An Education Intervention for Medication Adherence in Uncontrolled Diabetes in Thailand
Keywords:
Diabetes, HbA1c, Medication adherence, Medication beliefs, Medication education, Medication knowledge, Type 2 diabetes, ThailandAbstract
Medication adherence is crucial to achieving diabetic control. This quasiexperimental two-group pre-/post-test design aimed to evaluate the effects of a medication education intervention integrated in routine services of a diabetes clinic. People with uncontrolled type 2 diabetes treated by oral medication and history of non-adherence to medication were assigned to an intervention group (n=39) and a comparison group (n=37). The intervention group received medication education intervention four times consisting of a short individual education session provided by the physician and group counseling session provided by a nurse in a diabetes clinic at weeks 1 and 3, then individual follow-up telephone counseling by a nurse at weeks 6 and 9. The comparison group received patient education as routine service. Outcome variables including knowledge of medication use, beliefs and adherence, and blood glucose level were assessed at weeks 1 and 12, using an interview questionnaire and laboratory test of HbA1c values.
The results showed the intervention group had significantly better mean changes of knowledge of medication use, medication beliefs and medication adherence, than the comparison group. In addition, HbA1c in the intervention group decreased more significantly than the comparison group. The findings imply a success of the integrated medication education intervention. Nurses within healthcare teams can initiate this education intervention in routine services of diabetes clinics. However, further testing of the intervention with other populations is required to substantiate its effects.
References
1. International Diabetes Federation. IDF Diabetes Atlas, 7th edn. Brussels, Belgium: International Diabetes Federation, 2015 [cited 2017 Jun 26]. Available from: https://www. diabetesatlas.org
2. World Health Organization. Global Report on Diabetes. Geneva: World Health Organization; 2016.
3. Bureau of Non-communicable Disease, Department of Disease Control, Ministry of Public Health. Annual report 2015. Bangkok: The War Veterans Organization of Thailand Under Royal Patronage of His Majesty the King; 2016.
4. International Diabetes Federation. Across the Glove [Internet]. Brussels, Belgium: International Diabetes Federation; c2015 [cited 2017 Aug 30]. Available from: https://www.diabetesatlas.org/across-the-globe.html.
5. Department of Medical Services, Ministry of Public Health. Clinical practice guideline for diabetes, Thailand 2014. Bangkok: Aroonkarnpim; 2014.
6. American Diabetes Association. Standards of medical care in diabetes-2016. Diabetes Care. 2016;39 (Suppl 1): S1-S109.
7. Chaudhury A, Duvoor C, Dendi VSR, Kraleti S, Chada A, Ravilla R, et al. Clinical review of antidiabetic drugs: Implications for type 2 diabetes mellitus management. Front. Endocrinol. 2017;8:6. doi: 10.3389/fendo. 2017.00006.
8. Bailey GR, Barner JC, Weems JK, Leckbee G, Solis R, Montemayor D, et al. Assessing barriers to medication adherence in underserved patients with diabetes in Texas. Diabetes Educ. 2012;38(2):271-79.
9. Tiv M, Viel JF, Mauny F, Eschwege E, Weill A, Fournier C, et al. Medication adherence in type 2 diabetes: the ENTRED study 2007, a French Population-Based Study. PLoS One. 2012;7(3):e32412. doi:10.1371/journal. pone.0032412.
10. Teklay G, Hussien J, Tesfaye D. Non-adherence and associated factors among type 2 diabetic patients at Jimma University Specialized Hospital, Southwest Ethiopia. J Med Sci. 2013;13(7):e578. doi: 10.3923/jms.2013.578.584.
11. Wu P, Liu N. Association between patients’ beliefs and oral antidiabetic medication adherence in a chinese type 2 diabetic population. Patient Prefer Adherence. 2016; 10:1161-67.
12. Chongchareon W, Kahawong W, Apichato A, Sangchandr O, Chukumneard P, Boonsin K, Chugnan T. A self-care promotion model for controlling blood sugar in type 2 diabetes. Songkla Med J. 2008;26(1):71-84 [ in Thai].
13. Aflakseir A. Role of illness and medication perceptions on adherence to medication in a group of Iranian patients with type 2 diabetes. J Diabetes. 2012;4(3):243-7.
14. Sweileh WM, Sa’ed H.Z, Nab’a R.JA, Deleq MI, Enaia MI, Sana’a MN, et al. Influence of patients’ disease knowledge and beliefs about medicines on medication adherence: findings from a cross-sectional survey among patients with type 2 diabetes mellitus in Palestine. BMC Public Health. 2014;14(1):1. doi:10.1186/1471-2458-14-94.
