title: Understanding adherence-related beliefs about medicine amongst patients of South Asian origin with diabetes and cardiovascular disease patients: a qualitative synthesis.
abstract: BACKGROUND
  Prevalence of diabetes and cardiovascular (CVD) disease amongst UK South Asians is higher than in the general population. Non-adherence to medicines may lead to poor clinical outcomes for South Asian patients with diabetes and CVD. To understand the decision making processes associated with taking medicines, a qualitative systematic meta-synthesis exploring medicine taking behaviours, and beliefs was undertaken.
  
  
  METHODS
  Four databases (Medline, Embase, Science Citation Index and CINAHL) were searched to identify qualitative studies of South Asian patients taking diabetic medicines. Data were thematic coded and synthesised.
  
  
  RESULTS
  The following themes were identified: [1] beliefs about the need for and efficacy of medicines; [2] toxicity of medicines and polypharmacy; [3] the necessity of traditional remedies versus "western medicines"; [4] stigma and social support; and [5] communication.
  
  
  CONCLUSIONS
  South Asians described cultural social stigma associated with diabetes and reported fears about drug toxicity as barriers to taking medicines. Cultural beliefs about traditional remedies and interactions with healthcare professionals also appeared to play a role in the way people made decisions about medicines. Advice should be tailored provided to South Asian patients highlighting the long term consequences of diabetes and CVD.
authors.affiliation: Primary Care Clinical Sciences, University of Birmingham, Birmingham, B15 2TT, UK.|Faculty of Medical and Human Sciences, University of Manchester, Manchester, M13 9PL, UK.
authors.forename: Kanta
authors.initials: K
authors.lastname: Kumar
authors.affiliation: Primary Care Clinical Sciences, University of Birmingham, Birmingham, B15 2TT, UK.
authors.forename: Sheila
authors.initials: S
authors.lastname: Greenfield
authors.affiliation: Centre for Translational Inflammation Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, B15 2TT, UK.|Rheumatology Department, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, B18 7QH, UK.
authors.forename: Karim
authors.initials: K
authors.lastname: Raza
authors.affiliation: Primary Care Clinical Sciences, University of Birmingham, Birmingham, B15 2TT, UK. p.s.gill@bham.ac.uk.
authors.forename: Paramjit
authors.initials: P
authors.lastname: Gill
authors.affiliation: Centre for Translational Inflammation Research, The School of Immunity and Infection, University of Birmingham, Birmingham, B15 2TT, UK.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Stack
mesh_terms: D044466:Asian People / Q000523:psychology*; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000523:psychology*; D003920:Diabetes Mellitus / Q000188:drug therapy / Q000523:psychology*; D006801:Humans; D008519:Medicine, Traditional / Q000523:psychology; D010342:Patient Acceptance of Health Care / Q000523:psychology; D010349:Patient Compliance / Q000523:psychology*; D057545:Social Stigma; D012944:Social Support; D006113:United Kingdom
keywords: Adherence; Cardiovascular disease; Diabetes; Ethnicity; Meta-synthesis; South Asian