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Doya IF, Yahaya JJ, Ngaiza AI, Bintabara D. Low medication adherence and its associated factors among patients with type 2 diabetes mellitus attending Amana Hospital in Dar es Salaam, Tanzania: a cross-sectional study. Int Health 2024; 16:200-207. [PMID: 37310004 PMCID: PMC10911532 DOI: 10.1093/inthealth/ihad042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 04/22/2023] [Accepted: 05/19/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND Low medication adherence among patients with type 2 diabetes mellitus (T2DM) is associated with significant morbidity and mortality globally. We investigated the prevalence of low medication adherence and its associated factors among patients with T2DM. METHODS We used the Bengali version of the 8-item Morisky Medication Adherence Scale (MMAS-8) in measuring medication adherence among patients with T2DM who were attending the diabetes clinic at Amana Regional Referral Hospital in Dar es Salaam, Tanzania, from December 2021 to May 2022. Binary logistic regression analysis under multivariate analysis was used to determine the predictors of low medication adherence after controlling for confounders. A two-tailed p-value <0.05 was considered significant. RESULTS The prevalence of low medication adherence was 36.7% (91/248) of the subjects included in the study. Lack of formal education (adjusted odds ratio [AOR] 5.3 [95% confidence interval {CI} 1.717 to 16.312], p=0.004), having comorbidities (AOR 2.1 [95% CI 1.134 to 3.949], p=0.019) and drinking alcohol (AOR 3.5 [95% CI 1.603 to 7.650], p=0.031) were the independent predictors of low medication adherence. CONCLUSION More than one-third of the patients with T2DM in this study had low medication adherence. Our study also showed that a lack of formal education, having comorbidities and drinking alcohol were significantly associated with low medication adherence.
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Affiliation(s)
- Irene F Doya
- Department of Community Medicine, School of Medicine and Dentistry, University of Dodoma, Dodoma, Tanzania
| | - James J Yahaya
- Department of Pathology, School of Health Sciences, Soroti University, P. O. Box 211, Soroti, Uganda
| | - Advera I Ngaiza
- Department of Pathology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
- Department of Pathology, Muhimbili National Hospital, Dar es Salaam, Tanzania
| | - Deogratius Bintabara
- Department of Community Medicine, School of Medicine and Dentistry, University of Dodoma, Dodoma, Tanzania
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Amaama LA, Osei GN, Okyere P, Opoku VO, Yankey TJ, Attoh T, Essuman MA, Martey J, Ephraim RKD. Health-related quality of life of type 2 diabetes mellitus patients: A cross-sectional study in the cape coast metropolis. Health Sci Rep 2024; 7:e1937. [PMID: 38410501 PMCID: PMC10895150 DOI: 10.1002/hsr2.1937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 01/16/2024] [Accepted: 01/17/2024] [Indexed: 02/28/2024] Open
Abstract
Background and Aim Type 2 diabetes mellitus (DM) has in recent decades become a global pandemic, accounting for over 90% of DM cases. The study evaluated the health-related quality of life (HrQoL) and identified its determinants among type 2 DM patients at the University of Cape Coast Hospital. Methods We conducted our study at the University of Cape Coast Hospital from January to March 2022. The EQ-5D-5L questionnaire was administered to 68 type 2 DM patients. Data were then inputted into Microsoft Excel and analyzed accordingly using IBM SPSS statistical software version 26 and GraphPad Prism 8. Results The mean age of the participants was 60.71 ± 12.18 with 55.9% being females. The average systolic, diastolic blood pressure and fasting blood glucose (FBG) of participants were 140.99 ± 22.27, 85 ± 11.14 and 7.97 ± 2.66 respectively. With the EQ-5D-5L scale, participants reported severe to extreme problems mainly in pain/discomfort (19.1%) and mobility (8.8%) dimensions. Approximately 21% (14/68) of patients reported themselves as being in perfect health based on the EQ-5D index score with no significant difference between males and females (p ≥ 0.05). On a scale of 0 to 100, most (26.5%) of the participants rated their general health state at 80. Age was significantly associated with all five dimensions while patients with comorbidities had higher odds of experiencing pain/discomfort and anxiety/depression. Conclusion The study reveals that pain/discomfort and anxiety/depression are the most experienced problems among patients with type 2 DM. The HrQoL of type 2 DM patients was also found to be affected by age, comorbidities, systolic and diastolic blood pressure. Therefore, identifying these factors and developing appropriate interventions is crucial for improving patient outcomes and enhancing treatment outcomes.
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Affiliation(s)
- Leticia Awontayami Amaama
- Department of Medical Laboratory Science, School of Allied Health SciencesUniversity of Cape CoastCape CoastGhana
| | - George Nkrumah Osei
- Department of Medical Laboratory Science, School of Allied Health SciencesUniversity of Cape CoastCape CoastGhana
| | - Perditer Okyere
- Department of Internal Medicine, Komfo Anokye Teaching Hospital, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Victor Obiri Opoku
- Department of Physician Assistant Studies, School of Allied Health SciencesUniversity of Cape CoastCape CoastGhana
| | - Theophilus Junior Yankey
- Department of Physician Assistant Studies, School of Allied Health SciencesUniversity of Cape CoastCape CoastGhana
| | - Tetteh Attoh
- Department of Medical Laboratory Science, School of Allied Health SciencesUniversity of Cape CoastCape CoastGhana
| | - Mainprice Akuoko Essuman
- Department of Medical Laboratory Science, School of Allied Health SciencesUniversity of Cape CoastCape CoastGhana
| | - Jacob Martey
- Department of Medical Laboratory Science, School of Allied Health SciencesUniversity of Cape CoastCape CoastGhana
| | - Richard K D Ephraim
- Department of Medical Laboratory Science, School of Allied Health SciencesUniversity of Cape CoastCape CoastGhana
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Danpanichkul P, Manosroi W, Nilsirisuk T, Tosukhowong T. Predictors of weight reduction effectiveness of SGLT2 inhibitors in diabetes mellitus type 2 patients. Front Endocrinol (Lausanne) 2024; 14:1251798. [PMID: 38327904 PMCID: PMC10849059 DOI: 10.3389/fendo.2023.1251798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 12/26/2023] [Indexed: 02/09/2024] Open
Abstract
Background Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are a novel medication for treating type 2 diabetes (T2DM), which have the pleiotropic effect of weight reduction. This study aimed to evaluate clinical and biochemical predictors of effective weight reduction in T2DM patients who use various types of SGLT2i. Materials and methods A retrospective study was conducted with 289 adults diagnosed with T2DM who were first prescribed SGLT2i either as monotherapy or add-on therapy. The primary outcome was the identification of clinical and biochemical factors that can potentially induce meaningful weight reduction (>3% in 1 year) in T2DM patients while using SGLT2 inhibitors. The relationship between predictors and significant weight loss was assessed using logistic regression analysis, including adjustment for confounding factors. Results are presented as odds ratios (ORs) with a 95% confidence interval (CI). Results Among the 289 patients, 45.6% had significant weight loss following SGLT2i use. The significant clinical predictors were age >70 years old (OR 3.26, 95% CI 1.39-7.6, p=0.006), body mass index >25 kg/m2 (OR 1.02, 95% CI 1.01-1.05, p=0.049), and the use of sulfonylureas (OR 2.41, 95% CI 1.15-5.09, p=0.020). Additionally, the use of HCTZ showed significantly decreased odds of weight loss (OR 0.35, 95% CI 0.13-0.96, p=0.043). Conclusion This research highlights multiple clinical factors that potentially can predict meaningful weight loss in patients with T2DM who are treated with SGLT2i. These findings could facilitate the identification of patients who might benefit from the weight loss effects of SGLT2i.