15. Alatawi YM, Kavookjian J, Ekong G, Alrayees MM. The association between health beliefs and medication adherence among patients with type 2 diabetes. Res Social Adm Pharm. 2016;12(6):914-25.
16. Williams JLS, Walker RJ, Smalls BL, Campbell JA, Egede LE. Effective interventions to improve medication adherence in Type 2 diabetes: a systematic review. Diabetes Manag (Lond). 2014;4(1):29.
17. Sapkota S, Jo-anne EB, Greenfield JR, Aslani P. A systematic review of interventions addressing adherence to anti-diabetic medications in patients with type 2 diabetes— components of interventions. PLoS One. 2015;10(6): e0128581. doi:10.1371/journal.pone. 0128581.
18. Farmer A, Hardeman W, Hughes D, Prevost AT, Kim Y, Craven A, et al. An explanatory randomised controlled trial of a nurse-led, consultation-based intervention to support patients with adherence to taking glucose lowering medication for type 2 diabetes. BMC Fam Pract. 2012;13(1):1. doi: 10.1186/1471-2296-13-30.
19. Sunida S, Woranuch S, Payom W, Sanguan L. Clinical impact of pharmacist counseling on Type 2 diabetes patients. Isan Journal of Pharmaceutical Sciences. 2014; 9 (Suppl): 116-121 [in Thai].
20. Kusawadee M, Virat M, Nisana T, Aratchaporn K. Effects of telephone counseling in patients taking antibiotics. Isan Journal of Pharmaceutical Sciences. 2014;10(2):228- 241 [in Thai].
21. Phumipamorn S, Pongwecharak J, Soorapan S, Pattharachayakul S. Effects of the pharmacist’s input on glycaemic control and cardiovascular risks in Muslim diabetes. Prim Care Diabetes. 2008;2(1):31-7.
22. Street RL, Makoul G, Arora NK, Epstein RM. How does communication heal ? Pathways linking clinician–patient communication to health outcomes. Patient Educ Couns. 2009;74(3):295-301.
23. Glanz K, Rimer BK, Viswanath K. Health behavior and health education:Theory, research, and practice. 4 th ed. San Francisco:John Wiley & Sons; 2008.
24. Riffenburgh R.H. Statistics in medicine. 3 rd ed. San Diego:Elsevier; 2012.
25. Papsamut N. Comparison between individual and group counselling on patient with diabetes in Nongkhae Hospital [Master’s thesis]. Nakornpratom: Silapakorn University; 2002. [in Thai].
26. Ingkamanee N, Kusuma Na Ayuthya S, Puwarawuttipanit W, Peerapatdit T. Effectiveness of promoting a problem-solving ability program on medication adherence in patients with type 2 diabetic. J Nurs Sci. 2011;29(2):56-64 [in Thai]
27. Barba C, Cavalli-Sforza T, Cutter J, Darnton-Hill I. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. The Lancet. 2004;363(9403):157-163.
28. Selvaraj K, Ramaswamy G, Radhakrishnan S, Thekkur P, Chinnakali P, Roy G. Self-care practices among diabetes patients registered in a chronic disease clinic in Puducherry, South India. JOSH-Diabetes. 2016;4(1):25-29.
29. Colberg SR, Sigal RJ, Fernhall B, Regensteiner JG, Blissmer BJ, Rubin RR, et al. Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement. Diabetes Care. 2010;33(12):e147-67.
30. Malathy R, Narmadha M, Ramesh S, Alvin JM, Dinesh BN. Effect of a diabetes counseling programme on knowledge, attitude and practice among diabetic patients in Erode district of South India. J Young Pharm. 2011;3(1):65-72.
31. Shadish WR, Cook TD, Campbell DT. Experimental and quasi-experimental designs for generalized causal inference. Boston: Houghton Mifflin Company; 2002.
32. Shareef J, Vineeth V, Samaga LN. Impact of phamacist’s counseling on medication adherence in patients with diabetes mellitus in a tertiary care teaching hospital. Pharmacie Globale. 2013;4(9):1-4.
33. Butt M, Mhd Ali A, Bakry MM, Mustafa N. Impact of a pharmacist led diabetes mellitus intervention on HbA1c, medication adherence and quality of life: A randomised controlled study. Saudi Pharm J. 2016;24(1):40-48.
