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Erschienen in: International Journal of Clinical Pharmacy 6/2011

01.12.2011 | Research Article

Diabetes knowledge, medication adherence and glycemic control among patients with type 2 diabetes

Erschienen in: International Journal of Clinical Pharmacy | Ausgabe 6/2011

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Abstract

Background Most of interventions that have attempted to improve medication adherence in type 2 diabetes have been educational; on the assumption that knowledge regarding diabetes might affect patients’ adherence to their treatment regimen. Objectives The purpose of the study was to investigate any association of knowledge and medication adherence with glycemic control in patients with type 2 diabetes mellitus. Setting The study was conducted at the Diabetes Outpatients Clinic, Hospital Pulau Penang. Methods A cross-sectional study was conducted with a convenience sample of 540 adult patients with type 2 diabetes attending the clinic. A questionnaire including previously validated Michigan Diabetes Knowledge Test and Morisky Medication Adherence Scale was used and the patients’ medical records were reviewed for haemoglobin A1C (HbA1C) levels and other disease-related information. A total of 35 (6.48%) patients were excluded after data collection due to lack of HbA1C results. Results Five hundred and five patients were included in the final analysis, with a mean age of 58.15 years (SD = 9.16), 50.7% males and median HbA1C of 7.6 (IQR was 6.7–8.9). The median total knowledge score was 7.0 (IQR was 5.0–10.0) while the median adherence score was 6.5 (IQR was 4.75–7.75). Significant correlations were found between the three variables (HbA1C, knowledge and adherence). A significantly higher score for knowledge and adherence (P < 0.05) was found in those patients with lower HbA1C. Higher diabetes knowledge, higher medication adherence and using mono-therapy were significant predictors of good glycemic control in the multivariate analysis. Conclusion Patients’ knowledge about diabetes is associated with better medication adherence and better glycemic control. In addition to other factors affecting medication adherence and glycemic control, healthcare providers should pay attention to knowledge about diabetes that the patients carry towards medication adherence.
Literatur
1.
Zurück zum Zitat Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27(5):1047–53.PubMedCrossRef Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27(5):1047–53.PubMedCrossRef
3.
Zurück zum Zitat Wong J, Rahimah N. Glycaemic control of diabetic patients in an urban primary health care setting in Sarawak: the Tanah Puteh health centre experience. Med J Malaysia. 2004;59(3):411–7.PubMed Wong J, Rahimah N. Glycaemic control of diabetic patients in an urban primary health care setting in Sarawak: the Tanah Puteh health centre experience. Med J Malaysia. 2004;59(3):411–7.PubMed
4.
Zurück zum Zitat Mafauzy M. Diabetes control and complications in public hospitals in Malaysia. Med J Malaysia. 2006;61(4):477–83.PubMed Mafauzy M. Diabetes control and complications in public hospitals in Malaysia. Med J Malaysia. 2006;61(4):477–83.PubMed
5.
Zurück zum Zitat Ministry of Health Malaysia. Clinical practice guidelines: management of type 2 diabetes mellitus. 2009 [cited 2010 January, 20]; Available from: http://www.moh.gov.my. Ministry of Health Malaysia. Clinical practice guidelines: management of type 2 diabetes mellitus. 2009 [cited 2010 January, 20]; Available from: http://​www.​moh.​gov.​my.
6.
Zurück zum Zitat Ooyub S, Ismail F, Daud N. Diabetes program in Malaysia—current and future. NCD Malaysia. 2004;3:6–12. Ooyub S, Ismail F, Daud N. Diabetes program in Malaysia—current and future. NCD Malaysia. 2004;3:6–12.
7.
Zurück zum Zitat Murata G, Shah J, Adam K, Wendel C, Bokhari S, Solvas P, et al. Factors affecting diabetes knowledge in type 2 diabetic veterans. Diabetologia. 2003;46(8):1170–8.PubMedCrossRef Murata G, Shah J, Adam K, Wendel C, Bokhari S, Solvas P, et al. Factors affecting diabetes knowledge in type 2 diabetic veterans. Diabetologia. 2003;46(8):1170–8.PubMedCrossRef
8.
