From unwelcome to supportive. Patients' conceptions of being prescribed a glucose-lowering drug at type 2 diabetes diagnosis - a phenomenographic study.

ABSTRACT

PURPOSE: Guidelines recommend starting glucose-lowering drug upon type 2 diabetes mellitus diagnosis together with lifestyle changes. Lifestyle changes are as essential as the drug, earlier recommendations allowed some months of lifestyle changes while being drug-free. Prescription on diagnosis may interfere with patients' understanding and motivation for lifestyle changes if they cannot evaluate the effect on blood glucose. METHODS: A phenomenographic approach and interviews were conducted with patients who started a glucose-lowering drug at diagnosis. RESULTS: Three qualitatively different conceptions of being prescribed glucose-lowering drugs in connection to type 2 diabetes mellitus diagnosis were found "Drugs as something unwelcome," "Drugs as a support," and "Drugs as a means to reach the goal". These conceptions range broadly from drugs as unwelcome to drugs as a support for lifestyle changes and an opportunity to influence the course of the lifelong disease to reach a goal. CONCLUSIONS: This study has identified various perspectives of patients' understanding of the role of lifestyle changes in managing their disease. The patients undergo a process, and the perspectives vary, providing a more extensive and nuanced understanding. It is, therefore, impossible to apply a routine protocol and a person-centred approach is required when prescribing a glucose-lowering drug.