Factors contributing to medicine-related problems in adult patients with diabetes and/or cardiovascular diseases in Saudi Arabia: a qualitative study (original) (raw)
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Pharmacy
Uncontrolled diabetes is associated with macrovascular and microvascular complications that compromise the quality of life; however, the patients’ perspectives about medication non-adherence are unclear. We aimed to understand patient behavior and explore the barriers to medication adherence in uncontrolled diabetes patients. We employed a qualitative method of face-to-face interviews conducted with adult patients in Saudi Arabia who had uncontrolled diabetes mellitus (glycosylated hemoglobin >7% or fasting blood glucose >7.2 mmol/L). All interviews were audio-recorded and analyzed using thematic analysis. The interviews were conducted for 68 patients. Sixty-seven patients were suffering from Diabetes Mellitus Type 2, and one patient was suffering from Diabetes Mellitus Type 1. We identified the barriers to medication adherence and classified them under six main factors: patients-, medications-, healthcare-, provider-, social-, and disease-related factors. The main barriers id...
Barriers to medication taking among Kuwaiti patients with type 2 diabetes: a qualitative study
Patient Preference and Adherence, 2015
Background: Nonadherence to medications among Kuwaitis with type 2 diabetes mellitus (T2DM) is believed to be a major barrier to appropriate management of the disease. Published studies of barriers to medication adherence in T2DM suggest a Western bias, which may not adequately describe the Kuwaiti experience. Aim: The purpose of this study was to explore barriers to medication adherence among Kuwaiti adults with T2DM. Methods: Semi-structured interviews were conducted with 20 Kuwaiti patients with type 2 diabetes. The interviews were digitally recorded, transcribed, and analyzed using thematic analysis. Results: Barriers to medication adherence were identified. Emerging themes were: 1) lack of education/awareness about diabetes/medications, 2) beliefs about medicines/diabetes, 3) spirituality and God-centered locus of control, 4) attitudes toward diabetes 5) perceptions of self-expertise with the disease and body awareness, 6) social stigma, 7) perceptions of social support, 8) impact of illness on patient's life, 9) perceptions of health care providers' attitudes toward patients, and 10) health system-related factors, such as access difficulties and inequalities of medication supply and services. Conclusion: Personal, sociocultural, religious, health care provider, and health care systemrelated factors may impede medication adherence among Kuwaitis with type 2 diabetes. Interventions to improve care and therapeutic outcomes in this particular population must recognize and attempt to resolve these factors.
Primary Health Care Research & Development, 2013
Aim: This study aimed at exploring the experiences of primary health-care providers of their encounters with patients with type 2 diabetes, and their preferences and suggestions for future improvement of diabetes care. Background: Barriers to good diabetes care could be related to problems from health-care providers' side, patients' side or the healthcare system of the country. Treatment of patients with type 2 diabetes has become a huge challenge in Oman, where the prevalence has increased to high levels. Method: Semistructured interviews were conducted with 26 health-care professionals, 19 doctors and seven nurses, who worked in primary health care in Oman. Qualitative content analysis was applied. Findings: Organizational barriers and barriers related to patients and healthcare providers were identified. These included workload and lack of teamwork approach. Poor patients' management adherence and influence of culture on their attitudes towards illness were identified. From the providers' side, language barriers, providers' frustration and aggressive attitudes towards the patients were reflected. Decreasing the workload, availability of competent teams with diabetes specialist nurses and continuity of care were suggested. Furthermore, changing professional behaviours towards a more patient-centred approach and need for health education to the patients, especially on self-management, were addressed. Appropriate training for health-care providers in communication skills with emphasis on self-care education and individualization of care according to each patient's needs are important for improvement of diabetes care in Oman.
Sultan Qaboos University Medical Journal, 2011
Objectives:The quality of services delivered to type 2 diabetic patients in primary health care has an important impact on long-term outcomes. The aim of this study is to explore diabetic patients’ views of factors affecting quality of diabetic services delivered in primary care in Oman, a developing country with a high burden of diabetes.Methods:Semi-structured face to face interviews were conducted with 19 type 2 diabetic patients recruited from four selected primary healthcare centres (PHCs) in Muscat region, the capital city of Oman. A framework approach was used to analyse the qualitative data.Results:Participants identified several factors which could affect the quality of diabetic services provided in PHCs: delays in the follow-up process; lack of continuity of care; diabetes educational materials unavailable in waiting areas; shortage of Omani nurses able to speak the patients’ language; inadequate explanations from the attending primary care physician (PCP); under involvement of dieticians in patient management; delays in provision of laboratory results; inadequate supplies of diabetic medication between appointments, and long waits to see ophthalmologists.Conclusion:Several factors were identified by diabetic patients that may influence the quality of diabetic services provided in the PHC setting in Oman. Health care professionals and decision makers in the Ministry of Health (MOH) and other health care sectors in Oman should consider patients’ views and concerns in order to improve the quality of diabetic care services in primary health care.
