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Review
. 2018 Oct;9(5):1791-1810.
doi: 10.1007/s13300-018-0490-5. Epub 2018 Aug 17.

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  1 , Helen Cooper  2 , John P H Wilding  3
Affiliations
Review

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 et al. Diabetes Ther. 2018 Oct.

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.

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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
See this image and copyright information in PMC

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