Adherence to insulin therapy and associated factors among patients with diabetes mellitus in public hospitals of Central Zone of Tigray, Ethiopia, 2018: a cross-sectional study

Mariye, Teklewoini; Girmay, Alem; Wube, Tsiyon Birhanu; Tasew, Hagos; Weldesamuel, Girmay Teklay; Baraki, Zeray; Gerensea, Hadgu; Bezabeh, Gebrewahed

doi:10.11604/pamj.2019.33.309.17547

Cited by 15 publications

(24 citation statements)

References 30 publications

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“…Literature has shown that good knowledge of insulin use is associated with adherence to insulin therapy, effective blood glucose level control, self-management, and reduction of adverse outcomes [ 26 , 27 ]. However, in our study, participants only had a good awareness of some aspects of insulin pen use.…”

Section: Discussionmentioning

confidence: 99%

The Effectiveness of Health Education in Improving Knowledge about Hypoglycemia and Insulin Pen Use among Outpatients with Type 2 Diabetes Mellitus at a Primary Care Hospital in Vietnam

Chu

Nguyen

Pham

et al. 2021

Journal of Diabetes Research

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Background. Patients with type 2 diabetes mellitus (T2DM) who have limited knowledge about hypoglycemia and insulin pen use are likely to have hypoglycemia and other complications. Objective. This study aimed to evaluate the effectiveness of health education on knowledge about hypoglycemia and insulin pen use among outpatients with T2DM at a primary care hospital in Vietnam. Methods. A pretest–posttest study was conducted among 80 patients with T2DM at District 11 Hospital in Ho Chi Minh City, Vietnam. At baseline, patients were interviewed through a predefined, structural questionnaire to assess their knowledge about hypoglycemia and insulin pen use. After that, patients underwent an individual health education session about hypoglycemia and insulin pen. One month and two months after this intervention, knowledge about hypoglycemia and insulin pen use were recorded again. Results. The majority were males (65.0%) and the mean age was 59.6 (standard deviation 8.1, range 35-75) years. Very few patients had good knowledge and proper insulin pen use, with percentages ranging from 13.8% to 60%. There was a significant improvement of knowledge and practice after the intervention. Such improvement remained high one month and two months after the intervention. Conclusions. The health education intervention is effective in improving knowledge and practice in this population. There is a pressing need for such intervention at primary care hospitals to optimize treatment for patients with T2DM, possibly focusing on those who had characteristics to have the best effectiveness found in this study.

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Section: Discussionmentioning

confidence: 99%

The Effectiveness of Health Education in Improving Knowledge about Hypoglycemia and Insulin Pen Use among Outpatients with Type 2 Diabetes Mellitus at a Primary Care Hospital in Vietnam

Chu

Nguyen

Pham

et al. 2021

Journal of Diabetes Research

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“…Those who are members of diabetes association had 3 times increased odds of having a favorable attitude on insulin self-administration than those who are not. Being a member of the diabetes association was strongly associated with a favorable attitude and adherence to insulin use [6]. It could be because those who are members of the diabetes association might have the chance to get awareness creation services organized by the association; this may change their level of attitude as a result of their good knowledge.…”

Section: Discussionmentioning

confidence: 99%

“…Type 1 DM (T1DM) patients are treated by multiple-dose insulin injection or continuous subcutaneous insulin infusion. To control the burden, patients need to use insulin therapy as ordered by the health care providers [6,7]. The insulin injection technique is one of the most common areas with the likelihood of errors [5].…”

Section: Introductionmentioning

confidence: 99%

Knowledge and Attitude on Insulin Self-Administration among Type 1 Diabetic Patients at Metu Karl Referral Hospital, Ethiopia

