://doi.org/10.2337/diacare.27.5.1218.CrossRefPubMed

Krass I, Schieback P, Dhippayom T. Adherence to diabetes medication: a systematic review. Diabet Med. 2015;32(6):725–37.CrossRefPubMed

Rucker D, Padwal R, Li SK, Curioni C, Lau DC. Long term pharmacotherapy for obesity and overweight: updated meta-analysis. BMJ. 2007;335(7631):1194–9.CrossRefPubMedPubMedCentral

Haynes RB, Ackloo E, Sahota N, McDonald HP, Yao X. Interventions for enhancing medication adherence. Cochrane Database Syst Rev. 2008;(2):CD000011. https://doi.org/10.1002/14651858.CD000011.pub3.

Vermeire EI, Wens J, Van Royen P, Biot Y, Hearnshaw H, Lindenmeyer A. Interventions for improving adherence to treatment recommendations in people with type 2 diabetes mellitus. Cochrane Database Syst Rev. 2005;(2):CD003638. https://doi.org/10.1002/14651858.CD003638.pub2.

Sapkota S, Brien JA, Greenfield J, Aslani P. A systematic review of interventions addressing adherence to anti-diabetic medications in patients with type 2 diabetes—impact on adherence. PLoS One. 2015;10(2):e0118296.CrossRefPubMedPubMedCentral

Steiner JF, Earnest MA. The language of medication-taking. Ann Intern Med. 2000;132(11):926–30.CrossRefPubMed

10.

Hearnshaw H, Lindenmeyer A. What do we mean by adherence to treatment and advice for living with diabetes? A review of the literature on definitions and measurements. Diabet Med. 2006;23(7):720–8.CrossRefPubMed

11.

Blackburn DF, Swidrovich J, Lemstra M. Non-adherence in type 2 diabetes: practical considerations for interpreting the literature. Patient Prefer Adherence. 2013;7:183.CrossRefPubMedPubMedCentral

12.

Vermeire E, Hearnshaw H, Van Royen P, Denekens J. Patient adherence to treatment: three decades of research. A comprehensive review. J Clin Pharm Ther. 2001;26(5):331–42.CrossRefPubMed

13.

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(6):555–67.CrossRefPubMed

14.

Campbell R, Pound P, Pope C, Britten N, Pill R, Morgan M, Donovan J. Evaluating meta-ethnography: a synthesis of qualitative research on lay experiences of diabetes and diabetes care. Soc Sci Med. 2003;56(4):671–84.CrossRefPubMed

15.

Gomersall T, Madill A, Summers LK. A metasynthesis of the self-management of type 2 diabetes. Qual Health Res. 2011;21(6):853–71.CrossRefPubMed

16.

Nam S, Chesla C, Stotts NA, Kroon L, Janson SL. Barriers to diabetes management: patient and provider factors. Diabetes Res Clin Pract. 2011;93(1):1–9. https://doi.org/10.1016/j.diabres.2011.02.002.CrossRefPubMed

17.

Gherman A, Schnur J, Montgomery G, Sassu R, Veresiu I, David D. How are adherent people more likely to think? A meta-analysis of health beliefs and diabetes self-care. Diabetes Educ. 2011;37(3):392–408.CrossRefPubMed

18.

Odegard PS, Capoccia K. Medication taking and diabetes. Diabetes Educ. 2007;33(6):1014–29.CrossRefPubMed

19.

Peeters B, Van Tongelen I, Boussery K, Mehuys E, Remon JP, Willems S. Factors associated with medication adherence to oral hypoglycaemic agents in different ethnic groups suffering from type 2 diabetes: a systematic literature review and suggestions for further research. Diabet Med. 2011;28(3):262–75.PubMed

20.

Majeed-Ariss R, Jackson C, Knapp P, Cheater FM. A systematic review of research into black and ethnic minority patients’ views on self-management of type 2 diabetes. Health Expect. 2015;18(5):625–42.CrossRefPubMed

21.

Wang HF, Yeh MC. Psychological resistance to insulin therapy in adults with type 2 diabetes: mixed-method systematic review. J Adv Nurs. 2012;68(4):743–57.CrossRefPubMed

22.

