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

Aikaterini Psarou, Helen Cooper, John P H Wilding, Aikaterini Psarou, Helen Cooper, John P H Wilding

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.

Keywords: Medication adherence; Meta-ethnography; Patient perspectives; Systematic review; Type 2 diabetes medicines; Weight loss.

Figures

Fig. 1
Fig. 1
Seven-step meta-ethnography [26]
Fig. 2
Fig. 2
Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) flowchart
Fig. 3
Fig. 3
Medicine map-reciprocal synthesis. OGLD Oral glucose-lowering drug, HbA1c glycated hemoglobin, T2DM type 2 diabetes mellitus
Fig. 4
Fig. 4
Line-of-argument synthesis. HPs Health professionals

References

    1. Diabetes UK. Type 2 diabetes and obesity: a heavy burden. London: Diabetes UK; 2005.
    1. Philippe J, Raccah D. Treating type 2 diabetes: how safe are current therapeutic agents? Int J Clin Pract. 2009;63(2):321–332. doi: 10.1111/j.1742-1241.2008.01980.x.
    1. Cramer JA. A systematic review of adherence with medications for diabetes. Diabetes Care. 2004;27(5):1218–1224. doi: 10.2337/diacare.27.5.1218.
    1. Krass I, Schieback P, Dhippayom T. Adherence to diabetes medication: a systematic review. Diabet Med. 2015;32(6):725–737. doi: 10.1111/dme.12651.
    1. Rucker D, Padwal R, Li SK, Curioni C, Lau DC. Long term pharmacotherapy for obesity and overweight: updated meta-analysis. BMJ. 2007;335(7631):1194–1199. doi: 10.1136/bmj.39385.413113.25.
    1. Haynes RB, Ackloo E, Sahota N, McDonald HP, Yao X. Interventions for enhancing medication adherence. Cochrane Database Syst Rev. 2008;(2):CD000011. 10.1002/14651858.CD000011.pub3.
    1. 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. 10.1002/14651858.CD003638.pub2.
    1. 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. doi: 10.1371/journal.pone.0118296.
    1. Steiner JF, Earnest MA. The language of medication-taking. Ann Intern Med. 2000;132(11):926–930. doi: 10.7326/0003-4819-132-11-200006060-00026.
    1. 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):720–728. doi: 10.1111/j.1464-5491.2005.01783.x.
    1. Blackburn DF, Swidrovich J, Lemstra M. Non-adherence in type 2 diabetes: practical considerations for interpreting the literature. Patient Prefer Adherence. 2013;7:183. doi: 10.2147/PPA.S30613.
    1. 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):331–342. doi: 10.1046/j.1365-2710.2001.00363.x.
    1. 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):555–567. doi: 10.1016/S0022-3999(99)00057-4.
    1. 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):671–684. doi: 10.1016/S0277-9536(02)00064-3.
    1. Gomersall T, Madill A, Summers LK. A metasynthesis of the self-management of type 2 diabetes. Qual Health Res. 2011;21(6):853–871. doi: 10.1177/1049732311402096.
    1. 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. doi: 10.1016/j.diabres.2011.02.002.
    1. 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. doi: 10.1177/0145721711403012.
    1. Odegard PS, Capoccia K. Medication taking and diabetes. Diabetes Educ. 2007;33(6):1014–1029. doi: 10.1177/0145721707308407.
    1. 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):262–275.
    1. 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):625–642. doi: 10.1111/hex.12080.
    1. 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):743–757. doi: 10.1111/j.1365-2648.2011.05853.x.
    1. 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. doi: 10.1177/0145721712467696.
    1. Purnell TS, Joy S, Little E, Bridges JF, Maruthur N. Patient preferences for noninsulin diabetes medications: a systematic review. Diabetes Care. 2014;37(7):2055–2062. doi: 10.2337/dc13-2527.
    1. 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. doi: 10.1186/s12913-015-1174-8.
    1. Garrofe BC, Bjornberg A, Phang AY. Euro diabetes index 2014 report. 2014. Available from: .
    1. Noblit GW, Hare RD, Hare RD. Meta-ethnography: synthesizing qualitative studies. Thousand Oaks: Sage; 1988.
    1. 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):209–215. doi: 10.1258/135581902320432732.
    1. 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):133–155. doi: 10.1016/j.socscimed.2004.11.063.
    1. CASP UK. CASP qualitative research checklist. 2010. Available at: . Accessed 1 Apr 2014.
    1. 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. doi: 10.3310/hta15430.
    1. 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):1736–1747. doi: 10.1056/NEJMoa0905479.
    1. 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. doi: 10.1136/bmj.38460.642789.E0.
