title: Factors related to high and low levels of drug adherence according to patients with type 2 diabetes.
abstract: OBJECTIVE
  Adherence to medication in patients with type 2 diabetes varies widely, yet the factors that influence adherence according to patients are not fully known. The aim of this study is to explore both factors related to high and lower levels of adherence that patients with type 2 diabetes experienced in their medication use.
  
  
  METHODS
  Primary care in the Netherlands.
  
  
  METHODS
  Qualitative, semi-structured interviews were performed in 20 patients with type 2 diabetes. Interviews were audio-taped and transcribed verbatim. Transcripts were coded and analysed using content analysis and constant comparison. Main outcome measure experiences and opinions of patients concerning factors related to high and lower levels of adherence.
  
  
  RESULTS
  Comparable aspects influenced drug adherence in more and less adherent patients. Four aspects that influenced adherence to medication emerged from the interviews: (1) information about the prescribed medication, (2) experience with medication and complications with use, (3) social support for medication behaviour and (4) routines in medication behaviour. Experience with medication and social support for medication behaviour were related to high levels of adherence in some patients, and to lower levels of adherence in others. Complicated medication regimens were mainly related to lower adherence, while social support and routines in medication behaviour were related to higher adherence.
  
  
  CONCLUSIONS
  Routines in medication behaviour were related to higher drug adherence. Patient education should not only address information about the disease and medication, but also more practical issues concerning drug intake. Hence, to improve drug adherence in patients with type 2 diabetes, pharmaceutical care might be aimed at the counselling of patients to organise drug use in their daily schedule.
authors: Department of Clinical Pharmacology and Pharmacy, VU University Medical Center, De Boelelaan 1117, 1081HV, Amsterdam, The Netherlands. s.borgsteede@gmail.com
authors: Sander D
authors: SD
authors: Borgsteede
authors: Marjan J
authors: MJ
authors: Westerman
authors: Irene L
authors: IL
authors: Kok
authors: Joke C
authors: JC
authors: Meeuse
authors: Theo P G M
authors: TP
authors: de Vries
authors: Jacqueline G
authors: JG
authors: Hugtenburg
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D010353:Patient Education as Topic; D011320:Primary Health Care / Q000706:statistics & numerical data; D012944:Social Support; D011795:Surveys and Questionnaires