Polinski JM, Smith BF, Curtis BH, Seeger JD, Choudhry NK, Connolly JG, Shrank WH. Barriers to insulin progression among patients with type 2 diabetes: a systematic review. Diabetes Educ. 2013;39(1):53–65.CrossRefPubMed

23.

Purnell TS, Joy S, Little E, Bridges JF, Maruthur N. Patient preferences for noninsulin diabetes medications: a systematic review. Diabetes Care. 2014;37(7):2055–62. https://doi.org/10.2337/dc13-2527.CrossRefPubMedPubMedCentral

24.

Brundisini F, Vanstone M, Hulan D, DeJean D, Giacomini M. Type 2 diabetes patients’ and providers’ differing perspectives on medication nonadherence: a qualitative meta-synthesis. BMC Health Serv Res. 2015;15(1):516.CrossRefPubMedPubMedCentral

25.

Garrofe BC, Bjornberg A, Phang AY. Euro diabetes index 2014 report. 2014. Available from: https://old.healthpowerhouse.com/publications/euro-diabetes-index-2014/.

26.

Noblit GW, Hare RD, Hare RD. Meta-ethnography: synthesizing qualitative studies. Thousand Oaks: Sage; 1988.CrossRef

27.

Britten N, Campbell R, Pope C, Donovan J, Morgan M, Pill R. Using meta ethnography to synthesise qualitative research: a worked example. J Health Serv Res Policy. 2002;7(4):209–15.CrossRefPubMed

28.

Pound P, Britten N, Morgan M, Yardley L, Pope C, Daker-White G, Campbell R. Resisting medicines: a synthesis of qualitative studies of medicine taking. Soc Sci Med. 2005;61(1):133–55.CrossRefPubMed

29.

CASP UK. CASP qualitative research checklist. 2010. Available at: http://www.casp-uk.net/checklists. Accessed 1 Apr 2014.

30.

Campbell R, Pound P, Morgan M, Daker-White G, Britten N, Pill R, Yardley L, Pope C, Donovan J. Evaluating meta ethnography: systematic analysis and synthesis of qualitative research. Health Technol Assess. 2012;15:43. https://doi.org/10.3310/hta15430.CrossRef

31.

Holman RR, Farmer AJ, Davies MJ, Levy JC, Darbyshire JL, Keenan JF, Paul SK. Three-year efficacy of complex insulin regimens in type 2 diabetes. N Engl J Med. 2009;361(18):1736–47.CrossRefPubMed

32.

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(7502):1247.CrossRefPubMedPubMedCentral

33.

Lawton J, Peel E, Parry O, Araoz G, Douglas M. Lay perceptions of type 2 diabetes in Scotland: bringing health services back in. Social Sci Med. 2005;60(7):1423–35.CrossRef

34.

Lawton J, Peel E, Parry O, Douglas M. Patients’ perceptions and experiences of taking oral glucose-lowering agents: a longitudinal qualitative study. Diabet Med. 2008;25(4):491–5.CrossRefPubMed

35.

Parry O, Peel E, Douglas M, Lawton J. Issues of cause and control in patient accounts of Type 2 diabetes. Health Educ Res. 2005;21(1):97–107.CrossRefPubMed

36.

Morris JE, Povey RC, Street CG. Experiences of people with type 2 diabetes who have changed from oral medication to self-administered insulin injections. Pract Diabetes. 2005;22(7):239–43.CrossRef

37.

Phillips A. Experiences of patients with type 2 diabetes starting insulin therapy. Nurs Stand. 2007;21(23):35–41.CrossRefPubMed

38.

Khan H, Lasker SS, Chowdhury TA. Prevalence and reasons for insulin refusal in Bangladeshi patients with poorly controlled Type 2 diabetes in East London. Diabet Med. 2008;25(9):1108–11.CrossRefPubMed

39.

Noakes H. Perceptions of black African and African-Caribbean people regarding insulin. J Diabetes Nurs. 2010;14(4):148–56.

40.

Jenkins N, Hallowell N, Farmer AJ, Holman RR, Lawton J. Initiating insulin as part of the treating to target in type 2 diabetes (4-T) trial: an interview study of patients’ and health professionals’ experiences. Diabetes Care. 2010;33(10):2178–80.CrossRefPubMedPubMedCentral

41.

