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Table 1 An example of order construct

From: Understanding adherence-related beliefs about medicine amongst patients of South Asian origin with diabetes and cardiovascular disease patients: a qualitative synthesis

Study

Theme/category

Data extract (first order construct)

Data extract (second order construct)

Conclusion (synthesis)

Lawton et al., 2005 [21]

Adjusting of drugs/symptoms severity

“....And now in the morning I take three pills, sometimes two, meaning I check it (blood glucose) and according to that I do or don’t take all the pills”.

Popular ideas about medicines, derived from the Indian subcontinent, may have informed the ways respondents perceive and take their oral hypoglycaemic agents (OHAs). On the Indian subcontinent, people commonly self-medicate, make selective use of prescribed drugs, and abandon drugs that do not provide prompt relief of symptoms. This might explain why some respondents adjusted their OHAs without seeking medical approval and according to the presence or absence of symptoms.

Symptom control significantly influenced adherence to treatment. Patients’ health beliefs and medication adherence may be affected by the severity of disease. Patients make critical decisions that affect the therapeutic outcome of their disease. Patients’ beliefs about disease and medications may be crucial to their intentional adherence behaviours and may be very different to those of the health professional.

Lawton et al., 2006 [22]

God/fatalistic view

“....God has given me these diseases, and they will never go away, you just get more and you cannot do much about it”.

Whilst fatalism has been attributed to belief in God’s will, which is a strong feature of the Muslim, Hindu and Sikh religions our findings suggest that call/recall systems may reinforce patients’ perceptions that they are not responsible for disease self-management, when they have migrated from a country where they are expected to seek out medical care.

Generally south Asian patients were more likely than their European counterparts to contextualise their diseases in relation to their religion beliefs. This often resulted in lack of motivation to improve their disease.