Obstacles to adherence in living with type-2 diabetes: an international qualitative study using meta-ethnography (EUROBSTACLE) |
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Authors: | Vermeire Etienne Hearnshaw Hilary Rätsep Anneli Levasseur Gwenola Petek Davorina van Dam Henk van der Horst Frans Vinter-Repalust Nevenka Wens Johan Dale Jeremy Van Royen Paul |
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Institution: | Department of General Practice, University of Antwerp, Belgium. etienne.vermeire@ua.ac.be |
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Abstract: | Quantitative studies failed to determine variables which consistently explain adherence or non-adherence to treatment recommendations. Qualitative studies identified issues such as the quality of the health provider-health receiver relationship and the patient's health beliefs. According to these findings, 39 focus groups of 246 people living with type-2 diabetes were conducted in seven European countries, assessing health beliefs, communication with caregivers and problems encountered in adhering to treatment regimens. Meta-ethnography was later applied to make a qualitative meta-analysis. Obstacles to adherence are common across countries, and seem to be related less to issues of the health-care system and more to patient's knowledge about diabetes, beliefs and attitudes and the relationship with health-care professionals. The resulting key themes are course of diabetes, information, person and context, body awareness and relationship with the health care provider. Meta-ethnography is a feasible tool for the meta-analysis of multilingual qualitative data and leads to a richer account. |
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