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Affiliation(s)
- Pojsakorn Danpanichkul
- Immunology Unit, Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Worapaka Manosroi
- Division of Endocrinology, Department of Internal Medicine, Chiang Mai University, Chiang Mai, Thailand
- Clinical Epidemiology and Clinical Statistics Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | - Theetouch Tosukhowong
- Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Theivasigamani K, Palaniappan S. An Overview of Pharmaceutical Care in Type II Diabetes Mellitus Patients: Current Position and Prospects. Curr Diabetes Rev 2024; 20:e050523216588. [PMID: 37151063 DOI: 10.2174/1573399819666230505123428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 01/17/2023] [Accepted: 02/02/2023] [Indexed: 05/09/2023]
Abstract
Diabetes mellitus is an ongoing disease that is related to a high mortality rate due to severe complications. Diabetes mellitus type 2 (DMT2) is a persistent metabolic deficiency and its prevalence has been increasing consistently worldwide. As a result, it is rapidly turning into a plague in some parts of the world, and the number of people affected is expected to double in the following decade due to an increase in the maturing populace, adding to the overall existing importance for medical service providers, particularly in the underdeveloped nations. Extensive diabetes care is an intricate task that takes a whole group of medical care experts, including drug specialists, to provide multidisciplinary care for the patients. The duty of drug experts has changed significantly in recent years, changing from conventional drug dispensing in the drug store to patient- centered clinical support services. Upgrading the medication treatment to accomplish better remedial results without causing drug-related issues has been considered the essential objective of treatment for diabetic patients. This review discusses the healthcare needs of patients with T2DM, the current evidence for the role of pharmacists in diabetes care, and insight into the upcoming role of pharmacists in its management. The advanced role of clinical pharmacists in diabetes control through drug treatment, diabetes care centers, and diabetes health counselor schooling, is also discussed in this review.
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Affiliation(s)
- Kumutha Theivasigamani
- Research Scholar, Karpagam Academy of Higher Education, Coimbatore, India
- Nandha College of Pharmacy, Erode, India
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Xu Y, Wang Q, Zou J, Chen Y, Zhou J, Dai W, Liu R, Liu M, Li X, Jiang S. CHD-related/specific mortality of 3.17 million people in a transitioning region: trends, risk factors, and prevention. Aging Clin Exp Res 2023; 35:3147-3156. [PMID: 37985650 DOI: 10.1007/s40520-023-02618-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 11/01/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND Demographic shifts cause uncertain changes in the burden of coronary heart disease (CHD) in transitioning regions. We aimed to analyze the trends of CHD burden and its risk factors in Pudong, Shanghai, and explore prevention strategies for transitioning regions. METHODS We analyzed CHD-related and CHD-specific deaths in Pudong from 2005 to 2020, including the crude mortality rate (CMR), age-standardized mortality rate worldwide (ASMRW), years of life lost (YLL), and age-specific proportions. We also examined the impact of population aging on the burden of CHD. The Joinpoint Regression Program was used to analyze trends, and the decomposition method was used to evaluate the impact of demographics on the mortality rate. RESULTS Of the 86,171 CHD-related deaths, 52,152 (60.52%) were CHD-specific deaths. For both CHD-related and CHD-specific deaths, there was a significant increase in the CMR, ASMRW, and YLL rate, except in the 70-79-year age group, which exhibited a distinctive and statistically significant decline in these rates (all P < 0.05). There were steadily increasing trends in the rates caused by aging from 2005 to 2020, with average annual percent changes (AAPCs) of 42.59% and 41.43%, respectively (all P < 0.05). CONCLUSIONS Our results indicate that the CHD burden in Pudong has been persistently increasing, but in the age group of 70-79 years, substantial declines were observed. The quality of primary healthcare services may be a critical point in addressing the overwhelming CHD burden.
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Affiliation(s)
- Yaxin Xu
- Department of Health Management Centre, Zhongshan Hospital, Fudan University, No. 180 Fenglin Rd., Xuhui, Shanghai, 200032, China
- Department of General Practice, Zhongshan Hospital, Fudan University, No. 180 Fenglin Rd., Xuhui, Shanghai, 200032, China
| | - Qizhe Wang
- Department of Health Management Centre, Zhongshan Hospital, Fudan University, No. 180 Fenglin Rd., Xuhui, Shanghai, 200032, China
- Department of General Practice, Zhongshan Hospital, Fudan University, No. 180 Fenglin Rd., Xuhui, Shanghai, 200032, China
| | - Jian Zou
- Department of Health Management Centre, Zhongshan Hospital, Fudan University, No. 180 Fenglin Rd., Xuhui, Shanghai, 200032, China
| | - Yichen Chen
- Office of Scientific Research and Information Management, Centres for Disease Control and Prevention, Pudong New Area, Shanghai, 200136, China
- Office of Scientific Research and Information Management, Pudong Institute of Preventive Medicine, Pudong New Area, Shanghai, 200136, China
- School of Public Health, Fudan University, Shanghai, 200032, China
| | - Jing Zhou
- Department of Health Management Centre, Zhongshan Hospital, Fudan University, No. 180 Fenglin Rd., Xuhui, Shanghai, 200032, China
| | - Wei Dai
- Department of Health Management Centre, Zhongshan Hospital, Fudan University, No. 180 Fenglin Rd., Xuhui, Shanghai, 200032, China
| | - Ru Liu
- Department of General Practice, Zhongshan Hospital, Fudan University, No. 180 Fenglin Rd., Xuhui, Shanghai, 200032, China
| | - Ming Liu
- Department of Health Management Centre, Zhongshan Hospital, Fudan University, No. 180 Fenglin Rd., Xuhui, Shanghai, 200032, China.
