&amp;ldquo;I did not want to take that medicine&amp;rdquo;: African-Americans&amp;rsquo; reasons for diabetes medication nonadherence and perceived solutions for enhancing adherence

Shiyanbola, Olayinka O.; Brown, Carolyn M.; Ward, Earlise C.

doi:10.2147/ppa.s152146

Cited by 47 publications

(69 citation statements)

References 59 publications

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“…[ 57 ] In our prior work, AAs’ reasons for intentionally not taking their medicines were associated with their concerns about medication side effects, as well as fear and frustration associated with taking their diabetes medicines. [ 12 ] Managing diabetes is stressful and AAs are fearful and preoccupied with thoughts of future disability, loss of independence, and death. [ 25 , 58 ] Providing behavioral and psychological support that alleviates the distress and emotional toll of diabetes, and offers positive support through family, community and social organizations are needed for AAs with type 2 diabetes.…”

Section: Discussionmentioning

confidence: 99%

“…[ 8 , 9 ] Studies have shown that illness perceptions influence whether patients take their medicines or not, and hence should be taken into account in designing adherence interventions. [ 10 – 12 ] However, AA patients’ perception of type 2 diabetes is not well understood, and to date, no known studies have used a comprehensive evidence-based theoretical framework to explore what AAs with type 2 diabetes know, believe, and think about type 2 diabetes. Moodley et al, 2000, have called for qualitative studies that use comprehensive theories, since these type of studies are limited among AAs.…”

Section: Introductionmentioning

confidence: 99%

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Utilizing the common sense model to explore African Americans’ perception of type 2 diabetes: A qualitative study

2018

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Illness perceptions, which are likely influenced by patients’ cultural contexts, are associated with disease self-management and adherence. African American patients perceptions of type 2 diabetes is not well understood and no known studies has used a comprehensive evidence-based theoretical framework to explore what AAs with type 2 diabetes know, believe, and think about type 2 diabetes. Understanding perceptions of an illness shared by a group of people will be useful in developing culturally-appropriate interventions targeted to the needs of the community. The purpose of this study is to explore African Americans’ perceptions of type 2 diabetes based on the common sense model of illness and self-regulation. Using a phenomenology qualitative approach and purposive sampling, 40 African American men and women, age 45–60 years old with diagnosed type 2 diabetes at least one year prior, and who took at least one prescription diabetes medication, participated in six semi-structured 90-minute focus groups conducted in a private space. Qualitative content analysis was conducted to explore African Americans beliefs about type 2 diabetes. Participants expressed that historical issues, e.g., slavery, healthcare providers, the government, and God influenced how they developed diabetes. Participants reported a loss of autonomy, a change of their identity as an employee, a social individual and sexual person, as well as anger and frustration due to having diabetes. Diabetes made the African American family bonding experience of eating difficult, and the disease diminished their cultural experiences. Concerns about diabetes ranged from fear of death and amputations to the inability to prevent the disease among their children/grandchildren. Participants perceived that medications, faith in God, and positive thinking about survival helped control diabetes. Conclusions: Improved diabetes self-management and medication adherence may depend on the meaning African Americans attach to diabetes, available psychosocial support for managing diabetes, and African Americans experience with diabetes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Utilizing the common sense model to explore African Americans’ perception of type 2 diabetes: A qualitative study

2018

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“…However, a relevant proportion of patients do not stop taking medications because they feel worse but because they feel better. Given the plethora of reasons for intentional nonadherence, an individual approach is necessary to positively modulate adherence in elderly people with PD (31,32). Because many people discontinue medication because of side effects, comprehensive education on side effects and what to do in case of side effects is recommended for every patient.…”

Section: Self-reported Reasons For Nonadherencementioning

confidence: 99%

What Predicts Different Kinds of Nonadherent Behavior in Elderly People With Parkinson's Disease?

