Primary Care Diabetes
Volume 1, Issue 1 , Pages 25-33, February 2007

Obstacles to adherence in living with type-2 diabetes: An international qualitative study using meta-ethnography (EUROBSTACLE)

  • Etienne Vermeire

      Affiliations

    • Department of General Practice, University of Antwerp, Belgium
    • Corresponding Author InformationCorresponding author.
    • ,
  • Hilary Hearnshaw

      Affiliations

    • Warwick Medical School, University of Warwick, UK
    • ,
  • Anneli Rätsep

      Affiliations

    • Department of General Practice, University of Tartu, Estonia
    • ,
  • Gwenola Levasseur

      Affiliations

    • Department of General Practice, University of Rennes, France
    • ,
  • Davorina Petek

      Affiliations

    • Department of General Practice, University of Ljubljana, Slovenia
    • ,
  • Henk van Dam

      Affiliations

    • Department of General Practice, University of Maastricht, Netherlands
    • ,
  • Frans van der Horst

      Affiliations

    • Department of General Practice, University of Maastricht, Netherlands
    • ,
  • Nevenka Vinter-Repalust

      Affiliations

    • Department of General Practice, University of Zagreb, Croatia
    • ,
  • Johan Wens

      Affiliations

    • Department of General Practice, University of Antwerp, Belgium
    • ,
  • Jeremy Dale

      Affiliations

    • Warwick Medical School, University of Warwick, UK
    • ,
  • Paul Van Royen

      Affiliations

    • Department of General Practice, University of Antwerp, Belgium

Received 25 April 2006; received in revised form 18 July 2006; accepted 24 July 2006. published online 22 December 2006.

Abstract 

Quantitative studies failed to determine variables which consistently explain adherence or non-adherence to treatment recommendations. Qualitative studies identified issues such as the quality of the health provider–health receiver relationship and the patient's health beliefs. According to these findings, 39 focus groups of 246 people living with type-2 diabetes were conducted in seven European countries, assessing health beliefs, communication with caregivers and problems encountered in adhering to treatment regimens. Meta-ethnography was later applied to make a qualitative meta-analysis. Obstacles to adherence are common across countries, and seem to be related less to issues of the health-care system and more to patient's knowledge about diabetes, beliefs and attitudes and the relationship with health-care professionals. The resulting key themes are course of diabetes, information, person and context, body awareness and relationship with the health care provider. Meta-ethnography is a feasible tool for the meta-analysis of multilingual qualitative data and leads to a richer account.

Keywords: Europe, Diabetes type-2, Adherence, Qualitative, Meta-ethnography, Meta-analysis

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PII: S1751-9918(06)00004-0

doi:10.1016/j.pcd.2006.07.002

Primary Care Diabetes
Volume 1, Issue 1 , Pages 25-33, February 2007

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