- Shanghai Engineering Research Centre of AI Technology for Cardiopulmonary Diseases, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
| | - Xiaopan Li
- Department of Health Management Centre, Zhongshan Hospital, Fudan University, No. 180 Fenglin Rd., Xuhui, Shanghai, 200032, China.
- Office of Scientific Research and Information Management, Pudong Institute of Preventive Medicine, Pudong New Area, Shanghai, 200136, China.
| | - Sunfang Jiang
- Department of Health Management Centre, Zhongshan Hospital, Fudan University, No. 180 Fenglin Rd., Xuhui, Shanghai, 200032, China.
- Department of General Practice, Zhongshan Hospital, Fudan University, No. 180 Fenglin Rd., Xuhui, Shanghai, 200032, China.
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Mirzaei-Alavijeh M, Hosseini SN, Niksirt M, Hashemian AH, Khashij S, Jalilian F. The efficacy of theory driven treatment adherence promotion program among type 2 diabetic patients: application of intervention mapping and mHealth. J Diabetes Metab Disord 2023; 22:1609-1615. [PMID: 37975125 PMCID: PMC10638223 DOI: 10.1007/s40200-023-01291-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 08/23/2023] [Indexed: 11/19/2023]
Abstract
Background Mobile health interventions (mHealth) may improve health-related lifestyle behaviors and disease management. Successful management of diabetes is patient-centered responsibility. The aim of this research was to determine the efficacy of the theory driven program of promoting treatment adherence in type 2 diabetes (T2DM) patients based on mHealth. Methods This quasi-experimental research was conducted on 70 T2DM patients in Tehran, Iran. Participants were randomly divided into intervention (n = 35) or control (n = 35) groups. The data collection tool was a questionnaire based on some of constructs Social Cognitive Theory (SCT) which elicit from formative evaluation. The SCT theory-based intervention program was developed, implemented, and evaluated based on Intervention Mapping (IM) as a framework in 8 sessions using online WhatsApp application. The data was collected through by online interviews before and one month after the implementation of the program and analyzed in SPSS version 16. Results After the implementation of the program, a significant increase in self-efficacy (P = 0.009), outcome expectations (P < 0.001), and also diabetes treatment adherence behaviors (P = 0.024) were indicated in the intervention group. The estimated effect sizes for self-efficacy, outcome expectations, social support, and diabetes treatment adherence behaviors were 0.78, 0.06, 0.07, and 0.62, respectively. Conclusion Estimated effect size of the implemented intervention was evaluated as "large" effect for diabetes treatment adherence behaviors. Findings indicated the usefulness and efficacy of the mHealth educational program based on SCT constructs and the IM approach in treatment adherence behaviors promotion among T2DM patients in Iran. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-023-01291-5.
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Affiliation(s)
- Mehdi Mirzaei-Alavijeh
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Marzieh Niksirt
- Health Education and Promotion Department, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Amir Hossein Hashemian
- Biostatistics Department, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shima Khashij
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Farzad Jalilian
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Opoku R, Ackon SK, Kumah E, Botchwey COA, Appiah NE, Korsah S, Peprah M. Self-care behaviors and associated factors among individuals with type 2 diabetes in Ghana: a systematic review. BMC Endocr Disord 2023; 23:256. [PMID: 37993843 PMCID: PMC10664613 DOI: 10.1186/s12902-023-01508-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 11/08/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Self-care remains an effective model for diabetes management and care in low-and-middle-income countries due to the limited resources available for the clinical management of the disease and its complications This study examined adherence to self-care behaviors and associated factors among people with type 2 diabetes in Ghana. METHODS PubMed, PsycINFO, Scopus, Web of Science, Embase and Google scholar were used to identify quantitative observational studies published between 1990 and September 30, 2023. Studies exclusive to persons with type 2 diabetes ≥ 18 years of age in a Ghanaian setting were included in this review. Findings of primary studies were analyzed using narrative synthesis. RESULTS Twelve studies, presenting data on a total of 2,671 persons with type 2 diabetes, were included. All the studies were published in the last decade (2015-2022) and a majority of them were from the Greater Accra Region. The mean number of days (per week) participants adhered to a self-care behavior were in the ranges of 3.9-4.4 for diet, 4.2-4.8 for physical activity, 0.5-2.2 for self-monitoring of blood glucose (SMBG), and 2.9-5.0 for foot care. Adherence rates for medication were in the range of 33.5-84.5%. Patient-related factors, sociodemographic/economic-related factors, condition-related factors, and healthcare system-related factors were associated with various self-care behaviors. CONCLUSION Adherence to self-care behaviors among persons with type 2 diabetes in Ghana remains an ongoing challenge with significant variations in adherence among patients with different characteristics.
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Affiliation(s)
- Richmond Opoku
- Department of Health Administration and Education, University of Education, Winneba, Ghana
| | - Solomon Kwesi Ackon
- Department of Health Administration and Education, University of Education, Winneba, Ghana
| | - Emmanuel Kumah
- Department of Health Administration and Education, University of Education, Winneba, Ghana.
| | | | - Nana Esi Appiah
- Maxillofacial Surgery Unit, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Shadrach Korsah
- Mastercard Foundation Scholars Program, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Michael Peprah
- Department of Health Administration and Education, University of Education, Winneba, Ghana
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Studer CM, Linder M, Pazzagli L. A global systematic overview of socioeconomic factors associated with antidiabetic medication adherence in individuals with type 2 diabetes. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:122. [PMID: 37936205 PMCID: PMC10631092 DOI: 10.1186/s41043-023-00459-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/21/2023] [Indexed: 11/09/2023]
Abstract
BACKGROUND Antidiabetic medication adherence is a key aspect for successful control of type 2 diabetes mellitus (T2DM). This systematic review aims to provide an overview of the associations between socioeconomic factors and antidiabetic medication adherence in individuals with T2DM. METHODS A study protocol was established using the PRISMA checklist. A primary literature search was conducted during March 2022, searching PubMed, Embase, Web of Science, as well as WorldCat and the Bielefeld Academic Search Engine. Studies were included if published between 1990 and 2022 and included individuals with T2DM. During primary screening, one reviewer screened titles and abstracts for eligibility, while in the secondary screening, two reviewers worked independently to extract the relevant data from the full-text articles. RESULTS A total of 15,128 studies were found in the primary search, and 102 were finally included in the review. Most studies found were cross-sectional (72) and many investigated multiple socioeconomic factors. Four subcategories of socioeconomic factors were identified: economic (70), social (74), ethnical/racial (19) and geographical (18). The majority of studies found an association with antidiabetic medication adherence for two specific factors, namely individuals' insurance status (10) and ethnicity or race (18). Other important factors were income and education. CONCLUSIONS A large heterogeneity between studies was observed, with many studies relying on subjective data from interviewed individuals with a potential for recall bias. Several socioeconomic groups influencing medication adherence were identified, suggesting potential areas of intervention for the improvement of diabetes treatment adherence and individuals' long-term well-being.
