Table 5 Quotes for HCPs and patients in phase 1—context analysis to gain insights into the current standards of care to support medication adherence for people with T2DM, based on a focus group with patients N = 11 and a focus group with HCPs N = 5

1.1 Perspectives on care to support medication adherence by healthcare providers and T2DM patients

1.1.1

When I am guarding the door at night, because I work as a porter, that is a time when I use my Simvastatin. I am supposed to take those before going to bed, but those nights are different and I had to figure out how to deal with that by myself

Patient 1

1.1.2

Pharmacists are only in it for the money. The more pills they can give out, the more they earn

Patient 2

1.1.3

Well, sometimes there are patients at the front desk who complain about the size or the taste of their medication. Especially calcium chew, people don’t like that one. Or people might complain about the brand of the medication. But other than that, we don’t hear many problems, but I also think that there are not that many patients in our pharmacy that are non-adherent

Pharmacy assistant 1

1.1.4

I believe adherence is the responsibility of the patient. However, there is an exception in case of medical danger. If a patients’ blood sugar is so high that they are in danger or might end up in a coma, then I believe that we should take action

Nurse practitioner 1

1.2 Current standard of care

1.2.1

The NP often tells me that I can pick up the medication straight after our consult, but even when I return to the pharmacy the next day, they seem to be completely unaware of this request

Patient 3

1.2.2

Yes, the NP sometimes forgets to call me back, but that is understandable, because everybody at the GP is always working so hard

Patient 1

1.2.3

I am a GP, and therefore I am journal focused. When I look up a patient on my PC, the first thing I do is open the journal. Every HCP is different in this regard, I believe pharmacists are more medication oriented. They look up a patient and only look at their medication history. Therefore a pharmacist might add some relevant information under medications, but I might never see that because that is just not how I work

General practitioner 1

1.2.4

Yes, because a patient then says to me ‘I’m having these and these symptoms, and the pharmacy told me to quit my medication immediately’. Then I think to myself, I don’t believe any of that, but what am I to do? Tell the patient to wait for a second, while I phone the pharmacy and ask them ‘I have a patient here who claims you have said this and this, is that true?’. That is ridiculous of course

General practitioner 2

1.3 Barriers in the care to support medication adherence

1.3.1

I also believe the repeat dispensing, that is really something that makes me lose control. Sometimes patients call me and ask me questions about medication, but I really do not know why they are taking that medication. That might be something they took years ago, but the repeat dispensing service just keeps giving that to patients without my knowledge

General practitioner 2

1.3.2

That step [i.e. what to do when you noticed a non-adherent patient], if that is clear, then you make it a lot easier on others to identify non-adherent patients. Because otherwise you might say ‘yes, that person is here, but what now?’. Then I might have done my part and given the signal, but the follow-up action is completely unclear

Nurse practitioner 1