title: Ethiopian patients' perceptions of anti-diabetic medications: implications for diabetes education.
abstract: BACKGROUND
  The purpose of this study is to explore medication-related perceptions of adult patients with type 2 diabetes attending treatment in public hospitals of urban centers in central Ethiopia.
  
  
  METHODS
  Qualitative in-depth interviews were held with 39 participants selected to represent a range of treatment experiences and socio-demographic characteristics who were attending their treatment in 3 public hospitals. Interviews continued until key themes were saturated. The interview and analysis was guided by Horne's necessity-concerns model.
  
  
  RESULTS
  The findings revealed medication-related perceptions some of which were similar to those of Western patients and others that seem to be informed by local socio-cultural contexts. Participants' perceptions focused on the necessity of and concerns about their anti-diabetic medications, giving more emphasis to the latter. Concerns were expressed about both perceived and experienced adverse effects, inconveniences in handling the medications and access. It was evident that some of these concerns were exaggerated but could nevertheless negatively affect adherence to prescribed medications including resistance to initiate insulin with potential impact on health outcomes.
  
  
  CONCLUSIONS
  Understanding patients' perceptions of their medications is critical for developing a diabetes education program that considers local contexts and beliefs to enhance adherence. Education programs should consider patients' concerns about medication adverse effects and reasons for use so as to improve their adherence and health outcomes.
authors.affiliation: School of Pharmacy, College of Health Sciences (CHS), Addis Ababa University (AAU), Addis Ababa, Ethiopia.
authors.forename: Bruck Messele
authors.identifier: 0000-0003-3866-0621
authors.initials: BM
authors.lastname: Habte
authors.affiliation: School of Medicine, CHS, AAU, Addis Ababa, Ethiopia.
authors.forename: Tedla
authors.initials: T
authors.lastname: Kebede
authors.affiliation: School of Pharmacy, College of Health Sciences (CHS), Addis Ababa University (AAU), Addis Ababa, Ethiopia.
authors.forename: Teferi Gedif
authors.initials: TG
authors.lastname: Fenta
authors.affiliation: Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada.
authors.forename: Heather
authors.initials: H
authors.lastname: Boon
keywords: Anti-diabetic medications; Ethiopia; Necessity-concerns model; Patients’ perceptions; Qualitative interview