Alsairafi, ZK; (2016) Use of medicines and devices by adults in the management of Type 2 diabetes in Kuwait. Doctoral thesis , UCL (University College London).

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Abstract

Background: Diabetes is a threat to peoples’ health and lives around the world. Particularly, there is a large increase in its prevalence in the Middle East, especially type 2 diabetes. Knowledge, beliefs and attitudes are the major contributing factors to medicine misuse and poor glycaemic control. Insulin is the last treatment option that patients with type 2 diabetes might require to control their disease. In addition to traditional injections, newer insulin delivery methods, such as pens and pumps are available, which may impact medicine use. Aim To identify factors that impact the management of type 2 diabetes by examining patients’ experiences about their medicine/device use and lifestyle and exploring the perspectives of healthcare providers (HCPs) to inform service development. Method The study was conducted in hospitals in Kuwait. All patients (n=43) using medical treatment for the management of type 2 diabetes and HCPs (n=10) who were involved in management of those patients were invited to participate. Data were collected primarily through semi-structured interviews. Data analysis was performed using MAXQDA-11. Results Non-adherence to medicines was prevalent in this study. Interviews with patients revealed that poor health awareness, health beliefs and culture influenced health behaviour, in terms of medicine use and lifestyle. Some of the emergent beliefs were about the disease (downplaying its seriousness), medicines (disbelief in their efficacy) and self-beliefs. Using pens and pumps improved patients’ adherence, quality of life and satisfaction. Interviews with HCPs revealed that some barriers affected management of the disease, such as lack of staff, incentives and equipment. Recommendations to inform healthcare provision were identified. Conclusion To improve the management of type 2 diabetes and health outcomes, many issues need to be considered. For example, addressing patients’ beliefs, and the benefits of insulin pens and pumps and expanding their use. Taking into account concerns of HCPs would be valuable to inform service development.

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