    1. 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):1423–1435. doi: 10.1016/j.socscimed.2004.08.013.
    1. 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):491–495. doi: 10.1111/j.1464-5491.2008.02400.x.
    1. 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. doi: 10.1093/her/cyh044.
    1. 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):239–243. doi: 10.1002/pdi.829.
    1. Phillips A. Experiences of patients with type 2 diabetes starting insulin therapy. Nurs Stand. 2007;21(23):35–41. doi: 10.7748/ns.21.23.35.s54.
    1. 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):1108–1111. doi: 10.1111/j.1464-5491.2008.02538.x.
    1. Noakes H. Perceptions of black African and African-Caribbean people regarding insulin. J Diabetes Nurs. 2010;14(4):148–156.
    1. 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):2178–2180. doi: 10.2337/dc10-0494.
    1. 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):543–548. doi: 10.1111/j.1464-5491.2010.03200.x.
    1. 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):437–450. doi: 10.1007/s40271-014-0068-x.
    1. 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):635–644. doi: 10.1111/dme.12648.
    1. 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):851–862. doi: 10.1016/S0277-9536(03)00259-4.
    1. 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):647–652. doi: 10.1093/fampra/cmi069.
    1. 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):461–469.
    1. 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. doi: 10.1016/j.pcd.2006.07.002.
    1. 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):23–28. doi: 10.1002/edn.128.
    1. 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):1204–1210. doi: 10.1111/j.1464-5491.2008.02561.x.
    1. 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):1211–1226. doi: 10.1080/08870446.2012.662973.
    1. Gordon DR. Embodying illness, embodying cancer. Cult Med Psychiatry. 1990;14(2):275–297.
    1. 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. doi: 10.1016/0277-9536(94)90300-X.
    1. Frank AW. The rhetoric of self-change: illness experience as narrative. Sociol Q. 1993;34(1):39–52. doi: 10.1111/j.1533-8525.1993.tb00129.x.
    1. 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):147–150. doi: 10.2337/diaclin.22.3.147.
    1. Rosenstock IM, Strecher VJ, Becker MH. Social learning theory and the health belief model. Health Educ Q. 1988;15(2):175–183. doi: 10.1177/109019818801500203.
    1. 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):2543–2545. doi: 10.2337/diacare.28.10.2543.
    1. 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. doi: 10.1080/08870449908407311.
    1. 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. doi: 10.1370/afm.238.
    1. Kleinman A, Eisenberg L, Good B. Culture, illness, and care: clinical lessons from anthropologic and cross-cultural research. Ann Intern Med. 1978;88(2):251–258. doi: 10.7326/0003-4819-88-2-251.
    1. Bury M. Chronic illness as biographical disruption. Sociol Health Illn. 1982;4(2):167–182. doi: 10.1111/1467-9566.ep11339939.
    1. Leventhal H, Meyer D, Nerenz D. The common sense representation of illness danger. In: Rachman S, editor. Contributions to medical psychology. New York: Pergamon Press; 1980. pp. 7–30.
    1. Brown SA. Diabetes and grief. Diabetes Educ. 1985;11(2):53–57. doi: 10.1177/014572178501100211.
    1. Ahlström G. Experiences of loss and chronic sorrow in persons with severe chronic illness. J Clin Nurs. 2007;16(3a):76–83. doi: 10.1111/j.1365-2702.2006.01580.x.
    1. 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):2655–2666. doi: 10.1016/j.socscimed.2003.09.031.
    1. 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. doi: 10.1177/1742395307086673.
    1. Haslbeck JW, Schaeffer D. Routines in medication management: the perspective of people with chronic conditions. Chronic Illness. 2009;5(3):184–196. doi: 10.1177/1742395309339873.
    1. 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):407–414. doi: 10.1006/pmed.2000.0658.
    1. Lau DC. Diabetes and weight management. Primary Care Diabetes. 2010;1(4):S24–S30. doi: 10.1016/S1751-9918(10)60006-X.
    1. 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):1431–1438. doi: 10.1185/03007995.2011.585396.
    1. 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):512–524. doi: 10.1111/dme.12128.
    1. 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):1330–1338. doi: 10.1111/dme.13152.

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