Yosef

2019

Journal of Diabetes Research

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Background. Diabetes mellitus (DM) is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. It is a public health problem as the disease is epidemic in both developed and developing counties. Knowledge and attitude of patients regarding insulin self-administration could lead to better management of diabetes and eventually a good quality of life. Despite this, the evidence that showed the knowledge and attitude on insulin self-administration is a substantial deficiency in Ethiopia. Objective. To assess the level of knowledge, attitude, and associated factors on insulin self-administration among type 1 diabetic patients at Metu Karl Referral Hospital, Ethiopia, in 2019. Methods. An institutional-based cross-sectional study was conducted among systematically selected 245 type 1 diabetic patients at Metu Karl Referral Hospital, Ethiopia, in January 2019. The data were collected through a face-to-face interview. The collected data were entered using EpiData version 4.2.0.0, cleaned, and analyzed using SPSS version 20. A binary logistic regression model was used. Independent variables with a P value of less than 0.05 in the multivariable logistic regression model were considered significant. Results. Out of 242 type 1 diabetic patients interviewed, 93 (38.4%, 95% CI (32.3%-44.5%)) had good knowledge and 50 (20.7%, 95% CI (15.6%-25.8%)) had favorable attitude on insulin self-administration. The study also found that being unmarried (AOR=3.59, 95% CI (1.15-11.3), P=0.028), increased educational level (AOR=3.02, 95% CI (1.36-6.74), P=0.007), and more years of treatment (AOR=3.70, 95% CI (1.16-11.8), P=0.027) were factors associated with good knowledge on insulin self-administration, whereas being a member of DM association (AOR=3.57, 95% CI (1.66-7.69), P=0.001) was the only factor associated with favorable attitude on insulin self-administration. Conclusion. The knowledge and attitude on insulin self-administration among type 1 diabetic patients were substantially low. Diabetes and insulin self-administration education should be imparted by health professionals at each follow-up visit. Besides, strengthening of information, education, and communication (IEC) on the issue of diabetes and insulin self-administration using mass media (television/radio) plays paramount importance.

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“…All studies were conducted in a hospital and primary healthcare setting and only three of the studies were community-based. The majority of the studies (n= 28) were carried-out among individuals with type 2 diabetes 16,[19][20][21]24,26,28,[30][31][32]34,35,[37][38][39]41,43,44,[46][47][48]50,51,53,54,56 , four studies were conducted in individuals with both type 1 and type 2 diabetes 15,17,23,40 and the remaining 11 studies simply reported diabetes 12,18,22,25,27,33,36,45,49,52,55 .…”

Section: Literature Search Characteristics and Quality Of Included mentioning

confidence: 99%

A systematic review and meta-analysis of non-adherence to anti-diabetic medication: Evidence from low‐ and middle‐income countries

Azharuddin

Adil

Sharma

et al. 2021

Preprint

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Objective: There is lack of evidence on the burden of and factors associated with non-adherence to anti-diabetic medication among individuals living with diabetes in low-and middle-income countries (LMICs). Therefore, we carried out a systematic literature review and meta-analytic synthesis to estimate non-adherence to anti-diabetic medication reported among adults in LMICs and to explore factors affecting non-adherence. Methods: We systematically searched MEDLINE and Embase to identify studies investigating non-adherence to anti-diabetic medications published between January 2000 and May 2020. Cross-sectional studies that had been conducted among individuals with diabetes in LMICs were eligible for the selection process. Critical appraisal of the included studies was carried out using the Newcastle Ottawa Scale. Meta-analysis was carried out using Stata 14.2. Random effects model was used to compute the pooled proportion at 95% confidence interval. Results: Forty-three studies met the inclusion criteria, of which 13 studies were used in meta-analysis. The pooled proportion of non-adherence to anti-diabetic medications using the eight-item Morisky Medication Adherence Scale (MMAS) was 43.4% (95% CI: 17.5–69.4; p=0.000) and 29.1% (95% CI: 19.8–38.4; p=0.000) when using the cut-off at 80 or 90%. The pooled proportion of non-adherence was 29.5% (95% CI: 25.5–33.5; p=0.098) when using the four-item Morisky Medication Adherence Scale. The factors for non-adherence based on World Health Organization demonstrated considerable variation of non-adherence to ant-diabetic medication in LMICs depending on the methods used to estimate non-adherence. Conclusions: These findings demonstrate a significantly higher proportion of medication non-adherence among individuals with diabetes in LMIC settings when MMAS-8 item scale was used and low when 80-90% cut-off scales were used. Various factors, such as disease factors, therapy-related factors, healthcare system factor, patient-centered factors, and social and economic factors contributed to non-adherence. Therefore, comprehensive multifaceted strategies are urgently needed to address factors associated with anti-diabetic medication non-adherence.

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Adherence to insulin therapy and associated factors among patients with diabetes mellitus in public hospitals of Central Zone of Tigray, Ethiopia, 2018: a cross-sectional study

Cited by 15 publications

References 30 publications

The Effectiveness of Health Education in Improving Knowledge about Hypoglycemia and Insulin Pen Use among Outpatients with Type 2 Diabetes Mellitus at a Primary Care Hospital in Vietnam

The Effectiveness of Health Education in Improving Knowledge about Hypoglycemia and Insulin Pen Use among Outpatients with Type 2 Diabetes Mellitus at a Primary Care Hospital in Vietnam

Knowledge and Attitude on Insulin Self-Administration among Type 1 Diabetic Patients at Metu Karl Referral Hospital, Ethiopia

A systematic review and meta-analysis of non-adherence to anti-diabetic medication: Evidence from low‐ and middle‐income countries

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