title: Understanding medication adherence among patients of Turkish descent with type 2 diabetes: a qualitative study.
abstract: OBJECTIVE
  To explore perspectives of Turkish migrants with type 2 diabetes mellitus (T2DM) on adherence to oral hypoglycaemic agents (OHA).
  
  
  METHODS
  In-depth interviews with 21 T2DM patients of Turkish descent recruited from primary care and community sources in Ghent, Belgium, using a theoretical sampling procedure. Analysis was guided by a grounded theory approach, using Nvivo 8.
  
  
  RESULTS
  Respondents reported a multitude of barriers and facilitators of adherence to OHA. Some of these barriers are distinctive for T2DM patients of Turkish descent. Respondents' causal beliefs about stress and the Belgian climate often led to non-adherence during less stressful periods, like summer holidays in Turkey. Some respondents adjusted their medication use to food intake or during Ramadan fasting. Concerns about OHA were the main reason for the widespread use of herbal medicine in this sample. The religious framework used to interpret diabetes led, in combination with feelings of depression, to non-adherence in some respondents while it facilitated medication adherence in others. A potential gender effect with respect to the self-management of OHA was observed. Non-distinctive factors include: beliefs about OHA, polypharmacy, beliefs about the course of diabetes, forgetfulness, the perception of the doctor's medical expertise, feelings of depression and social support.
  
  
  CONCLUSIONS
  Health care providers should explore in detail and regularly patients' perspectives on illness beliefs, medication beliefs and their trust in doctors' medical expertise as this will provide useful starting points for promoting medication adherence. Whenever possible health care workers should engage with their patients in therapeutic alliances.
authors.affiliation: a Pharmaceutical Care Unit , Ghent University , Ghent , Belgium.
authors.forename: Bart
authors.initials: B
authors.lastname: Peeters
authors.forename: Inge
authors.initials: I
authors.lastname: Van Tongelen
authors.forename: Zehra
authors.initials: Z
authors.lastname: Duran
authors.forename: Gülhan
authors.initials: G
authors.lastname: Yüksel
authors.forename: Els
authors.initials: E
authors.lastname: Mehuys
authors.forename: Sara
authors.initials: S
authors.lastname: Willems
authors.forename: Jean Paul
authors.initials: JP
authors.lastname: Remon
authors.forename: Koen
authors.initials: K
authors.lastname: Boussery
mesh_terms: D000328:Adult; D000368:Aged; D001530:Belgium / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005215:Fasting; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007407:Interviews as Topic; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010817:Physician-Patient Relations; D028321:Plant Preparations; D036301:Qualitative Research; D012067:Religion; D012648:Self Care; D014171:Transients and Migrants / Q000523:psychology*; D014421:Turkey / Q000208:ethnology
chemical_list: D007004:Hypoglycemic Agents; D028321:Plant Preparations
keywords: Turkish ethnic minority; immigrant; medication adherence; oral hypoglycaemic agents; qualitative research; type 2 diabetes