title: Obstacles to adherence in living with type-2 diabetes: an international qualitative study using meta-ethnography (EUROBSTACLE).
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.
authors.affiliation: Department of General Practice, University of Antwerp, Belgium. etienne.vermeire@ua.ac.be
authors.forename: Etienne
authors.initials: E
authors.lastname: Vermeire
authors.forename: Hilary
authors.initials: H
authors.lastname: Hearnshaw
authors.forename: Anneli
authors.initials: A
authors.lastname: Rätsep
authors.forename: Gwenola
authors.initials: G
authors.lastname: Levasseur
authors.forename: Davorina
authors.initials: D
authors.lastname: Petek
authors.forename: Henk
authors.initials: H
authors.lastname: van Dam
authors.forename: Frans
authors.initials: F
authors.lastname: van der Horst
authors.forename: Nevenka
authors.initials: N
authors.lastname: Vinter-Repalust
authors.forename: Johan
authors.initials: J
authors.lastname: Wens
authors.forename: Jeremy
authors.initials: J
authors.lastname: Dale
authors.forename: Paul
authors.initials: P
authors.lastname: Van Royen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000884:Anthropology, Cultural / Q000379:methods; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology / Q000523:psychology* / Q000628:therapy; D005060:Europe / Q000208:ethnology; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000523:psychology*; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D011320:Primary Health Care; D036301:Qualitative Research; D011795:Surveys and Questionnaires