Jenkins N, Hallowell N, Farmer AJ, Holman RR, Lawton J. Participants’ experiences of intensifying insulin therapy during the treating to target in type 2 diabetes (4-T) trial: qualitative interview study. Diabet Med. 2011;28(5):543–8.CrossRefPubMed

42.

Brod M, Alolga SL, Meneghini L. Barriers to initiating insulin in type 2 diabetes patients: development of a new patient education tool to address myths, misconceptions and clinical realities. Patient. 2014;7(4):437–50.CrossRefPubMedPubMedCentral

43.

Patel N, Stone MA, McDonough C, Davies MJ, Khunti K, Eborall H. Concerns and perceptions about necessity in relation to insulin therapy in an ethnically diverse UK population with type 2 diabetes: a qualitative study focusing mainly on people of South Asian origin. Diabet Med. 2015;32(5):635–44.CrossRefPubMed

44.

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(4):851–62.CrossRefPubMed

45.

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(6):647–52.CrossRefPubMed

46.

Brown K, Avis M, Hubbard M. Health beliefs of African-Caribbean people with type 2 diabetes: a qualitative study. Br J Gen Pract. 2007;57(539):461–9.PubMedPubMedCentral

47.

Vermeire E, Hearnshaw H, Rätsep A, Levasseur G, Petek D, van Dam H, van der Horst F, Vinter-Repalust N, Wens J, Dale J, Van Royen P. Obstacles to adherence in living with type-2 diabetes: an international qualitative study using meta-ethnography (EUROBSTACLE). Primary Care Diabetes. 2007;1(1):25–33.CrossRefPubMed

48.

Hood G, Huber J, Gustaffson U, Scambler S, Asimakopoulou K. ‘With age comes wisdom almost always too late’: older adults’ experiences of T2DM. Eur Diabetes Nurs. 2009;6(1):23–8.CrossRef

49.

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

50.

Bower P, Harkness E, Macdonald W, Coventry P, Bundy C, Moss-Morris R. Illness representations in patients with multimorbid long-term conditions: qualitative study. Psychol Health. 2012;27(10):1211–26.CrossRefPubMed

51.

Gordon DR. Embodying illness, embodying cancer. Cult Med Psychiatry. 1990;14(2):275–97.PubMed

52.

Cohen MZ, Tripp-Reimer T, Smith C, Sorofman B, Lively S. Explanatory models of diabetes: patient practitioner variation. Soc Sci Med. 1994;38(1):59–66.CrossRefPubMed

53.

Frank AW. The rhetoric of self-change: illness experience as narrative. Sociol Q. 1993;34(1):39–52.CrossRef

54.

Polonsky WH, Jackson RA. What’s so tough about taking insulin? Addressing the problem of psychological insulin resistance in type 2 diabetes. Clin Diabetes. 2004;22(3):147–50.CrossRef

55.

Rosenstock IM, Strecher VJ, Becker MH. Social learning theory and the health belief model. Health Educ Q. 1988;15(2):175–83.CrossRefPubMed

56.

Polonsky WH, Fisher L, Guzman S, Villa-Caballero L, Edelman SV. Psychological insulin resistance in patients with type 2 diabetes: the scope of the problem. Diabetes Care. 2005;28(10):2543–5.CrossRefPubMed

57.

Horne R, Weinman J, Hankins M. The beliefs about medicines questionnaire: the development and evaluation of a new method for assessing the cognitive representation of medication. Psychol Health. 1999;14(1):1–24.CrossRef

58.

Aikens JE, Nease DE, Nau DP, Klinkman MS, Schwenk TL. Adherence to maintenance-phase antidepressant medication as a function of patient beliefs about medication. Ann Family Med. 2005;3(1):23–30.CrossRef

59.

Kleinman A, Eisenberg L, Good B. Culture, illness, and care: clinical lessons from anthropologic and cross-cultural research. Ann Intern Med. 1978;88(2):251–8.CrossRefPubMed

60.

Bury M. Chronic illness as biographical disruption. Sociol Health Illn. 1982;4(2):167–82.CrossRefPubMed

61.

Leventhal H, Meyer D, Nerenz D. The common sense representation of illness danger. In: Rachman S, editor. Contributions to medical psychology, vol. 2. New York: Pergamon Press; 1980. p. 7–30.