et al. 2020

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Background: Detailed knowledge about nonadherence to medication could improve medical care in elderly patients. We aimed to explore patterns and reasons for nonadherence in people with Parkinson's disease (PD) aged 60 years and older. Methods: Detailed clinical data and adherence (German Stendal Adherence with Medication Score) were assessed in 230 patients with PD (without dementia). Descriptive statistics were used to study reasons for nonadherence in detail, and general linear models were used to study associations between clusters of nonadherence and clinical parameters. Results: Overall, 14.2% (n = 32) of the patients were fully adherent, 66.8% (n = 151) were moderately nonadherent, and 19.0% (n = 43) showed clinically meaningful nonadherence. In the multivariable analysis, nonadherence was associated with a lower education level, higher motor impairment in activities of daily living, higher number of medications per day, and motor complications of PD. Three clusters of nonadherence were observed: 59 (30.4%) patients reported intentional nonadherence by medication modification; in 72 (37.1%) patients, nonadherence was associated with forgetting to take medication; and 63 (32.5%) patients had poor knowledge about the prescribed medication. A lower education level was mainly associated with modification of medication and poorer knowledge about prescribed medication, but not with forgetting to take medication. Patients with motor complications, which frequently occur in those with advanced disease stages, tend to be intentionally nonadherent by modifying their prescribed medication. Increased motor problems and a higher total number of drugs per day were associated with less knowledge about the names, reasons, and dosages of their prescribed medication. Conclusions: Elderly patients with PD report many reasons for intentional and non-intentional nonadherence. Understanding the impact of clinical parameters on different patterns of nonadherence may facilitate tailoring of interventions and counseling to improve outcomes.

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“…Fearing medication and fearing side effects are an important issue for treatment non‐adherence (Harrold & Andrade, ). Among hypertension, diabetes and atopic dermatitis patients, this is significantly associated with poor adherence (Al‐Ramahi, ; Patel & Feldman, ; Shiyanbola, Brown, & Ward, ). Hromadkova et al (), in line with our study, could not detect this association in SSc patients.…”

Section: Discussionmentioning

confidence: 99%

Treatment adherence in systemic sclerosis: A cross‐sectional study

Brijs

Arat

Westhovens

et al. 2018

Musculoskeletal Care

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Background: Treatment adherence is an important medical and pharmacoeconomical phenomenon, influenced by multiple variables. Treatment adherence in systemic sclerosis (SSc) has been poorly studied.Objective: The aim of the present study was to assess treatment adherence in SSc patients and to identify factors associated with good and poor adherence. Methods:We conducted a monocentric, cross-sectional, observational study. Treatment adherence was evaluated by the Compliance Questionnaire of Rheumatology (CQR). The necessity of treatment and concerns about treatment were investigated using the Beliefs about Medicines Questionnaire-Specific (BMQ-S). The Illness Perception Questionnaire-Revised (IPQ-R) assessed illness perceptions. Diseaserelated characteristics were collected retrospectively.Results: A total of 66 patients were enrolled in this study. Of these, 47 (71.2%) had a weighted CQR score of ≤80% ("poor adherence") and 19 (28.8%) had a weighted CQR score of >80% ("good adherence"). No significant relationship between demographic, clinical or psychological factors and overall adherence could be found, except with the IPQ subscale "timeline acute/chronic" (p = 0.042). Our patient population estimated the necessity of their medication high (mean necessity score 20.5), with moderate concern beliefs (mean concern score 15.1). Subjective adherence, as selfreported by patients, was high.Conclusions: This study demonstrated low treatment adherence rates in SSc patients. We could not identify demographic, clinical or psychological factors associated with treatment adherence, except with the IPQ subscale "timeline acute/chronic". This suggests a correlation between poor adherence and the belief that the disease will be chronic without improvement over time. Symptom relief was an important motivating factor for taking medication. The treatment necessity was scored higher than treatment concerns, but the necessity beliefs were not associated with adherence.

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“I did not want to take that medicine”: African-Americans’ reasons for diabetes medication nonadherence and perceived solutions for enhancing adherence

Cited by 47 publications

References 59 publications

Utilizing the common sense model to explore African Americans’ perception of type 2 diabetes: A qualitative study

Utilizing the common sense model to explore African Americans’ perception of type 2 diabetes: A qualitative study

What Predicts Different Kinds of Nonadherent Behavior in Elderly People With Parkinson's Disease?

Treatment adherence in systemic sclerosis: A cross‐sectional study

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