Exploring perceptions, attitudes and beliefs of Thai patients with type 2 diabetes mellitus as they relate to medication adherence at an out-patient primary care clinic in Chiang Mai, Thailand
Exploring perceptions, attitudes and beliefs of Thai patients with type 2 diabetes mellitus as they relate to medication adherence at an out-patient primary care clinic in Chiang Mai, Thailand
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DOI：
10.1186/s12875-020-01233-7
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发表时间：
2020-08-21
影响因子：
2.9
通讯作者：
Angkurawaranon, Chaisiri
中科院分区：
文献类型：
--
作者：
Jiraporncharoen, Wichuda;Pinyopornpanish, Kanokporn;Angkurawaranon, Chaisiri
背景在糖尿病自我管理的范围内，非常重视药物依从性。关于药物依从性的思考已经发生了转变，从“依从性”和历史上的家长式护理模式转变为寻求更好的方法来表征决定药物依从性和糖尿病控制的动态和复杂的关系。本研究旨在了解患者的态度和药物依从性之间的关系，口服抗糖尿病药物在泰国。方法对2016年5月至12月期间在清迈大学家庭医学系门诊接受口服降糖药治疗的2型糖尿病患者进行深入访谈。主题分析遵循世界卫生组织慢性病药物治疗依从性框架，探讨患者的态度及其对药物治疗依从性的影响。结果24例患者中男性9例。平均年龄为62岁（SD 8.9岁）。67%的人有很高的依从性。影响服药依从性的重要因素包括对疾病的态度、对治疗的态度、对家庭支持的态度和对医疗团队的态度。具体而言，诊断时的症状、对服药的理解和接受程度、家庭支持的存在以及医生的关注感与改善服药依从性有关。结论泰国糖尿病患者的药物依从性需要来自医疗保健提供者和家庭的支持。病人对医生关心的看法使病人对医疗保健团队产生更大的信任。这种信任，沿着家人的支持，有助于加深患者对疾病的理解，接受其疾病的慢性性质，并产生积极的服药态度，从而提高服药依从性。
Background Within the sphere of diabetes self-management, much emphasis has been placed on medication adherence. There has been a shift in thinking about medication adherence, moving from "compliance" and historically paternalistic models of care, to seeking better ways of characterizing dynamic and complex relationships that determine medication adherence and diabetes control. This study sought to understand the relationship between patient's attitudes and medication adherence for oral anti-diabetics in Thailand. Methods In-depth interviews of patients with type 2 diabetes mellitus, taking oral anti-diabetic drugs, at the out-patient clinic run by the Department of Family Medicine, Chiang Mai University between May and December 2016. Thematic analysis followed the WHO framework for medication adherence in chronic disease to explore patient's attitudes and their influence on medication compliance. Results Of 24 patients, 9 were men. The mean age was 62 years (SD 8.9 years). 67% had high compliance. Four themes were identified as important factors related to medication adherence: attitudes toward disease, attitudes toward treatment, attitudes toward family support and attitudes toward health care team. Specifically, symptoms at diagnosis, understanding and acceptance in taking medication, the presence of family support and the perception of concern by the doctor relate to improved medication compliance. Conclusions Medication adherence in Thai patients with diabetes requires support from both the health care providers and the family. The patient's perception of the doctor's concern creates greater patient trust in the health care team. This trust, along with family support, helps deepen patients' understanding of the disease, accept the chronic nature of their disease, and engenders a positive attitude towards taking medication that can improve medication adherence.