34. Mohd MMA-H, Phung H, Sun J, Morisky DE. Improving adherence to medication in adults with diabetes in the United Arab Emirates. BMC Public H ealth. 2016; 16(1):857. doi: 10.1186/s12889-016-3492-0
35. Bogner HR, Morales KH, de Vries HF, Cappola A.R. Integrated management of type 2 diabetes mellitus and depression treatment to improve medication adherence: A randomized controlled trial. Ann Fam Med. 2012;10(1): 15-22.
36. World Health Organization. Health education, theoretical concepts, effective strategies and core competencies:A foundation document to guide capacity development of health educators. Geneva: World Health Organization; 2012.
37. Morisky DE, Ang A, Krousel‐Wood M, Ward HJ. Predictive validity of a medication adherence measure in an outpatient setting. J Clin Hypertens. 2008;10(5):348-54.
2. World Health Organization. Global Report on Diabetes. Geneva: World Health Organization; 2016.
3. Bureau of Non-communicable Disease, Department of Disease Control, Ministry of Public Health. Annual report 2015. Bangkok: The War Veterans Organization of Thailand Under Royal Patronage of His Majesty the King; 2016.
4. International Diabetes Federation. Across the Glove [Internet]. Brussels, Belgium: International Diabetes Federation; c2015 [cited 2017 Aug 30]. Available from: https://www.diabetesatlas.org/across-the-globe.html.
5. Department of Medical Services, Ministry of Public Health. Clinical practice guideline for diabetes, Thailand 2014. Bangkok: Aroonkarnpim; 2014.
6. American Diabetes Association. Standards of medical care in diabetes-2016. Diabetes Care. 2016;39 (Suppl 1): S1-S109.
7. Chaudhury A, Duvoor C, Dendi VSR, Kraleti S, Chada A, Ravilla R, et al. Clinical review of antidiabetic drugs: Implications for type 2 diabetes mellitus management. Front. Endocrinol. 2017;8:6. doi: 10.3389/fendo. 2017.00006.
8. Bailey GR, Barner JC, Weems JK, Leckbee G, Solis R, Montemayor D, et al. Assessing barriers to medication adherence in underserved patients with diabetes in Texas. Diabetes Educ. 2012;38(2):271-79.
9. Tiv M, Viel JF, Mauny F, Eschwege E, Weill A, Fournier C, et al. Medication adherence in type 2 diabetes: the ENTRED study 2007, a French Population-Based Study. PLoS One. 2012;7(3):e32412. doi:10.1371/journal. pone.0032412.
10. Teklay G, Hussien J, Tesfaye D. Non-adherence and associated factors among type 2 diabetic patients at Jimma University Specialized Hospital, Southwest Ethiopia. J Med Sci. 2013;13(7):e578. doi: 10.3923/jms.2013.578.584.
11. Wu P, Liu N. Association between patients’ beliefs and oral antidiabetic medication adherence in a chinese type 2 diabetic population. Patient Prefer Adherence. 2016; 10:1161-67.
12. Chongchareon W, Kahawong W, Apichato A, Sangchandr O, Chukumneard P, Boonsin K, Chugnan T. A self-care promotion model for controlling blood sugar in type 2 diabetes. Songkla Med J. 2008;26(1):71-84 [ in Thai].
13. Aflakseir A. Role of illness and medication perceptions on adherence to medication in a group of Iranian patients with type 2 diabetes. J Diabetes. 2012;4(3):243-7.
14. Sweileh WM, Sa’ed H.Z, Nab’a R.JA, Deleq MI, Enaia MI, Sana’a MN, et al. Influence of patients’ disease knowledge and beliefs about medicines on medication adherence: findings from a cross-sectional survey among patients with type 2 diabetes mellitus in Palestine. BMC Public Health. 2014;14(1):1. doi:10.1186/1471-2458-14-94.
15. Alatawi YM, Kavookjian J, Ekong G, Alrayees MM. The association between health beliefs and medication adherence among patients with type 2 diabetes. Res Social Adm Pharm. 2016;12(6):914-25.
16. Williams JLS, Walker RJ, Smalls BL, Campbell JA, Egede LE. Effective interventions to improve medication adherence in Type 2 diabetes: a systematic review. Diabetes Manag (Lond). 2014;4(1):29.
17. Sapkota S, Jo-anne EB, Greenfield JR, Aslani P. A systematic review of interventions addressing adherence to anti-diabetic medications in patients with type 2 diabetes— components of interventions. PLoS One. 2015;10(6): e0128581. doi:10.1371/journal.pone. 0128581.
18. Farmer A, Hardeman W, Hughes D, Prevost AT, Kim Y, Craven A, et al. An explanatory randomised controlled trial of a nurse-led, consultation-based intervention to support patients with adherence to taking glucose lowering medication for type 2 diabetes. BMC Fam Pract. 2012;13(1):1. doi: 10.1186/1471-2296-13-30.