Zurück zum Zitat Al Shafaee M, Al-Shukaili S, Rizvi S, Al Farsi Y, Khan M, Ganguly S, et al. Knowledge and perceptions of diabetes in a semi-urban Omani population. BMC Public Health. 2008;8(1):249.PubMedCrossRef Al Shafaee M, Al-Shukaili S, Rizvi S, Al Farsi Y, Khan M, Ganguly S, et al. Knowledge and perceptions of diabetes in a semi-urban Omani population. BMC Public Health. 2008;8(1):249.PubMedCrossRef
9.
Zurück zum Zitat Bruce D, Davis W, Cull C, Davis T. Diabetes education and knowledge in patients with type 2 diabetes from the community: the Fremantle diabetes study. J Diabetes Complic. 2003;17(2):82–9.CrossRef Bruce D, Davis W, Cull C, Davis T. Diabetes education and knowledge in patients with type 2 diabetes from the community: the Fremantle diabetes study. J Diabetes Complic. 2003;17(2):82–9.CrossRef
10.
Zurück zum Zitat McClean M, McElnay J, Andrews W. The association of psychosocial and diabetes factors to diabetes knowledge. Int J Pharm Pract. 2001;9:R9.CrossRef McClean M, McElnay J, Andrews W. The association of psychosocial and diabetes factors to diabetes knowledge. Int J Pharm Pract. 2001;9:R9.CrossRef
11.
Zurück zum Zitat Gunay T, Ulusel B, Velipasaoglu S, Unal B, Ucku R, Ozgener N. Factors affecting adult knowledge of diabetes in Narlidere Health District, Turkey. Acta Diabetol. 2006;43(4):142–7.PubMedCrossRef Gunay T, Ulusel B, Velipasaoglu S, Unal B, Ucku R, Ozgener N. Factors affecting adult knowledge of diabetes in Narlidere Health District, Turkey. Acta Diabetol. 2006;43(4):142–7.PubMedCrossRef
12.
Zurück zum Zitat Angeles-Llerenas A, Carbajal-Sánchez N, Allen B, Zamora-Muñoz S, Lazcano-Ponce E. Gender, body mass index and socio-demographic variables associated with knowledge about type 2 diabetes mellitus among 13 293 Mexican students. Acta Diabetol. 2005;42(1):36–45.PubMedCrossRef Angeles-Llerenas A, Carbajal-Sánchez N, Allen B, Zamora-Muñoz S, Lazcano-Ponce E. Gender, body mass index and socio-demographic variables associated with knowledge about type 2 diabetes mellitus among 13 293 Mexican students. Acta Diabetol. 2005;42(1):36–45.PubMedCrossRef
13.
Zurück zum Zitat Murugesan N, Snehalatha C, Shobhana R, Roglic G, Ramachandran A. Awareness about diabetes and its complications in the general and diabetic population in a city in southern India. Diabetes Res Clin Pract. 2007;77(3):433–7.PubMedCrossRef Murugesan N, Snehalatha C, Shobhana R, Roglic G, Ramachandran A. Awareness about diabetes and its complications in the general and diabetic population in a city in southern India. Diabetes Res Clin Pract. 2007;77(3):433–7.PubMedCrossRef
14.
Zurück zum Zitat Funnell M, Brown T, Childs B, Haas L, Hosey G, Jensen B, et al. National standards for diabetes self-management education. Diabetes Care. 2007;30(6):1630–7.PubMedCrossRef Funnell M, Brown T, Childs B, Haas L, Hosey G, Jensen B, et al. National standards for diabetes self-management education. Diabetes Care. 2007;30(6):1630–7.PubMedCrossRef
15.
Zurück zum Zitat World Health Organization. Report on medication adherence: Geneva, WHO; 2003. World Health Organization. Report on medication adherence: Geneva, WHO; 2003.
16.
Zurück zum Zitat Rhee M, Slocum W, Ziemer D, Culler S, Cook C, El-Kebbi I, et al. Patient adherence improves glycemic control. Diabetes Educ. 2005;31(2):240–50.PubMedCrossRef Rhee M, Slocum W, Ziemer D, Culler S, Cook C, El-Kebbi I, et al. Patient adherence improves glycemic control. Diabetes Educ. 2005;31(2):240–50.PubMedCrossRef
17.
