Understanding Challenges, Strategies, and the Role of Support Networks in Medication Self-management Among Patients With Type 2 Diabetes.
Purpose The purpose of this qualitative study was to investigate the challenges and strategies of patients with type 2 diabetes mellitus (T2DM) regarding daily management of their medication regimen focusing on the role of their support networks. Methods A purposeful sample of 25 patients with T2DM was recruited from local self-help groups, general practitioner practices, and a university hospital in southwestern Germany. Four semi-structured focus groups were conducted to identify the challenges patients experienced, the strategies they used, and their collaboration with support networks to assist them in self-managing their medication regimen. Sessions were audio- and video-recorded, fully transcribed, and subjected to computer-aided qualitative content analysis, guided by the Self- and Family Management Framework (SFMF). Results Patients with T2DM experienced numerous challenges affecting medication self-management arising from their personal situation, health status and resources, characteristics of their regimen, and how health care is currently organized. Patients' self-initiated strategies included activating health care, community, social, and online resources; taking ownership of medication-related needs; and integrating medication-taking into daily life. Patients drew on self-help groups, family, and friends to discuss concerns regarding medication safety and receive experience-based information and advice for navigating within the health care system as well as practical hands-on support with daily medication self-management. Conclusions Understanding the challenges and building on strategies patients with T2DM devised help diabetes educators to better address patients' needs and priorities and guide patient-centered interventions to support patients' self-management activities. Community and social support networks operating in patients' lives need to be engaged in the self-management support.
Department of General Practice and Health Services Research, University Hospital of Heidelberg, Heidelberg, Germany (Mrs Bernhard, Dr Ose, Dr Baudendistel, Prof Szecsenyi, Prof Wensing, Dr Mahler).
Gerda
G
Bernhard
Department of General Practice and Health Services Research, University Hospital of Heidelberg, Heidelberg, Germany (Mrs Bernhard, Dr Ose, Dr Baudendistel, Prof Szecsenyi, Prof Wensing, Dr Mahler).|Department of Population Health Sciences, Health System Innovation and Research, University of Utah, Salt Lake City, Utah (Dr Ose).
Dominik
D
Ose
Department of General Practice and Health Services Research, University Hospital of Heidelberg, Heidelberg, Germany (Mrs Bernhard, Dr Ose, Dr Baudendistel, Prof Szecsenyi, Prof Wensing, Dr Mahler).
Ines
I
Baudendistel
Cooperation Unit Clinical Pharmacy, University of Heidelberg, Heidelberg, Germany (Dr Seidling, Dr Stützle).|Department of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Heidelberg, Germany (Dr Seidling, Dr Stützle).
Hanna M
HM
Seidling
Cooperation Unit Clinical Pharmacy, University of Heidelberg, Heidelberg, Germany (Dr Seidling, Dr Stützle).|Department of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Heidelberg, Germany (Dr Seidling, Dr Stützle).
Marion
M
Stützle
Department of General Practice and Health Services Research, University Hospital of Heidelberg, Heidelberg, Germany (Mrs Bernhard, Dr Ose, Dr Baudendistel, Prof Szecsenyi, Prof Wensing, Dr Mahler).
Joachim
J
Szecsenyi
Department of General Practice and Health Services Research, University Hospital of Heidelberg, Heidelberg, Germany (Mrs Bernhard, Dr Ose, Dr Baudendistel, Prof Szecsenyi, Prof Wensing, Dr Mahler).
Michel
M
Wensing
Department of General Practice and Health Services Research, University Hospital of Heidelberg, Heidelberg, Germany (Mrs Bernhard, Dr Ose, Dr Baudendistel, Prof Szecsenyi, Prof Wensing, Dr Mahler).
Cornelia
C
Mahler
D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D012648:Self Care / Q000379:methods / Q000523:psychology*; D012657:Self-Help Groups; D000073278:Self-Management / Q000379:methods / Q000523:psychology*; D012944:Social Support
D007004:Hypoglycemic Agents