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Affiliation(s)
- Christian Ming Studer
- Department of Chemistry and Applied Biosciences, Institute for Pharmaceutical Sciences, ETH Zurich, Zurich, Switzerland
| | - Marie Linder
- Centre for Pharmacoepidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Laura Pazzagli
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
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Tuobenyiere J, Mensah GP, Korsah KA. Patient perspective on barriers in type 2 diabetes self-management: A qualitative study. Nurs Open 2023; 10:7003-7013. [PMID: 37488987 PMCID: PMC10495717 DOI: 10.1002/nop2.1956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 05/21/2023] [Accepted: 07/12/2023] [Indexed: 07/26/2023] Open
Abstract
AIM To explore the perceived barriers in Type 2 Diabetes care among patients with diabetes. Design The study adopted a qualitative exploratory-descriptive design. METHODS A semi-structured interview guide was used to collect data from fifteen (15) purposively sampled patients with Type 2 Diabetes at a primary level health facility in the Bono East region. Participants' ages ranged between 42-72 years. The interviews were audio-recorded, transcribed verbatim and analysed using thematic content analysis. RESULTS Patients with Type 2 Diabetes encountered a range of barriers in diabetes care. These barriers included lack of knowledge of diabetes dietary management strategies, financial constraints, non-compliance to treatment, lack of glucometers, lack of social support, and increased waiting time at health care facilities. The findings indicate that more education on diabetes and dietary management is required as well as social support from peers, family, and non-governmental organizations. PATIENT OR PUBLIC CONTRIBUTION Diabetes self-management barriers as revealed by the patients who were participants of this study requires nurses and midwives to ensure that self-management education is well understood by patients and their relatives. This would empower the patients and bring clarity to their confusion about self-care practices.
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Affiliation(s)
- Justin Tuobenyiere
- General Nursing Department, Holy Family Nursing and Midwifery Training CollegeTechimanGhana
| | | | - Kwadwo Ameyaw Korsah
- Department of Adult Health, School of Nursing and MidwiferyUniversity of GhanaAccraGhana
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Li X, Liu R, Chen Y, Han Y, Wang Q, Xu Y, Zhou J, Jiang S. Patterns and Trends in Mortality Associated With and Due to Diabetes Mellitus in a Transitioning Region With 3.17 Million People: Observational Study. JMIR Public Health Surveill 2023; 9:e43687. [PMID: 37665630 PMCID: PMC10507522 DOI: 10.2196/43687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 06/20/2023] [Accepted: 07/25/2023] [Indexed: 09/05/2023] Open
Abstract
BACKGROUND Diabetes mellitus (DM) imposes a significant disease burden in economically transitioning regions. Most transitioning regions share similar experience in urbanization processes. Shanghai's Pudong district serves as a representative area of such regions. OBJECTIVE We aimed to assess the burden of and trends in DM mortality in Shanghai's Pudong district and analyze the impact of aging and multimorbidity. METHODS A longitudinal, population-based study was conducted to analyze DM mortality in Pudong from 2005 to 2020. We used joinpoint regression to analyze epidemiological features and long-term trends in crude mortality rate (CMR), age-standardized mortality rate worldwide (ASMRW), and years of life lost (YLL). Furthermore, the decomposition method was used to evaluate the contribution of demographic and nondemographic factors associated with mortality. RESULTS There were 49,414 deaths among individuals with DM, including 15,512 deaths due to DM. The CMR and ASMRW were 109.55/105 and 38.01/105 person-years, respectively. Among the mortality associated with and due to DM, the total annual ASMRW increased by 3.65% (95% CI 3.25%-4.06%) and 1.38% (95% CI 0.74%-2.02%), respectively. Additionally, the total annual YLL rate increased by 4.98% (95% CI 3.92%-6.05%) and 2.68% (95% CI 1.34%-4.04%). The rates of YLL increase in persons aged 30 to 44 years (3.98%, 95% CI 0.32%-7.78%) and 45 to 59 years (4.31%, 95% CI 2.95%-5.69%) were followed by the increase in persons aged 80 years and older (10.53%, 95% CI 9.45%-11.62%) for deaths associated with DM. The annual CMR attributable to demographic factors increased by 41.9% (95% CI 17.73%-71.04%) and 36.72% (95% CI 16.69%-60.2%) for deaths associated with and due to DM, respectively. Hypertension, cerebrovascular disease, and ischemic heart disease were the top 3 comorbidities. CONCLUSIONS Aging and multimorbidity played essential roles in changing the burden of DM in an urbanizing and transitioning region. There is an increasing disease burden among young and middle-aged people, emphasizing the need for greater attention to these groups. Health management is an emerging method that holds important implications for alleviating the future burden of DM.