62.

Brown SA. Diabetes and grief. Diabetes Educ. 1985;11(2):53–7.CrossRefPubMed

63.

Ahlström G. Experiences of loss and chronic sorrow in persons with severe chronic illness. J Clin Nurs. 2007;16(3a):76–83.CrossRefPubMed

64.

Savoca MR, Miller CK, Quandt SA. Profiles of people with type 2 diabetes mellitus: the extremes of glycemic control. Soc Sci Med. 2004;58(12):2655–66.CrossRefPubMed

65.

Ockleford E, Shaw RL, Willars J, Dixon-Woods M. Education and self-management for people newly diagnosed with type 2 diabetes: a qualitative study of patients’ views. Chronic Illness. 2008;4(1):28–37.CrossRefPubMed

66.

Haslbeck JW, Schaeffer D. Routines in medication management: the perspective of people with chronic conditions. Chronic Illness. 2009;5(3):184–96. https://doi.org/10.1177/1742395309339873.CrossRefPubMed

67.

Nothwehr F, Stump T. Health-promoting behaviors among adults with type 2 diabetes: findings from the Health and Retirement Study. Prev Med. 2000;30(5):407–14.CrossRefPubMed

68.

Lau DC. Diabetes and weight management. Primary Care Diabetes. 2010;1(4):S24–30.CrossRef

69.

Ross SA, Dzida G, Vora J, Khunti K, Kaiser M, Ligthelm RJ. Impact of weight gain on outcomes in type 2 diabetes. Curr Med Res Opin. 2011;27(7):1431–8.CrossRefPubMed

70.

Davies MJ, Gagliardino JJ, Gray LJ, Khunti K, Mohan V, Hughes R. Real-world factors affecting adherence to insulin therapy in patients with Type 1 or Type 2 diabetes mellitus: a systematic review. Diabet Med. 2013;30(5):512–24.CrossRefPubMed

71.

McSharry J, McGowan L, Farmer AJ, French DP. Perceptions and experiences of taking oral medications for the treatment of Type 2 diabetes mellitus: a systematic review and meta-synthesis of qualitative studies. Diabet Med. 2016;33(10):1330–8.CrossRefPubMed

Title: Patients’ Perspectives of Oral and Injectable Type 2 Diabetes Medicines, Their Body Weight and Medicine-Taking Behavior in the UK: A Systematic Review and Meta-Ethnography
Authors: Aikaterini Psarou
Helen Cooper
John P. H. Wilding
Publication date: 01-10-2018
Publisher: Springer Healthcare
Published in: Diabetes Therapy / Issue 5/2018
Print ISSN: 1869-6953
Electronic ISSN: 1869-6961
DOI: https://doi.org/10.1007/s13300-018-0490-5

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

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

STEP AAG HeroTeaserCollection image/© Tarek / Generated with AI / Stock.adobe.com, ACC 2024 Pediatric and Congenital Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Pulmonary Vascular Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Valvular Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 HF and Cardiomyopathies: Year in Review/© 2024 American College of Cardiology, Woman out walking/© Seventyfour / stock.adobe.com (symbolic image with model), Woman checking smartwatch /© saltdium / stock.adobe.com (symbolic image with model), Cardiac catheterization/© Damian / stock.adobe.com

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 5/2018

Cost-Effectiveness of Insulin Degludec vs. Insulin Glargine U100 in Type 1 and Type 2 Diabetes Mellitus in a UK Setting

A Prospective Cohort Study on the Management of Young Patients with Newly Diagnosed Type 2 Diabetes Using Mobile Medical Applications

SGLT2 Inhibitors in Type 2 Diabetes Management: Key Evidence and Implications for Clinical Practice

Impact of Glucose Measuring Systems and Sample Type on Diagnosis Rates of Diabetes Mellitus

Safety and Efficacy of DPP4 Inhibitor and Basal Insulin in Type 2 Diabetes: An Updated Review and Challenging Clinical Scenarios

Long-Term Effects of Oral Antidiabetic Drugs During Pregnancy on Offspring: A Systematic Review and Meta-analysis of Follow-up Studies of RCTs

Highlights from the ACC 2024 Congress

ACC 2024 Congress Coverage