Zurück zum Zitat Simpson S, Eurich D, Majumdar S, Padwal R, Tsuyuki R, Varney J, et al. A meta-analysis of the association between adherence to drug therapy and mortality. Br Med J. 2006;333(7557):18–9.CrossRef Simpson S, Eurich D, Majumdar S, Padwal R, Tsuyuki R, Varney J, et al. A meta-analysis of the association between adherence to drug therapy and mortality. Br Med J. 2006;333(7557):18–9.CrossRef
18.
Zurück zum Zitat Krapek K, King K, Warren S, George K, Caputo D, Mihelich K, et al. Medication adherence and associated hemoglobin A1c in type 2 diabetes. Ann Pharmacother. 2004;38(9):1357–62.PubMedCrossRef Krapek K, King K, Warren S, George K, Caputo D, Mihelich K, et al. Medication adherence and associated hemoglobin A1c in type 2 diabetes. Ann Pharmacother. 2004;38(9):1357–62.PubMedCrossRef
19.
Zurück zum Zitat Briesacher B, Andrade S, Fouayzi H, Chan K. Comparison of drug adherence rates among patients with seven different medical conditions. Pharmacotherapy. 2008;28(4):437–43.PubMedCrossRef Briesacher B, Andrade S, Fouayzi H, Chan K. Comparison of drug adherence rates among patients with seven different medical conditions. Pharmacotherapy. 2008;28(4):437–43.PubMedCrossRef
20.
Zurück zum Zitat Funnell M, Anderson R. Empowerment and self-management of diabetes. Clin Diabetes. 2004;22(3):123–7.CrossRef Funnell M, Anderson R. Empowerment and self-management of diabetes. Clin Diabetes. 2004;22(3):123–7.CrossRef
21.
Zurück zum Zitat Merican M, Rohaizat Y, Haniza S. Developing the Malaysian health system to meet the challenges of the future. Med J Malaysia. 2004;59(1):84–93.PubMed Merican M, Rohaizat Y, Haniza S. Developing the Malaysian health system to meet the challenges of the future. Med J Malaysia. 2004;59(1):84–93.PubMed
22.
Zurück zum Zitat Fitzgerald J, Funnell M, Hess G, Barr P, Anderson R, Hiss R, et al. The reliability and validity of a brief diabetes knowledge test. Diabetes Care. 1998;21(5):706–10.PubMedCrossRef Fitzgerald J, Funnell M, Hess G, Barr P, Anderson R, Hiss R, et al. The reliability and validity of a brief diabetes knowledge test. Diabetes Care. 1998;21(5):706–10.PubMedCrossRef
23.
Zurück zum Zitat Al-Qazaz H, Hassali M, Shafie A, Sulaiman S, Sundram S. The 14-item Michigan diabetes knowledge test: translation and validation study of the Malaysian version. Pract Diabetes Int. 2010;27(6):238–241a.CrossRef Al-Qazaz H, Hassali M, Shafie A, Sulaiman S, Sundram S. The 14-item Michigan diabetes knowledge test: translation and validation study of the Malaysian version. Pract Diabetes Int. 2010;27(6):238–241a.CrossRef
24.
Zurück zum Zitat Morisky D, Ang A, Krousel-Wood M, Ward H. Predictive validity of a medication adherence measure in an outpatient setting. J Clin Hypertens. 2008;10(5):348–54.CrossRef Morisky D, Ang A, Krousel-Wood M, Ward H. Predictive validity of a medication adherence measure in an outpatient setting. J Clin Hypertens. 2008;10(5):348–54.CrossRef
25.
Zurück zum Zitat Al-Qazaz H, Hassali M, Shafie A, Sulaiman S, Sundram S, Morisky D. The eight-item Morisky Medication Adherence Scale MMAS: translation and validation of the Malaysian version. Diabetes Res Clin Pract. 2010;90:216–21.PubMedCrossRef Al-Qazaz H, Hassali M, Shafie A, Sulaiman S, Sundram S, Morisky D. The eight-item Morisky Medication Adherence Scale MMAS: translation and validation of the Malaysian version. Diabetes Res Clin Pract. 2010;90:216–21.PubMedCrossRef
26.