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Affiliation(s)
- Xiaopan Li
- Department of Health Management Center, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Ru Liu
- Department of Health Management Center, Zhongshan Hospital, Fudan University, Shanghai, China
- Department of General Practice, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yichen Chen
- Office of Scientific Research and Information Management, Center for Disease Control and Prevention, Pudong New Area, Shanghai, China
- School of Public Health, Fudan University, Shanghai, China
| | - Yan Han
- Department of Health Management Center, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Qizhe Wang
- Department of Health Management Center, Zhongshan Hospital, Fudan University, Shanghai, China
- Department of General Practice, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yaxin Xu
- Department of Health Management Center, Zhongshan Hospital, Fudan University, Shanghai, China
- Department of General Practice, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jing Zhou
- Department of Health Management Center, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Sunfang Jiang
- Department of Health Management Center, Zhongshan Hospital, Fudan University, Shanghai, China
- Department of General Practice, Zhongshan Hospital, Fudan University, Shanghai, China
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Yorke E, Boima V, Ganu V, Tetteh J, Twumasi L, Ekem‐Ferguson G, Kretchy I, Mate‐Kole CC. The mediating role of quality of life on depression and medication adherence among patients with type 2 diabetes mellitus: A cross-sectional study. Health Sci Rep 2023; 6:e1539. [PMID: 37662538 PMCID: PMC10469042 DOI: 10.1002/hsr2.1539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/27/2023] [Accepted: 08/17/2023] [Indexed: 09/05/2023] Open
Abstract
Background and Aim Patients living with diabetes mellitus have a high burden of psychological distress such as depression and anxiety as well as impaired quality of life, which may negatively impact their adherence to medications, glucose control, and health-related costs.This study assessed the impact of quality of life and depression on medication adherence among patients with type 2 diabetes (type 2 diabetes mellitus [T2DM]) in a tertiary care setting in Ghana. Methods The study was a cross-sectional study involving 238 patients with diabetes aged 18 years and above. Validated tools were used to assess medication adherence, depressive symptoms, and quality of life. Structural Equation Modeling was adopted to examine the mediation effect of quality of life on the relationship between depression and medication adherence among participants. Results The mean age of the participants was 58.82 ± 13.49, and 169 (71.0%) out of a total of 238 respondents were females. Depression had a significant direct relationship with the quality of life of respondents [aβ (95% confidence interval, CI) = -0.20 (-0.03, -0.00), p < 0.05; -0.21 (-0.41, -0.01) p < 0.05, respectively] and indirect relationship with quality of life [aβ (95% CI) = -0.01 (-0.02, -0.004) p < 0.001]. Educational status and religion both showed a significant indirect relationship with quality of life [aβ (95% CI) = 0.06 (0.07, 0.12), p < 0.05; 0.18 (0.01, 0.35) p < 0.05, respectively]. The mediating effect of quality of life on the relationship between depression and medication adherence was significant (Sobel = -3.19, p < 0.001). Conclusion Depression, medication adherence, and quality of life were higher among older adults with T2DM. Depression was also found to have a strong negative association with both medication adherence and quality of life. Interventions to screen for depression and to improve the quality of life in patients living with diabetes are also recommended and this should go beyond the provision of standard treatments to explore further the mechanisms of this relationships.
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Affiliation(s)
- Ernest Yorke
- Department of Medicine & Therapeutics, University of Ghana Medical School, College of Health SciencesUniversity of GhanaAccraGhana
| | - Vincent Boima
- Department of Medicine & Therapeutics, University of Ghana Medical School, College of Health SciencesUniversity of GhanaAccraGhana
| | - Vincent Ganu
- Department of Medicine and Cardiothoracic UnitKorle‐Bu Teaching HospitalAccraGhana
| | - John Tetteh
- Department of Community Health, University of Ghana Medical School, College of Health SciencesUniversity of GhanaAccraGhana
| | | | - George Ekem‐Ferguson
- Department of PsychologyUniversity of GhanaAccraGhana
- National Cardiothoracic CenterKorle Bu Teaching HospitalAccraGhana
- Department of Psychiatry, University of Ghana Medical School, College of Health SciencesUniversity of GhanaAccraGhana
| | - Irene Kretchy
- Department of PsychologyUniversity of GhanaAccraGhana
| | - Christopher C. Mate‐Kole
- Department of PsychologyUniversity of GhanaAccraGhana
- Department of Psychiatry, University of Ghana Medical School, College of Health SciencesUniversity of GhanaAccraGhana
- Center for Ageing Studies, College of HumanitiesUniversity of Ghana
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12
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Lamptey R, Amoakoh-Coleman M, Djobalar B, Grobbee DE, Adjei GO, Klipstein-Grobusch K. Diabetes self-management education interventions and self-management in low-resource settings; a mixed methods study. PLoS One 2023; 18:e0286974. [PMID: 37450431 PMCID: PMC10348576 DOI: 10.1371/journal.pone.0286974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 05/27/2023] [Indexed: 07/18/2023] Open
Abstract
INTRODUCTION Diabetes is largely a self-managed disease; thus, care outcomes are closely linked to self-management behaviours. Structured self-management education (DSME) interventions are, however, largely unavailable in Africa. AIM We sought to characterise DSME interventions in two urban low-resource primary settings; and to explore diabetes self-management knowledge and behaviours, of persons living with diabetes (PLD). RESEARCH DESIGN AND METHODS A convergent parallel mixed-methods study was conducted between January and February 2021 in Accra, Ghana. The sampling methods used for selecting participants were total enumeration, consecutive sampling, purposive and judgemental sampling. Multivariable regression models were used to study the association between diabetes self-management knowledge and behaviours. We employed inductive content analysis of informants' experiences and context, to complement the quantitative findings. RESULTS In total, 425 PLD (70.1% (n = 298) females, mean age 58 years (SD 12), with a mean blood glucose of 9.4 mmol/l (SD 6.4)) participated in the quantitative study. Two managers, five professionals, two diabetes experts and 16 PLD participated in in-depth interviews. Finally, 24 PLD were involved in four focus group discussions. The median diabetes self-management knowledge score was 40% ((IQR 20-60). For every one unit increase in diabetes self-management knowledge, there were corresponding increases in the diet (5%;[95% CI: 2%-9%, p<0.05]), exercise (5%; [95% CI:2%-8%, p<0.05]) and glucose monitoring (4%;[95% CI:2%-5%, p<0.05]) domains of the diabetes self-care activities scale respectively. The DSME interventions studied, were unstructured and limited by resources. Financial constraints, conflicting messages, beliefs, and stigma were the themes underpinning self-management behaviour. CONCLUSIONS The DSME interventions studied were under-resourced, and unstructured. Diabetes self-management knowledge though limited, was associated with self-management behaviour. DSME interventions in low resource settings should be culturally tailored and should incorporate sessions on mitigating financial constraints. Future studies should focus on creating structured DSME interventions suited to resource-constrained settings.
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Affiliation(s)
- Roberta Lamptey
- Polyclinic/ Family Medicine Department, Korle Bu Teaching Hospital, Accra, Ghana
- Department of Community Health, University of Ghana Medical School, Accra, Ghana
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Mary Amoakoh-Coleman
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Babbel Djobalar
- Internal Medicine Department, Korle Bu Teaching Hospital, Accra, Ghana
| | - Diederick E. Grobbee
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - George Obeng Adjei
- Centre for Tropical Clinical Pharmacology and Therapeutics, University of Ghana Medical School, Accra, Ghana
- Office of Research Innovation and Development, University of Ghana, Legon, Ghana
| | - Kerstin Klipstein-Grobusch
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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13
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Grandieri A, Trevisan C, Gentili S, Vetrano DL, Liotta G, Volpato S. Relationship between People's Interest in Medication Adherence, Health Literacy, and Self-Care: An Infodemiological Analysis in the Pre- and Post-COVID-19 Era. J Pers Med 2023; 13:1090. [PMID: 37511703 PMCID: PMC10381156 DOI: 10.3390/jpm13071090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 06/24/2023] [Accepted: 06/28/2023] [Indexed: 07/30/2023] Open
Abstract
The prevalence of non-communicable diseases has risen sharply in recent years, particularly among older individuals who require complex drug regimens. Patients are increasingly required to manage their health through medication adherence and self-care, but about 50% of patients struggle to adhere to prescribed treatments. This study explored the relationship between interest in medication adherence, health literacy, and self-care and how it changed during the COVID-19 pandemic. We used Google Trends to measure relative search volumes (RSVs) for these three topics from 2012 to 2022. We found that interest in self-care increased the most over time, followed by health literacy and medication adherence. Direct correlations emerged between RSVs for medication adherence and health literacy (r = 0.674, p < 0.0001), medication adherence and self-care (r = 0.466, p < 0.0001), and health literacy and self-care (r = 0.545, p < 0.0001). After the COVID-19 pandemic outbreak, interest in self-care significantly increased, and Latin countries showed a greater interest in self-care than other geographical areas. This study suggests that people are increasingly interested in managing their health, especially in the context of the recent pandemic, and that infodemiology may provide interesting information about the attitudes of the population toward chronic disease management.