Diabetes management challenges in Iran: A qualitative content analysis
Journal of Nursing Management, 2019
Aim:To explore and analyze diabetes management challenges in the patients visiting a diabetes unit in Iran. Background:Managing a chronic disease like diabetes needs the patients' follow-up and coherent care delivery system.In fact, it requires a systematic and organized care delivery system with skillful and specialist team. Methods: This qualitative research was conducted at a specialized poly-clinic of Isfahan insurance organization in 2016.The research participants were the members of clinic diabetes unit (physician, nurse, secretary, clinic director) and 21 type 2 diabetic patients of the clinic who were selected using purposeful sampling method.Data were collected by semi-structured interviews and analysed using content analysis. Results:The qualitative findings of this research were obtained in two main categories including: 1) weak care delivery system and 2) Defective diabetes self-care. Conclusions:The results of this research have demonstrated that there are system-centered and patient-centered challenges in diabetes management and they can affect the patients' health outcomes. Implications for nursing management:Since diabetes is one of the health system priorities, the findings of this study can be a warning for managers and policy makers to plan seriously to reform diabetes management system infrastructures.
Open Access Macedonian Journal of Medical Sciences, 2019
BACKGROUND: Minimizing the number of therapy failures and decreasing the diabetic complications can be achieved by the application of personalising diabetes therapy, based on patient`s genetics, however, currently, personalised Medicine (PM) in diabetes mellitus management is not extensively applied. AIM: To assess the knowledge, attitudes, and willingness of physicians in practising of PM in diabetes management. METHODS: A cross-sectional analytical study was implemented among 126 physicians from six different governmental hospitals and 12 primary care centres selected by the stratified random sampling technique in the Tabuk region of Saudi Arabia. A structured self-administered questionnaire was utilised for data collection. A simple scoring system (scale of 5 points) was utilised to assess knowledge and willingness. Likert scale was applied to evaluate the attitudes towards practising PM in DM management by the fixed choice response formats. RESULTS: The majority of the participa...
Patient preference and adherence, 2018
To develop an in-depth understanding of the barriers to medication adherence among patients with uncontrolled diabetes attending primary health care (PHC) centers in Qatar by exploring and integrating patients' and health care providers' perspectives. A descriptive qualitative methodology was used in this study. A trained researcher conducted semi-structured face-to-face interviews at two PHC centers. Patients with uncontrolled diabetes (with varied sociodemographic characteristics) and their respective health care providers (physicians, pharmacists, nurses, dieticians, and others) were purposively selected from the two PHC centers. All interviews were audio recorded, transcribed verbatim, and analyzed using thematic content analysis. Thirty interviews (14 patients and 16 health care providers) were conducted. A number of barriers to medication adherence were identified and classified broadly under three main themes: 1) patient-related factors, which included patients' i...
2020
Background. Primary care physicians with an inadequate attitude and practics in managing diabetes may have a detrimental effect on the diabetic patients treated by them. These deficiencies need to be identified so that corrective measures can be planned. Objectives. The aim of the study was to assess the attitude and practices of primary health care physicians of Jeddah City in managing type 2 diabetes mellitus. Material and methods. This is a cross-sectional quantitative study conducted among primary care physicians in Jeddah, Saudi Arabia. A validated and pretested questionnaire was randomly distributed among physicians working in most of the primary healthcare centers for data collection. Formal ethical approval and informed consent from participants was obtained, and confidentiality was maintained. Results. A total of 225 PCPs working in PHCs of Jeddah participated in the study. 143 of them were male, and most were in the age group of 31 to 40 years. 83 PCPs had work experience ...
Quality of diabetes care at Armed Forces Hospital, Southern Region, Kingdom of Saudi Arabia, 2006
Journal of Family and Community Medicine, 2010
Objectives: To assess the current status of care provided by the Diabetes Center at Armed Forces Hospital, Southern Region in the Kingdom of Saudi Arabia. Methods: A total of 260 diabetic patients were randomly selected from those attending the Diabetes Center at Armed Forces Hospital, Southern Region in the Kingdom of Saudi Arabia. Study tools comprised patients' data sheet and patients' interview questionnaire. Results: Two thirds of patients aged 50 years or more. Half of patients had their disease for less than 10 years. Diet therapy alone was followed by 2.3% of diabetic patients. More than half of patients (56.5%) received insulin. Most patients were tested for HbA 1 c at least once per year (88.1%), and 71.5% received their lipid profile at least once within two years. Low indicators included receiving a dilated eye examination (35.4%), assessment for nephropathy (28.8%) and receiving a well-documented foot examination (12.7%). Highest risk HbA 1 c level (>9.5%) was reached by 38.8% of patients, 48.8% had a low density lipoprotein level of <130mg/dL and 36.5% had controlled blood pressure (!9 130/80mmHg). Most patients were satisfied with their interaction with the treating doctor, 41.5% were satisfied with access to treatment. Hypertension was the most frequent comorbidity (38.5%). Conclusions: The quality of services as regard process and outcome is low at the Diabetes Center. The overall diabetic patients' satisfaction is high while their satisfaction with access to treatment or health professionals is low.