19. Sunida S, Woranuch S, Payom W, Sanguan L. Clinical impact of pharmacist counseling on Type 2 diabetes patients. Isan Journal of Pharmaceutical Sciences. 2014; 9 (Suppl): 116-121 [in Thai].
20. Kusawadee M, Virat M, Nisana T, Aratchaporn K. Effects of telephone counseling in patients taking antibiotics. Isan Journal of Pharmaceutical Sciences. 2014;10(2):228- 241 [in Thai].
21. Phumipamorn S, Pongwecharak J, Soorapan S, Pattharachayakul S. Effects of the pharmacist’s input on glycaemic control and cardiovascular risks in Muslim diabetes. Prim Care Diabetes. 2008;2(1):31-7.
22. Street RL, Makoul G, Arora NK, Epstein RM. How does communication heal ? Pathways linking clinician–patient communication to health outcomes. Patient Educ Couns. 2009;74(3):295-301.
23. Glanz K, Rimer BK, Viswanath K. Health behavior and health education:Theory, research, and practice. 4 th ed. San Francisco:John Wiley & Sons; 2008.
24. Riffenburgh R.H. Statistics in medicine. 3 rd ed. San Diego:Elsevier; 2012.
25. Papsamut N. Comparison between individual and group counselling on patient with diabetes in Nongkhae Hospital [Master’s thesis]. Nakornpratom: Silapakorn University; 2002. [in Thai].
26. Ingkamanee N, Kusuma Na Ayuthya S, Puwarawuttipanit W, Peerapatdit T. Effectiveness of promoting a problem-solving ability program on medication adherence in patients with type 2 diabetic. J Nurs Sci. 2011;29(2):56-64 [in Thai]
27. Barba C, Cavalli-Sforza T, Cutter J, Darnton-Hill I. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. The Lancet. 2004;363(9403):157-163.
28. Selvaraj K, Ramaswamy G, Radhakrishnan S, Thekkur P, Chinnakali P, Roy G. Self-care practices among diabetes patients registered in a chronic disease clinic in Puducherry, South India. JOSH-Diabetes. 2016;4(1):25-29.
29. Colberg SR, Sigal RJ, Fernhall B, Regensteiner JG, Blissmer BJ, Rubin RR, et al. Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement. Diabetes Care. 2010;33(12):e147-67.
30. Malathy R, Narmadha M, Ramesh S, Alvin JM, Dinesh BN. Effect of a diabetes counseling programme on knowledge, attitude and practice among diabetic patients in Erode district of South India. J Young Pharm. 2011;3(1):65-72.
31. Shadish WR, Cook TD, Campbell DT. Experimental and quasi-experimental designs for generalized causal inference. Boston: Houghton Mifflin Company; 2002.
32. Shareef J, Vineeth V, Samaga LN. Impact of phamacist’s counseling on medication adherence in patients with diabetes mellitus in a tertiary care teaching hospital. Pharmacie Globale. 2013;4(9):1-4.
33. Butt M, Mhd Ali A, Bakry MM, Mustafa N. Impact of a pharmacist led diabetes mellitus intervention on HbA1c, medication adherence and quality of life: A randomised controlled study. Saudi Pharm J. 2016;24(1):40-48.
34. Mohd MMA-H, Phung H, Sun J, Morisky DE. Improving adherence to medication in adults with diabetes in the United Arab Emirates. BMC Public H ealth. 2016; 16(1):857. doi: 10.1186/s12889-016-3492-0
35. Bogner HR, Morales KH, de Vries HF, Cappola A.R. Integrated management of type 2 diabetes mellitus and depression treatment to improve medication adherence: A randomized controlled trial. Ann Fam Med. 2012;10(1): 15-22.
36. World Health Organization. Health education, theoretical concepts, effective strategies and core competencies:A foundation document to guide capacity development of health educators. Geneva: World Health Organization; 2012.
37. Morisky DE, Ang A, Krousel‐Wood M, Ward HJ. Predictive validity of a medication adherence measure in an outpatient setting. J Clin Hypertens. 2008;10(5):348-54.
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2018-03-13
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Supachaipanichpong P, Vatanasomboon P, Tansakul S, Chumchuen P. An Education Intervention for Medication Adherence in Uncontrolled Diabetes in Thailand. PRIJNR [Internet]. 2018 Mar. 13 [cited 2024 Apr. 24];22(2):144-55. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/84819
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