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Affiliation(s)
- Andrea Grandieri
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", 00133 Rome, Italy
- Geriatric and Orthogeriatric Unit, St. Anna University Hospital of Ferrara, 44124 Ferrara, Italy
| | - Caterina Trevisan
- Geriatric and Orthogeriatric Unit, St. Anna University Hospital of Ferrara, 44124 Ferrara, Italy
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, 141 86 Stockholm, Sweden
| | - Susanna Gentili
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, 141 86 Stockholm, Sweden
| | - Davide Liborio Vetrano
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, 141 86 Stockholm, Sweden
- Stockholm Gerontology Center, 141 86 Stockholm, Sweden
| | - Giuseppe Liotta
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", 00133 Rome, Italy
| | - Stefano Volpato
- Geriatric and Orthogeriatric Unit, St. Anna University Hospital of Ferrara, 44124 Ferrara, Italy
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14
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Shahabi N, Fakhri Y, Aghamolaei T, Hosseini Z, Homayuni A. Socio-personal factors affecting adherence to treatment in patients with type 2 diabetes: A systematic review and meta-analysis. Prim Care Diabetes 2023; 17:205-220. [PMID: 37012162 DOI: 10.1016/j.pcd.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 03/16/2023] [Accepted: 03/19/2023] [Indexed: 04/03/2023]
Abstract
PURPOSE The purpose of study was to identify the socio-personal factors affecting adherence to the treatment of patients with type 2 diabetes. METHODS Cross-sectional articles were extracted from databases such as Web of Science, PubMed, Elsevier. A meta-analysis was performed using integrated odds ratios (OR) and 95% confidence interval (CIs) for age, BMI, depression, educational level, gender, employment status, marital status, smoking status. STATA 12.0 was used to estimate pooled RR in definite subgroups. The quality of the studies included was evaluated using the STROBE checklist. RESULTS Thirty-one studies out of 7407 extracted articles were finally selected for the meta-analysis. The results showed that younger people had a 17% higher risk than older people, smokers had a 22% higher risk than non-smokers, and the employed had a 15% higher risk of non-adherence to treatment. CONCLUSION In conclusion, older age, smoking and employment can lead to non-adherence to T2D treatment. Interventions are suggested to be made besides common health care considering the socio-personal features on type 2 diabetes patients' treatment adherence.
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Affiliation(s)
- Nahid Shahabi
- Student Research Committee, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Yadolah Fakhri
- Food Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Teamur Aghamolaei
- Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Zahra Hosseini
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
| | - Atefeh Homayuni
- Student Research Committee, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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15
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Adherence to Oral Antidiabetic Drugs in Patients with Type 2 Diabetes: Systematic Review and Meta-Analysis. J Clin Med 2023; 12:jcm12051981. [PMID: 36902770 PMCID: PMC10004070 DOI: 10.3390/jcm12051981] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 02/27/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023] Open
Abstract
Poor adherence to oral antidiabetic drugs (OADs) in patients with type 2 diabetes (T2D) can lead to therapy failure and risk of complications. The aim of this study was to produce an adherence proportion to OADs and estimate the association between good adherence and good glycemic control in patients with T2D. We searched in MEDLINE, Scopus, and CENTRAL databases to find observational studies on therapeutic adherence in OAD users. We calculated the proportion of adherent patients to the total number of participants for each study and pooled study-specific adherence proportions using random effect models with Freeman-Tukey transformation. We also calculated the odds ratio (OR) of having good glycemic control and good adherence and pooled study-specific OR with the generic inverse variance method. A total of 156 studies (10,041,928 patients) were included in the systematic review and meta-analysis. The pooled proportion of adherent patients was 54% (95% confidence interval, CI: 51-58%). We observed a significant association between good glycemic control and good adherence (OR: 1.33; 95% CI: 1.17-1.51). This study demonstrated that adherence to OADs in patients with T2D is sub-optimal. Improving therapeutic adherence through health-promoting programs and prescription of personalized therapies could be an effective strategy to reduce the risk of complications.
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16
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Abd El Kader AI, Ibrahim ME, Mohamed HS, Osman BM. Diabetes Distress and Self-Care Activities Among Patients With Diabetes Type II: A Correlation Study. SAGE Open Nurs 2023; 9:23779608231189944. [PMID: 37584032 PMCID: PMC10424545 DOI: 10.1177/23779608231189944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 07/05/2023] [Accepted: 07/09/2023] [Indexed: 08/17/2023] Open
Abstract
Introduction Diabetes mellitus (DM) is a main, highly prevalent, and challenging public health issue. Suboptimal self-care for type II diabetes can lead to poor glycemic control, complications, and even death. Objective This study investigated the incidence of distress and its link with self-care habits of patients with diabetes type II. Methods A correlational, cross-sectional design with a convenient sample of 200 patients was used to conduct this study. Three questionnaires were administered: (A) the demographic and medical data questionnaire; (B) diabetes self-care activities in brief; and (C) the diabetes distress scale in Arabic language. Results The patients' mean age was 51.78 ± 11.34; 80% of patients practiced lower levels of diabetes self-care, and 37% of them had a high level of diabetes distress. Self-care is associated with diabetes distress (R = -0.152, p-value = .032). Conclusion Self-care activities can help in the early detection and management of diabetes distress. Sustained self-care education is promising to minimize diabetes distress. The potential advantages of association between diabetes distress and self-care can offer self-care programs that enhance diabetes distress management.
