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Understanding medication adherence among patients of Turkish descent with type 2 diabetes: a qualitative study

Bart Peeters (UGent) , Inge Van Tongelen (UGent) , Zehra Duran (UGent) , Gülhan Yüksel, Els Mehuys (UGent) , Sara Willems (UGent) , Jean Paul Remon (UGent) and Koen Boussery (UGent)
(2015) ETHNICITY & HEALTH. 20(1). p.87-105
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Abstract
Objectives: To explore perspectives of Turkish migrants with type 2 diabetes mellitus (T2DM) on adherence to oral hypoglycaemic agents (OHA). Design: In-depth interviews with 21 T2DM patients of Turkish descent recruited from primary care and community sources in Ghent, Belgium, using a theoretical sampling procedure. Analysis was guided by a grounded theory approach, using Nvivo 8. Results: Respondents reported a multitude of barriers and facilitators of adherence to OHA. Some of these barriers are distinctive for T2DM patients of Turkish descent. Respondents' causal beliefs about stress and the Belgian climate often led to non-adherence during less stressful periods, like summer holidays in Turkey. Some respondents adjusted their medication use to food intake or during Ramadan fasting. Concerns about OHA were the main reason for the widespread use of herbal medicine in this sample. The religious framework used to interpret diabetes led, in combination with feelings of depression, to non-adherence in some respondents while it facilitated medication adherence in others. A potential gender effect with respect to the self-management of OHA was observed. Non-distinctive factors include: beliefs about OHA, polypharmacy, beliefs about the course of diabetes, forgetfulness, the perception of the doctor's medical expertise, feelings of depression and social support. Conclusion: Health care providers should explore in detail and regularly patients' perspectives on illness beliefs, medication beliefs and their trust in doctors' medical expertise as this will provide useful starting points for promoting medication adherence. Whenever possible health care workers should engage with their patients in therapeutic alliances.
Keywords
immigrant, medication adherence, qualitative research, Turkish ethnic minority, oral hypoglycaemic agents, type 2 diabetes, ORAL HYPOGLYCEMIC AGENTS, DIFFERENT ETHNIC-GROUPS, MOROCCAN IMMIGRANTS, HEALTH BELIEFS, RISK-FACTORS, DEPRESSION, PREVALENCE, MELLITUS, METAANALYSIS, NETHERLANDS

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Chicago
Peeters, Bart, Inge Van Tongelen, Zehra Duran, Gülhan Yüksel, Els Mehuys, Sara Willems, Jean Paul Remon, and Koen Boussery. 2015. “Understanding Medication Adherence Among Patients of Turkish Descent with Type 2 Diabetes: a Qualitative Study.” Ethnicity & Health 20 (1): 87–105.
APA
Peeters, Bart, Van Tongelen, I., Duran, Z., Yüksel, G., Mehuys, E., Willems, S., Remon, J. P., et al. (2015). Understanding medication adherence among patients of Turkish descent with type 2 diabetes: a qualitative study. ETHNICITY & HEALTH, 20(1), 87–105.
Vancouver
1.
Peeters B, Van Tongelen I, Duran Z, Yüksel G, Mehuys E, Willems S, et al. Understanding medication adherence among patients of Turkish descent with type 2 diabetes: a qualitative study. ETHNICITY & HEALTH. 2015;20(1):87–105.
MLA
Peeters, Bart, Inge Van Tongelen, Zehra Duran, et al. “Understanding Medication Adherence Among Patients of Turkish Descent with Type 2 Diabetes: a Qualitative Study.” ETHNICITY & HEALTH 20.1 (2015): 87–105. Print.
@article{6940665,
  abstract     = {Objectives: To explore perspectives of Turkish migrants with type 2 diabetes mellitus (T2DM) on adherence to oral hypoglycaemic agents (OHA). 
Design: In-depth interviews with 21 T2DM patients of Turkish descent recruited from primary care and community sources in Ghent, Belgium, using a theoretical sampling procedure. Analysis was guided by a grounded theory approach, using Nvivo 8. 
Results: Respondents reported a multitude of barriers and facilitators of adherence to OHA. Some of these barriers are distinctive for T2DM patients of Turkish descent. Respondents' causal beliefs about stress and the Belgian climate often led to non-adherence during less stressful periods, like summer holidays in Turkey. Some respondents adjusted their medication use to food intake or during Ramadan fasting. Concerns about OHA were the main reason for the widespread use of herbal medicine in this sample. The religious framework used to interpret diabetes led, in combination with feelings of depression, to non-adherence in some respondents while it facilitated medication adherence in others. A potential gender effect with respect to the self-management of OHA was observed. Non-distinctive factors include: beliefs about OHA, polypharmacy, beliefs about the course of diabetes, forgetfulness, the perception of the doctor's medical expertise, feelings of depression and social support. 
Conclusion: Health care providers should explore in detail and regularly patients' perspectives on illness beliefs, medication beliefs and their trust in doctors' medical expertise as this will provide useful starting points for promoting medication adherence. Whenever possible health care workers should engage with their patients in therapeutic alliances.},
  author       = {Peeters, Bart and Van Tongelen, Inge and Duran, Zehra and Y{\"u}ksel, G{\"u}lhan and Mehuys, Els and Willems, Sara and Remon, Jean Paul and Boussery, Koen},
  issn         = {1355-7858},
  journal      = {ETHNICITY \& HEALTH},
  keyword      = {immigrant,medication adherence,qualitative research,Turkish ethnic minority,oral hypoglycaemic agents,type 2 diabetes,ORAL HYPOGLYCEMIC AGENTS,DIFFERENT ETHNIC-GROUPS,MOROCCAN IMMIGRANTS,HEALTH BELIEFS,RISK-FACTORS,DEPRESSION,PREVALENCE,MELLITUS,METAANALYSIS,NETHERLANDS},
  language     = {eng},
  number       = {1},
  pages        = {87--105},
  title        = {Understanding medication adherence among patients of Turkish descent with type 2 diabetes: a qualitative study},
  url          = {http://dx.doi.org/10.1080/13557858.2014.890174},
  volume       = {20},
  year         = {2015},
}

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