Barriers to medication taking among Kuwaiti patients with type 2 diabetes: a qualitative study

Fatima B Jeragh-Alhaddad,1,2 Mohammad Waheedi,2 Nick D Barber,1 Tina Penick Brock3 1Department of Practice and Policy, University College London School of Pharmacy, London, UK; 2Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, Kuwait City, Kuwait; 3Department of Clinical Pharmacy, School of Pharmacy, University of California, San Francisco, CA, USA Background: Nonadherence to medications among Kuwaitis with type 2 diabetes mellitus (T2DM) is believed to be a major barrier to appropriate management of the disease. Published studies of barriers to medication adherence in T2DM suggest a Western bias, which may not adequately describe the Kuwaiti experience. Aim: The purpose of this study was to explore barriers to medication adherence among Kuwaiti adults with T2DM. Methods: Semi-structured interviews were conducted with 20 Kuwaiti patients with type 2 diabetes. The interviews were digitally recorded, transcribed, and analyzed using thematic analysis. Results: Barriers to medication adherence were identified. Emerging themes were: 1) lack of education/awareness about diabetes/medications, 2) beliefs about medicines/diabetes, 3) spirituality and God-centered locus of control, 4) attitudes toward diabetes 5) perceptions of self-expertise with the disease and body awareness, 6) social stigma, 7) perceptions of social support, 8) impact of illness on patient’s life, 9) perceptions of health care providers’ attitudes toward patients, and 10) health system-related factors, such as access difficulties and inequalities of medication supply and services. Conclusion: Personal, sociocultural, religious, health care provider, and health care system-related factors may impede medication adherence among Kuwaitis with type 2 diabetes. Interventions to improve care and therapeutic outcomes in this particular population must recognize and attempt to resolve these factors. Keywords: medication adherence, type 2 diabetes mellitus, Kuwait, qualitativ