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Affiliation(s)
| | | | - Helalia Shalabi Mohamed
- Community Health Nursing, Faculty of Nursing, Cairo University, Cairo, Egypt
- Community Health Nursing, College of Nursing, PAAET, Safat, Kuwait
| | - Basma Mohamed Osman
- Community Health Nursing, Faculty of Nursing, Cairo University, Cairo, Egypt
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17
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Sendekie AK, Netere AK, Kasahun AE, Belachew EA. Medication adherence and its impact on glycemic control in type 2 diabetes mellitus patients with comorbidity: A multicenter cross-sectional study in Northwest Ethiopia. PLoS One 2022; 17:e0274971. [PMID: 36130160 PMCID: PMC9491880 DOI: 10.1371/journal.pone.0274971] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 09/07/2022] [Indexed: 11/17/2022] Open
Abstract
Background
Medication nonadherence in patients with chronic diseases, particularly in type 2 diabetes mellitus (T2DM) with comorbidity, has continued to be the cause of treatment failure. The current study assessed medication adherence and its impact on glycemic control in T2DM patients with comorbidity.
Methods
An institutional-based multicenter cross-sectional study was conducted among T2DM patients with comorbidity at the selected hospitals in Northwest Ethiopia. Medication adherence was measured using a structured questionnaire of the General Medication Adherence Scale (GMAS). A logistic regression model was used to identify predictors of the level of medication adherence and glycemic control. P < 0.05 at 95% confidence interval (CI) was statistically significant.
Results
A total of 403 samples were included in the final study. This study showed that more than three-fourths (76.9%) of the participants were under a low level of medication adherence. Source of medication cost coverage [AOR = 10.593, 95% CI (2.628–41.835; P = 0.003], monthly income (P < 0.00), self-monitoring of blood glucose (SMBG) practice [AOR = 0.266, 95% CI (0.117–0.604); P = 0.002], number of medications [AOR = 0.068, 95% CI (0.004–0.813); P = 0.014] and medical conditions [AOR = 0.307, 95% CI (0.026–0.437); P = 0.018] were found to be significant predictors of medication adherence. Significantly, majority (74.7%) of participants had poor levels of glycemic control. Patients who had a high level of medication adherence [AOR = 0.003, 95% CI (0.000–0.113); P = 0.002] were found less likely to have poor glycemic control compared with patients who were low adherent to their medications.
Conclusion
The current study concluded that medication adherence was low and significantly associated with poor glycemic control. Number of medical conditions and medications were found to be associated with medication adherence. Management interventions of T2DM patients with comorbidity should focus on the improvement of medication adherence.
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Affiliation(s)
- Ashenafi Kibret Sendekie
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
- * E-mail: ,
| | - Adeladlew Kassie Netere
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Asmamaw Emagn Kasahun
- Department of Pharmaceutics, School of Pharmacy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Eyayaw Ashete Belachew
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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18
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Tang Z, Shen C, Tong W, Xiang X, Feng Z, Han B. Frailty in Community-Dwelling Adults Aged 40 Years and over with Type 2 Diabetes: Association with Self-Management Behaviors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159092. [PMID: 35897460 PMCID: PMC9332363 DOI: 10.3390/ijerph19159092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 07/21/2022] [Accepted: 07/22/2022] [Indexed: 11/16/2022]
Abstract
Background: Evidence is lacking on risk factors for frailty and prefrailty and their relationship with self-management behaviors in patients ≥40 years of age with type 2 diabetes. Methods: Participants were selected as a cross-sectional cohort at five communities in Shanghai, China during January−March 2021. The modified FRAIL scale and the Summary of Diabetes Self-Care Activities (SDSCA) measure were used. Results: Of the 558 participants, 10.2% were classified as frailty and 34.1% as prefrailty. The prevalence of frailty was higher in males than in females (p = 0.009), whereas females were associated with higher odds of prefrailty (aOR 1.67, 95% CI [1.08−2.60]). Multimorbidity, ≥3 chronic diseases, and hospitalization in the past year were considered risk factors for both frailty and prefrailty. Each point earned on SDSCA and physical activity were associated with lower odds of frailty (aOR 0.95, 95% CI [0.92−0.98]) and prefrailty (aOR 0.52, 95% CI [0.31−0.85]), respectively. Frail participants performed significantly worse self-care practice than prefrail and non-frail ones, especially on diet, physical activity, and medication adherence (p < 0.001). Conclusions: Frail patients ≥40 years of age with type 2 diabetes reported poorer self-care performance. Further interventional studies are warranted to clarify their causal relationship.
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Affiliation(s)
- Zhijia Tang
- Department of Clinical Pharmacy and Pharmacy Administration, School of Pharmacy, Fudan University, Shanghai 201203, China; (Z.T.); (W.T.); (X.X.)
| | - Chunying Shen
- Minhang Hospital & School of Pharmacy, Fudan University, Shanghai 201199, China;
| | - Waikei Tong
- Department of Clinical Pharmacy and Pharmacy Administration, School of Pharmacy, Fudan University, Shanghai 201203, China; (Z.T.); (W.T.); (X.X.)
| | - Xiaoqiang Xiang
- Department of Clinical Pharmacy and Pharmacy Administration, School of Pharmacy, Fudan University, Shanghai 201203, China; (Z.T.); (W.T.); (X.X.)
| | - Zhen Feng
- Department of Clinical Pharmacy and Pharmacy Administration, School of Pharmacy, Fudan University, Shanghai 201203, China; (Z.T.); (W.T.); (X.X.)
- Correspondence: (Z.F.); (B.H.)
| | - Bing Han
- Minhang Hospital & School of Pharmacy, Fudan University, Shanghai 201199, China;
- Correspondence: (Z.F.); (B.H.)
