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      Patients’ perspective of disease and medication adherence for type 2 diabetes in an urban area in Bangladesh: a qualitative study

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          Patients’ perspective of diabetes and adherence to its prescribed medications is a significant predictor of glycemic control and overall management of the disease. However, there is a paucity of such information in Bangladesh. This study aimed to explore patients’ perspective of diabetes, their experience of taking oral hypoglycemic medications and explore factors that contribute to medication adherence in patients with type 2 diabetes in Bangladesh.


          We conducted in-depth face-to-face interviews with 12 type 2 diabetes patients attending a tertiary hospital in Dhaka city between February and March, 2014. Participants were purposively sampled representing different age groups, education levels, years since diagnosis with diabetes, and glycemic status, to achieve maximum variation sampling. All interviews were conducted using a topic guide and were audio-recorded, transcribed verbatim, checked for errors, coded and analyzed by means of a qualitative content analysis framework.


          The data analysis generated rich information on the participants’ knowledge and perception on diabetes, its causes, self-management, medication use, adverse effects of medication use, medication adherence, and impact of diabetes, Although most of the participants demonstrated substantive knowledge on diabetes and its consequences, they also reported numerous misconceptions about the disease. Knowledge on diabetes medication, their appropriate use and side effects was rather poor. Respondents also reported non-compliance to dietary and physical activity advice by their physicians and concerns on diabetes diabetes-induced psychological stress. High cost of medications, concerns over medication side effects and forgetfulness was noted as factors for non-adherence to medication.


          Participants’ knowledge and perception on diabetes are key factors determining their adherence to medications and, thereby, diabetes management. Healthcare providers should explore to better understand patients’ perspective on diabetes, medication beliefs, identify psychological stress and provide more effective health education interventions to enhance medication adherence.

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          Most cited references 19

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          Non‐Communicable Diseases (NCDs) in developing countries: a symposium report

          In recent years, non-communicable diseases (NCDs) have globally shown increasing impact on health status in populations with disproportionately higher rates in developing countries. NCDs are the leading cause of mortality worldwide and a serious public health threat to developing countries. Recognizing the importance and urgency of the issue, a one-day symposium was organized on NCDs in Developing Countries by the CIHLMU Center for International Health, Ludwig-Maximilians-Universität, Munich on 22nd March 2014. The objective of the symposium was to understand the current situation of different NCDs public health programs and the current trends in NCDs research and policy, promote exchange of ideas, encourage scientific debate and foster networking, partnerships and opportunities among experts from different clinical, research, and policy fields. The symposium was attended by more than seventy participants representing scientists, physicians, academics and students from several institutes in Germany and abroad. Seven key note presentations were made at the symposium by experts from Germany, UK, France, Bangladesh and Vietnam. This paper highlights the presentations and discussions during the symposium on different aspects of NCDs in developing countries. The symposium elucidated the dynamics of NCDs in developing countries and invited the participants to learn about evidence-based practices and policies for prevention and management of major NCDs and to debate the way forward.
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            Prevalence of diabetes and prediabetes and their risk factors among Bangladeshi adults: a nationwide survey

            Objective To estimate the prevalence of diabetes and prediabetes in Bangladesh using national survey data and to identify risk factors. Methods Sociodemographic and anthropometric data and data on blood pressure and blood glucose levels were obtained for 7541 adults aged 35 years or more from the biomarker sample of the 2011 Bangladesh Demographic and Health Survey (DHS), which was a nationally representative survey with a stratified, multistage, cluster sampling design. Risk factors for diabetes and prediabetes were identified using multilevel logistic regression models, with adjustment for clustering within households and communities. Findings The overall age-adjusted prevalence of diabetes and prediabetes was 9.7% and 22.4%, respectively. Among urban residents, the age-adjusted prevalence of diabetes was 15.2% compared with 8.3% among rural residents. In total, 56.0% of diabetics were not aware they had the condition and only 39.5% were receiving treatment regularly. The likelihood of diabetes in individuals aged 55 to 59 years was almost double that in those aged 35 to 39 years. Study participants from the richest households were more likely to have diabetes than those from the poorest. In addition, the likelihood of diabetes was also significantly associated with educational level, body weight and the presence of hypertension. The prevalence of diabetes varied significantly with region of residence. Conclusion Almost one in ten adults in Bangladesh was found to have diabetes, which has recently become a major public health issue. Urgent action is needed to counter the rise in diabetes through better detection, awareness, prevention and treatment.
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              Using the framework method for the analysis of qualitative data in multi-disciplinary health research

               NK GALE,  G Heath,  E CAMERON (2013)

                Author and article information

                +61 405105012 , shariful.islam@icddrb.org , drsislam@gmail.com
                BMC Res Notes
                BMC Res Notes
                BMC Research Notes
                BioMed Central (London )
                21 March 2017
                21 March 2017
                : 10
                [1 ]ISNI 0000 0004 0600 7174, GRID grid.414142.6, NCD Program, , International Center for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), ; 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212 Bangladesh
                [2 ]ISNI 0000 0004 1936 973X, GRID grid.5252.0, Center for International Health, , Ludwig-Maximilians Univetsitat, ; Munich, Germany
                [3 ]ISNI 0000 0001 2295 628X, GRID grid.267193.8, Department of Public Health, , The University of Southern Mississippi, ; Hattiesburg, MS USA
                [4 ]ISNI 0000 0004 4682 8196, GRID grid.472353.4, , Bangladesh University of Health Science (BUHS), ; Dhaka, Bangladesh
                [5 ]ISNI 0000 0004 1936 9430, GRID grid.21100.32, Faculty of Health, School of Health Policy and Management, , York University, ; Toronto, Canada
                [6 ]GRID grid.443020.1, Department of Public Health, , North South University, ; Dhaka, Bangladesh
                [7 ]ISNI 0000 0004 1936 834X, GRID grid.1013.3, The George Institute for Global Health, , University of Sydney, ; Sydney, Australia
                © The Author(s) 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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                type 2 diabetes, medication adherence, compliance, perception, glycemic control, bangladesh


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