Zurück zum Zitat Krousel-Wood M, Islam T, Webber L, Re RN, Morisky D, Muntner P. New medication adherence scale versus pharmacy fill rates in seniors with hypertension. Am J Manag Care. 2009;15(1):59–66.PubMed Krousel-Wood M, Islam T, Webber L, Re RN, Morisky D, Muntner P. New medication adherence scale versus pharmacy fill rates in seniors with hypertension. Am J Manag Care. 2009;15(1):59–66.PubMed
27.
Zurück zum Zitat Sacks D, Bruns D, Goldstein D, Maclaren N, McDonald J, Parrott M. Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus. Clin Chem. 2002;48(3):436–72.PubMed Sacks D, Bruns D, Goldstein D, Maclaren N, McDonald J, Parrott M. Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus. Clin Chem. 2002;48(3):436–72.PubMed
28.
Zurück zum Zitat Gonen B, Rochman H, Rubenstein A, Tanega S, Horwitz D. Haemoglobin A1: an indicator of the metabolic control of diabetic patients. Lancet. 1977;310(8041):734–7.CrossRef Gonen B, Rochman H, Rubenstein A, Tanega S, Horwitz D. Haemoglobin A1: an indicator of the metabolic control of diabetic patients. Lancet. 1977;310(8041):734–7.CrossRef
29.
Zurück zum Zitat Hinton P, Brownlow C. SPSS explained. New York: Theatre Arts Books; 2004. Hinton P, Brownlow C. SPSS explained. New York: Theatre Arts Books; 2004.
30.
Zurück zum Zitat Mickey R, Greenland S. The impact of confounder selection criteria on effect estimation. Am J Epidemiol. 1989;129(1):125.PubMed Mickey R, Greenland S. The impact of confounder selection criteria on effect estimation. Am J Epidemiol. 1989;129(1):125.PubMed
31.
Zurück zum Zitat He X, Wharrad H. Diabetes knowledge and glycemic control among Chinese people with type 2 diabetes. Int Nurs Rev. 2007;54(3):280–7.PubMedCrossRef He X, Wharrad H. Diabetes knowledge and glycemic control among Chinese people with type 2 diabetes. Int Nurs Rev. 2007;54(3):280–7.PubMedCrossRef
32.
Zurück zum Zitat Tan M, Magarey J. Self-care practices of Malaysian adults with diabetes and sub-optimal glycaemic control. Patient Educ Couns. 2008;72(2):252–67.PubMedCrossRef Tan M, Magarey J. Self-care practices of Malaysian adults with diabetes and sub-optimal glycaemic control. Patient Educ Couns. 2008;72(2):252–67.PubMedCrossRef
33.
Zurück zum Zitat West J, Goldberg K. Diabetes self-care knowledge among outpatients at a Veterans Affairs medical center. Am J Health Syst Pharm. 2002;59(9):849–52.PubMed West J, Goldberg K. Diabetes self-care knowledge among outpatients at a Veterans Affairs medical center. Am J Health Syst Pharm. 2002;59(9):849–52.PubMed
34.
Zurück zum Zitat Heisler M, Piette J, Spencer M, Kieffer E, Vijan S. The relationship between knowledge of recent HbA1c values and diabetes care understanding and self-management. Diabetes Care. 2005;28(4):816–22.PubMedCrossRef Heisler M, Piette J, Spencer M, Kieffer E, Vijan S. The relationship between knowledge of recent HbA1c values and diabetes care understanding and self-management. Diabetes Care. 2005;28(4):816–22.PubMedCrossRef
35.
Zurück zum Zitat Al-Adsani A, Moussa M, Al-Jasem L, Abdella N, Al-Hamad N. The level and determinants of diabetes knowledge in Kuwaiti adults with type 2 diabetes. Diabetes Metab. 2009;35(2):121–8.PubMedCrossRef Al-Adsani A, Moussa M, Al-Jasem L, Abdella N, Al-Hamad N. The level and determinants of diabetes knowledge in Kuwaiti adults with type 2 diabetes. Diabetes Metab. 2009;35(2):121–8.PubMedCrossRef
36.
