Disclosure of Herbal Medicine Usage in Diabetes Management: A Qualitative Study amongst Type 2 Diabetes Mellitus Patients and Health Care Providers in Negeri Sembilan, Malaysia

Abstract

The use of herbal medicine (HM) and its products has significantly increased in the past decade. Type 2 Diabetes mellitus patients (T2DM) are always rendering herbal medicine as an alternative to the current option of treatment to manage their disease. This article is aimed to explore the extent of communication process of patients who disclose their HM usage to healthcare providers (HCPs) and HCP’s experiences in managing these patients. Purposive sampling method was applied in this qualitative study, which involved 28 respondents from four government clinics in Negeri Sembilan, Malaysia. A semi-structured interview was developed for the in-depth interview (IDI) and focus group interview (FGD). Both IDIs and FGDs were audio-recorded and conducted for approximately (40–60) minutes. The contents were transcribed verbatim and thematically analysed. The majority of T2DM patients did not reveal their HM usage due to fear of negative feedback, never been inquired by HCP and bad experiences after disclosure. Whereas, patients will disclose if they have a good rapport with HCPs and HCP asked patients courteously. However, HCPs reported that they did not discuss HM usage with patients due to limited knowledge, patients refuse to admit and time constraint to consult patients. Communication between T2DM patients and HCPs during consultation concerning the proper use of HM alongside modern medicine needs to be improved. Therefore, a better understanding factor of HM usage and its disclosure would make patients more open-minded to discuss and encourage HCPs to be attentive to avoid any potential adverse effects in HM usage.

Allopathic medicine practitioners’ experiences with non-disclosure of traditional medicine use

“…In a recent study about the usage of TM and AM in healthcare facilities, it was discovered that patients lacked adequate engagement and were afraid of AMPs (Mokhesi & Modjadji 2022 ). Furthermore, bad interactions between patients and AMPs may lead to the patients feeling pitiful, frightened, and demoralised at the same time (Amirudin et al 2021 ). Hence, AMPs need to enhance their communication with patients as their negative responses are the main drivers of the fear the patients have for them (Hajj et al 2020 ; Amirudin et al 2021 ).To improve communication between AMPs and patients about TM use, AMPs must consider the likelihood of their patients using TM and be objective in their interactions with these patients during a consultation (James et al 2018 ).…”

“…Furthermore, bad interactions between patients and AMPs may lead to the patients feeling pitiful, frightened, and demoralised at the same time (Amirudin et al 2021). Hence, AMPs need to enhance their communication with patients as their negative responses are the main drivers of the fear the patients have for them (Hajj et al 2020;Amirudin et al 2021).…”

“…Literature underscores that disclosure hinders AMPs' negative attitudes, perceived lack of support, unpleasant interactions and behaviours, mistrust, and stigma (James et al 2018;Kelak et al 2018). This, in turn, may lead to detrimental effects for AMPs emanating from the bad experience of patients with AMPs (Amirudin et al 2021;Logiel et al 2021). Patients who have had bad encounters where AMPs have abused them would not effectively need to return to the same facility for any benefit and would go for TM (Logiel et al 2021) Traditional medicine is timeless and has formed a significant part of the healthcare system in Africa long before AM was established (Mothibe & Sibanda 2019).…”

Topic: Facilitating disclosure of traditional medicine use to Allopathic Medicine Practitioners: A case study in Gauteng

“…Furthermore, they should create a conducive environment, AMPs should respect their patients' beliefs about TM and be aware of the implications of not disclosing its use during consultations [11]. Previous studies found that AMPs can facilitate this dialogue by asking direct questions which can elicit numerous reasons for non-disclosure [12,13]. Undoubtedly, discussing their TM usage with the AMPs is crucial for the overall well-being of these patients.…”

Allopathic Medicine Practitioners’ perspectives on facilitating disclosure of traditional medicine use in Gauteng, South Africa: a qualitative study

“…Furthermore, they should create a conducive environment, AMPs should respect their patients’ beliefs about TM use and be aware of the implications of not disclosing its use during consultations [ 15 ]. Previous studies found that AMPs can facilitate this dialogue by asking direct questions which can elicit numerous reasons for non-disclosure [ 12 , 16 ]. Undoubtedly, discussing their TM usage with the AMPs is crucial for the overall well-being of these patients.…”