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Obirikorang Y, Acheampong E, Anto EO, Afrifa-Yamoah E, Adua E, Taylor J, Fondjo LA, Lokpo SY, Adu EA, Adutwum B, Antwi EO, Acheampong EN, Gyamfi MA, Aidoo F, Owiredu EW, Obirikorang C. Nexus between constructs of social cognitive theory model and diabetes self-management among Ghanaian diabetic patients: A mediation modelling approach. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000736. [PMID: 36962448 PMCID: PMC10022127 DOI: 10.1371/journal.pgph.0000736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 06/13/2022] [Indexed: 11/19/2022]
Abstract
The promotion of Diabetes Self-Management (DSM) practices, education, and support is vital to improving the care and wellbeing of diabetic patients. Identifying factors that affect DSM behaviours may be useful to promote healthy living among these patients. The study assessed the determinants of DSM practices among Type 2 diabetes mellitus (T2DM) patients using a model-based social cognitive theory (SCT). This cross-sectional study comprised 420 (T2DM) patients who visited the Diabetic Clinic of the Komfo Anokye Teaching Hospital (KATH), Kumasi-Ghana. Data was collected using self-structured questionnaires to obtain socio-demographic characteristics, T2DM-related knowledge, DSM practices, SCT constructs; beliefs in treatment effectiveness, level of self-efficacy, perceived family support, and healthcare provider-patient communication. Path analysis was used to determine direct and indirect effects of T2DM-related knowledge, perceived family support, and healthcare provider service on DSM practices with level of self-efficacy mediating the relationships, and beliefs in treatment effectiveness as moderators. The mean age of the participants was 53.1(SD = 11.4) years and the average disease duration of T2DM was 10 years. Most of the participants (65.5%) had high (>6.1mmol/L) fasting blood glucose (FBG) with an average of 6.93(SD = 2.41). The path analysis model revealed that age (p = 0.176), gender (p = 0.901), and duration of T2DM (p = 0.119) did not confound the relationships between the SCT constructs and DSM specified in the model. A significant direct positive effect of family and friends' support (Critical ratio (CR) = 5.279, p < 0.001) on DSM was observed. Self-efficacy was a significant mediator in this relationship (CR = 4.833, p < 0.001). There were significant conditional indirect effects (CIE) for knowledge of T2DM and family and friends' support at medium and high levels of belief in treatment effectiveness (p < 0.05) via level of self-efficacy on DSM practices. However, no evidence of moderated-mediation was observed for the exogenous variables on DSM. Diabetes-related knowledge of T2DM, family and friends' support, level of self-efficacy, and belief in treatment effectiveness are crucial in DSM practices among Ghanaian T2DM patients. It is incumbent to consider these factors when designing interventions to improve DSM adherence.
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Affiliation(s)
- Yaa Obirikorang
- Department of Nursing, Faculty of Health Sciences, Garden City University College (GCUC), Kenyasi, Kumasi, Ghana
| | - Emmanuel Acheampong
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
- Centre for Precision Health, ECU Strategic Research Centre, Edith Cowan University, Perth, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Enoch Odame Anto
- Centre for Precision Health, ECU Strategic Research Centre, Edith Cowan University, Perth, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
- Department of Medical Diagnostics, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Eric Adua
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - John Taylor
- Centre for Precision Health, ECU Strategic Research Centre, Edith Cowan University, Perth, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Linda Ahenkorah Fondjo
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Sylvester Yao Lokpo
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Evans Asamoah Adu
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Bernard Adutwum
- Department of Nursing, Faculty of Health Sciences, Garden City University College (GCUC), Kenyasi, Kumasi, Ghana
| | - Enoch Ofori Antwi
- Department of Nursing, Faculty of Health Sciences, Garden City University College (GCUC), Kenyasi, Kumasi, Ghana
| | - Emmanuella Nsenbah Acheampong
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Michael Adu Gyamfi
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Freeman Aidoo
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Eddie-Williams Owiredu
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Christian Obirikorang
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
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20
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Portela RDA, Silva JRS, Nunes FBBDF, Lopes MLH, Batista RFL, Silva ACO. Diabetes mellitus type 2: factors related to adherence to self-care. Rev Bras Enferm 2022; 75:e20210260. [DOI: 10.1590/0034-7167-2021-0260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 11/04/2021] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objectives: to analyze the sociodemographic and clinical variables related to the adherence to self-care activities in people with diabetes mellitus type 2. Methods: quantitative, cross-sectional study, carried out with 270 people with diabetes from December 2019 to October 2020, in São Luís, Maranhão. Results: the adherence to self-care was greater when it comes to medications (Md=7.0) and foot care (Md= 6.0), but lower in regard to blood sugar testing (Md=1.0), exercise (Md=2,0), and diet (general) (Md=4.0). The variables age group (p=0.007), educational level (p=0.015), body mass index (p=0.035), complications with diabetes (p=0.009), and nutritional follow-up (p=0.000) had associations with self-care activities. Conclusions: identifying the factors related to the adherence to self-care was found to be essential to strengthen the line of care in chronic diseases and to direct educational actions, aiming to improve the quality of life of people with diabetes.
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Alhassan Y, Kwakye AO, Dwomoh AK, Baah-Nyarkoh E, Ganu VJ, Appiah B, Kretchy IA. Determinants of blood pressure and blood glucose control in patients with co-morbid hypertension and type 2 diabetes mellitus in Ghana: A hospital-based cross-sectional study. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0001342. [PMID: 36962917 PMCID: PMC10022155 DOI: 10.1371/journal.pgph.0001342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 11/09/2022] [Indexed: 12/12/2022]
Abstract
Hypertension and diabetes are major risk factors for cardiovascular diseases and optimal control of blood pressure (BP) and blood glucose are associated with reduced cardiovascular disease events. This study, therefore, sought to estimate the prevalence and associated factors of controlled BP and blood glucose levels among patients diagnosed with both hypertension and Type 2- diabetes mellitus (T2DM). A quantitative cross-sectional study was conducted in a primary health setting in Ghana among patients 18 years and older diagnosed with both hypertension and T2DM. Pearson's chi-square was used to assess the association between BP and blood glucose levels and the independent variables. The multivariable binary logistic regression model was used to assess the adjusted odds of controlled BP and blood glucose levels. Among the 329 participants diagnosed with both hypertension and T2DM, 41.3% (95% CI: 36.1-46.8%) had controlled BP, 57.1% (95% CI: 51.7-62.4%) had controlled blood glucose whilst 21.8% (95% CI: 17.7-26.7%) had both controlled BP and blood glucose levels. Increased age, non-formal education, non-married, employed, single-dose anti-hypertensives or anti-diabetic medications, and hyperlipidaemia or stroke co-morbidities were positively associated with controlled BP levels. Being female, married, taking 2 or more anti-hypertensive medications, and moderate to high medication-related burden were positively associated with controlled blood glucose levels. In terms of both controlled BP and blood glucose levels, being employed, reduced income level, being registered with national health insurance, single anti-diabetes or anti-hypertensive medications, hyperlipidaemia or stroke co-morbidities, and moderate to high medication-related burden were positively associated with having both controlled BP and blood glucose levels. One in five patients with hypertension and T2DM had both BP and blood glucose levels under control. The benefits and risks of blood pressure and blood glucose targets should thus be factored into the management of patients with hypertension and T2DM.
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Affiliation(s)
- Yakubu Alhassan
- Department of Biostatistics, School of Public Health, University of Ghana, Accra, Ghana
| | - Adwoa Oforiwaa Kwakye
- Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Andrews K Dwomoh
- Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Emmanuella Baah-Nyarkoh
- Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, University of Ghana, Legon, Ghana
| | | | - Bernard Appiah
- Department of Public Health, Falk College, Syracuse University, Syracuse, NY, United States of America
| | - Irene A Kretchy
- Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, University of Ghana, Legon, Ghana
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