Zurück zum Zitat Lerman I. Adherence to treatment: the key for avoiding long-term complications of diabetes. Arch Med Res. 2005;36(3):300–6.PubMedCrossRef Lerman I. Adherence to treatment: the key for avoiding long-term complications of diabetes. Arch Med Res. 2005;36(3):300–6.PubMedCrossRef
37.
Zurück zum Zitat Rubin R. Adherence to pharmacologic therapy in patients with type 2 diabetes mellitus. Am J Med. 2005;118(5):27S–34S.PubMedCrossRef Rubin R. Adherence to pharmacologic therapy in patients with type 2 diabetes mellitus. Am J Med. 2005;118(5):27S–34S.PubMedCrossRef
38.
Zurück zum Zitat Bezie Y, Molina M, Hernandez N, Batista R, Niang S, Huet D. Therapeutic compliance: a prospective analysis of various factors involved in the adherence rate in type 2 diabetes. Diabetes Metab. 2006;32(6):611–6.PubMedCrossRef Bezie Y, Molina M, Hernandez N, Batista R, Niang S, Huet D. Therapeutic compliance: a prospective analysis of various factors involved in the adherence rate in type 2 diabetes. Diabetes Metab. 2006;32(6):611–6.PubMedCrossRef
39.
Zurück zum Zitat Ho P, Rumsfeld J, Masoudi F, McClure D, Plomondon M, Steiner J, et al. Effect of medication nonadherence on hospitalization and mortality among patients with diabetes mellitus. Arch Intern Med. 2006;166(17):1836–41.PubMedCrossRef Ho P, Rumsfeld J, Masoudi F, McClure D, Plomondon M, Steiner J, et al. Effect of medication nonadherence on hospitalization and mortality among patients with diabetes mellitus. Arch Intern Med. 2006;166(17):1836–41.PubMedCrossRef
40.
Zurück zum Zitat Odegard P, Gray S. Barriers to medication adherence in poorly controlled diabetes mellitus. Diabetes Educ. 2008;34(4):692–7.PubMedCrossRef Odegard P, Gray S. Barriers to medication adherence in poorly controlled diabetes mellitus. Diabetes Educ. 2008;34(4):692–7.PubMedCrossRef
41.
Zurück zum Zitat Vermeire E, Hearnshaw H, Van Royen P, Denekens J. Patient adherence to treatment: three decades of research. A comprehensive review. J Clin Pharm Ther. 2001;26(5):331–42.PubMedCrossRef Vermeire E, Hearnshaw H, Van Royen P, Denekens J. Patient adherence to treatment: three decades of research. A comprehensive review. J Clin Pharm Ther. 2001;26(5):331–42.PubMedCrossRef
42.
Zurück zum Zitat Vlasnik J, Aliotta S, DeLor B. Medication adherence: factors influencing compliance with prescribed medication plans* 1. Case Manager. 2005;16(2):47–51.PubMedCrossRef Vlasnik J, Aliotta S, DeLor B. Medication adherence: factors influencing compliance with prescribed medication plans* 1. Case Manager. 2005;16(2):47–51.PubMedCrossRef
43.
Zurück zum Zitat Albright T, Parchman M, Burge S. Predictors of self-care behavior in adults with type 2 diabetes: an RRNeST study. Family Med. 2001;33(5):354–60. Albright T, Parchman M, Burge S. Predictors of self-care behavior in adults with type 2 diabetes: an RRNeST study. Family Med. 2001;33(5):354–60.
44.
Zurück zum Zitat Mustaffa B, Wan Mohamad W, Chan S, Rokiah P, Mafauzy M, Kumari S, et al. The current status of diabetes management in Malaysia. JAFES. 1998;16(2):1–13. Mustaffa B, Wan Mohamad W, Chan S, Rokiah P, Mafauzy M, Kumari S, et al. The current status of diabetes management in Malaysia. JAFES. 1998;16(2):1–13.
