Understanding the Subjective Experience of Medication Adherence for Older Urban African Americans With Type 2 Diabetes and a History of Illicit Drug Addiction

Abstract

Objective: African Americans experience high rates of type 2 diabetes mellitus (T2D). Self-management strategies, such as medication adherence, are key to mitigating negative T2D outcomes. This article addresses a gap in the literature by examining the intersections of drug abuse histories and medication adherence among urban, older African Americans with T2D. Method: In-depth interview data were collected as part of a larger ethnographic study examining the subjective experience of T2D among urban older adults. Two representative focal cases were selected and thematic analysis performed to illustrate how former illicit drug addicts perceive prescription medication usage. Results: Narratives reveal that participants are displeased about having to take prescription drugs and are making lifestyle changes to reduce medication usage and maintain sobriety. Discussion: Previous drug abuse not only complicates medication adherence but is also a significant part of how older African Americans who are former drug users frame their understanding of T2D more broadly.

Keywords

African Americans diabetes medications drug abuse illness prototypes

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References

American Diabetes Association. (2015). Strategies for improving care. Sec. 1. In standards of medical care in diabetes. Diabetes Care, 38(Suppl. 1), S5-S7.

Aston

(2013). Diabetes: An alarming epidemic. Hospitals & Health Networks/AHA, 87(2), 34-38.

Beckles

Zhu

Moonesinghe

(2011). Diabetes-United States, 2004-2008. Morbidity and Mortality Weekly Report, 60, 90-93.

Bird

C. E.

Rieker

P. P.

(2008). Gender and health: The effects of constrained choices and social policies. Cambridge, UK: Cambridge University Press.

Bullock

K. C.

Edwards

K. L.

Greene

R. S.

Shah

S. R.

Blaszczyk

A. T.

(2013). Race as a factor for intensification of diabetes medications. Diabetes Educator, 39, 335-343.

Cameron

L. D.

Leventhal

Love

R. R.

(1998). Trait anxiety, symptom perceptions, and illness-related responses among women with breast cancer in remission during a tamoxifen clinical trial. Health Psychology, 17, 459-469.

Centers for Disease Control and Prevention. (2008). National diabetes fact sheet: General information and national estimates on diabetes in the United States, 2007. Atlanta, GA: Author.

Department of Health and Human Services, Office of Minority Health. (2015). Diabetes and African Americans. Retrieved from http://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&;lvlid=18

Evans

Lepkowski

J. M.

Powe

N. R.

LaVeist

Kuczmarski

M. F.

Zonderman

A. B.

(2010). Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS): A longitudinal, epidemiologic, urban study of health, race, and socioeconomic status. Ethnicity & Disease, 20, 267-275.

10.

Funnell

M. R.

Nwankwo

Gillard

Anderson

R. M.

Tang

(2005). Implementing an empowerment-based diabetes self-management education program. The Diabetes Educator, 31, 55-56.

11.

Glazier

Bajcar

Kennie

Wilson

(2006). A systematic review of interventions to improve diabetes care in socially disadvantaged populations. Diabetes Care, 29, 1675-1688.

12.

Greenwood

Lowenthal

(2005). Case study as a means of researching social work and improving practitioner education. Journal of Social Work Practice, 19, 181-193.

13.

Groleau

Young

Kirmayer

(2006). The McGill Illness Narrative Interview (MINI): An interview schedule to elicit meanings and modes of reasoning related to illness experience. Transcultural Psychiatry, 43, 671-691.

14.

Han

Gfroerer

J. C.

Colliver

J. D.

(2010). Associations between duration of illicit drug use and health conditions: Results from the 2005–2007 National Surveys on Drug Use and Health. Annals of Epidemiology, 20, 289-297.

15.

Hill-Briggs

Gary

T. L.

Bone

L. R.

Hill

M. N.

Levine

D. M.

Brancati

F. L.

(2005). Medication adherence and diabetes control in urban African Americans with type 2 diabetes. Health Psychology, 24, 349-357.

16.

Hummer

R. A.

Rogers

R. G.

Nam

C. B.

Ellison

C. G.

(1999). Religious involvement and US adult mortality. Demography, 36, 273-285.

17.

Johnson

K. H.

Bazargan

Cherpitel

C. J.

(2001). Alcohol, tobacco, and drug use and the onset of type 2 diabetes among inner-city minority patients. The Journal of the American Board of Family Practice, 14, 430-436.

18.

Koenig

H. G.

(1998). Religious beliefs and practices of hospitalized medically ill older adults. International Journal of Geriatric Psychiatry, 13, 213-224.

19.

Magai

Consedine

Neugut

Hershman

D. L.

(2007). Common psychosocial factors underlying breast cancer screening and breast cancer treatment adherence: A conceptual review and synthesis. Journal of Women’s Health, 16, 11-23.

20.

Onwudiwe

Mullins

C. D.

Winston

(2011). Barriers to self-management of diabetes: A qualitative study among low-income minority diabetics. Ethnicity & Disease, 21, 27-32.

21.

Pieterse

A. L.

Carter

(2007). An examination of the relationship between general life stress, racism-related stress, and psychological health among black men. Journal of Counseling Psychology, 54, 101-109.

22.

Roepke

S. K.

Grant

(2011). Toward a more complete understanding of the effects of personal mastery on cardiometabolic health. Health Psychology, 30, 615-632.

23.

Rosen

Engel

R. J.

Hunsaker

A. E.

Engel

Detlefsen

E. G.

Reynolds

C. F.

(2013). Just say know: An examination of substance use disorders among older adults in gerontological and substance abuse journals. Social Work in Public Health, 28, 377-387.

24.

Salmon

C. A.

Shackelford

T. K.

Michalski

R. L.

(2012). Birth order, sex of child, and perceptions of parental favoritism. Personality and Individual Differences, 52, 357-362.

25.

Substance Abuse and Mental Health Services Administration. (1998). Substance abuse among older adults: An invisible epidemic. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK64422/

26.

Substance Abuse and Mental Health Services Administration. (2012). The NSDUH report: Substance use among black adults. Rockville, MD: Office of Applied Studies.

27.

Suitor

J. J.

Pillemer

(2007). Mothers’ favoritism in later life. Research on Aging, 29, 32-55.

28.

Turner

W. L.

Wallace

(2003). African American substance use epidemiology, prevention, and treatment. Violence Against Women, 9, 576-589.

29.

Two Feathers

Keiffer

Palmisano

. (2005). Racial and Ethnic Approaches to Community Health (REACH) Detroit partnership: Improving diabetes-related outcomes among African-American and Latino adults. American Journal of Public Health, 95, 1552-1560.

30.

Yin

(2009). Case study research: Design and methods. Thousand Oaks, CA: SAGE.