45.
Zurück zum Zitat Golin C, DiMatteo M, Gelberg L. The role of patient participation in the doctor visit. Implications for adherence to diabetes care. Diabetes Care. 1996;19(10):1153–64.PubMedCrossRef Golin C, DiMatteo M, Gelberg L. The role of patient participation in the doctor visit. Implications for adherence to diabetes care. Diabetes Care. 1996;19(10):1153–64.PubMedCrossRef
46.
Zurück zum Zitat Guillausseau P. Influence of oral antidiabetic drugs compliance on metabolic control in type 2 diabetes. A survey in general practice. Diabetes Metab. 2003;29(1):79–81.PubMedCrossRef Guillausseau P. Influence of oral antidiabetic drugs compliance on metabolic control in type 2 diabetes. A survey in general practice. Diabetes Metab. 2003;29(1):79–81.PubMedCrossRef
47.
Zurück zum Zitat Berikai P, Meyer P, Kazlauskaite R, Savoy B, Kozik K, Fogelfeld L. Gain in patients’ knowledge of diabetes management targets is associated with better glycemic control. Diabetes Care. 2007;30(6):1587–9.PubMedCrossRef Berikai P, Meyer P, Kazlauskaite R, Savoy B, Kozik K, Fogelfeld L. Gain in patients’ knowledge of diabetes management targets is associated with better glycemic control. Diabetes Care. 2007;30(6):1587–9.PubMedCrossRef
48.
Zurück zum Zitat Cramer J. A systematic review of adherence with medications for diabetes. Diabetes Care. 2004;27(5):1218–24.PubMedCrossRef Cramer J. A systematic review of adherence with medications for diabetes. Diabetes Care. 2004;27(5):1218–24.PubMedCrossRef
49.
Zurück zum Zitat Hill-Briggs F, Gary T, Bone L, Levine D, Brancati F, Hill M. Medication adherence and diabetes control in urban African Americans with type 2 diabetes. Health Psychol. 2005;24:349–57.PubMedCrossRef Hill-Briggs F, Gary T, Bone L, Levine D, Brancati F, Hill M. Medication adherence and diabetes control in urban African Americans with type 2 diabetes. Health Psychol. 2005;24:349–57.PubMedCrossRef
50.
Zurück zum Zitat Lawrence D, Ragucci K, Long L, Parris B, Helfer L. Relationship of oral antihyperglycemic (sulfonylurea or metformin) medication adherence and hemoglobin A1c goal attainment for HMO patients enrolled in a diabetes disease management program. J Manag Care Pharm. 2006;12(6):466–71.PubMed Lawrence D, Ragucci K, Long L, Parris B, Helfer L. Relationship of oral antihyperglycemic (sulfonylurea or metformin) medication adherence and hemoglobin A1c goal attainment for HMO patients enrolled in a diabetes disease management program. J Manag Care Pharm. 2006;12(6):466–71.PubMed
51.
Zurück zum Zitat Rozenfeld Y, Hunt J, Plauschinat C, Wong K. Oral antidiabetic medication adherence and glycemic control in managed care. Am J Manag Care. 2008;14:71–5.PubMed Rozenfeld Y, Hunt J, Plauschinat C, Wong K. Oral antidiabetic medication adherence and glycemic control in managed care. Am J Manag Care. 2008;14:71–5.PubMed
52.
Zurück zum Zitat Schectman J, Nadkarni M, Voss J. The association between diabetes metabolic control and drug adherence in an indigent population. Diabetes Care. 2002;25(6):1015–21.PubMedCrossRef Schectman J, Nadkarni M, Voss J. The association between diabetes metabolic control and drug adherence in an indigent population. Diabetes Care. 2002;25(6):1015–21.PubMedCrossRef
Metadaten
Titel
Diabetes knowledge, medication adherence and glycemic control among patients with type 2 diabetes
Publikationsdatum
01.12.2011
Erschienen in
International Journal of Clinical Pharmacy / Ausgabe 6/2011
Print ISSN: 2210-7703
Elektronische ISSN: 2210-7711
DOI
https://doi.org/10.1007/s11096-011-9582-2

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