Impact of an education program on patient anxiety, depression, glycemic control, and adherence to self-care and medication in Type 2 diabetes

Abstract

Background:Diabetes mellitus (DM) requires continuous medical care, patients’ self-management, education, and adherence to prescribed medication to reduce the risk of long-term complications. The aim of this study was to assess the benefits of an education program on diabetes, patient self-management, adherence to medication, anxiety, depression and glycemic control in type 2 diabetics in Saudi Arabia.Materials and Methods:This was a prospective study, conducted among 104 diabetic patients at a major tertiary hospital in Riyadh, Saudi Arabia, between May 2011 and October 2012. Education materials given to diabetic patients included pamphlets/handouts written in Arabic, the national language. Special videotapes about DM were made and distributed to all participants. In addition, specific educational programs through the diabetes educators and one-on-one counseling sessions with the doctor were also arranged. Patients were interviewed using a structured interview schedule both during the baseline, and after 6 months of the program. The interview schedule included, socio-demographics, clinical characteristics, diabetes self-management, adherence to medication, anxiety, and depression. Glycemic control was considered poor, if hemoglobin A1c (HbA1c) was ≥ 7%.Results:The mean age of the study population was 57.3 ± 14.4 years. Seventy one were males (68.3%) and 33 (31.7%) were females. After six months of the diabetes education program, there were significant improvements in patients’ dietary plan (P = 0.0001), physical exercise (P = 0.0001), self-monitoring of blood glucose (SMBG) (P = 0.0001), HbA1c (P = 0.04), adherence to medication (P = 0.007), and depression (P = 0.03).Conclusions:Implementation of education programs on diabetes among type 2 diabetic patients is associated with better outcomes such as their dietary plan, physical exercise, SMBG, adherence to medication, HbA1c and depression.

Treatment Adherence among Diabetes Mellitus Type II Patients at Ambulatory Clinics in the Western Region of Saudi Arabia: Descriptive Correlational Study

“…The mean BMI of 31.49 was consistent with previous research in Riyadh (N=113), which revealed a mean of 31.06 (Al Hayek et al, 2013) among diabetics. Research in the Asir Region (N=14,252), obtained a lower BMI, namely a median of 29 (AlShahrani and Al-Khaldi, 2013).…”

“…In addition, wellness clinics could be established to promote selfdiscipline and an active lifestyle. Research in Riyadh confirmed that diabetes self-management education improved dietary, exercise and self-monitoring adherence (Al Hayek et al, 2013).…”

“…Previous research found that health education is positively associated with improved medication adherence, lifestyle adherence and glycaemic control (Al Hayek et al, 2013). This study recommends that preference should be given to face-to-face health education by doctors and nurse health educators.…”

“…Diabetic patients develop complications as a result of poor insight of the disease and inadequate glycaemic control (Al Hayek et al, 2013). Participants in this research showed partial understanding of DM management, low perception of risk and external locus of control.…”

“…Glycaemic control was measured using HbA1c results based on laboratory analysis of three millilitres of blood submitted in an EDTA tube (lavender top). Poor glycaemic control was defined as HbA1c ≥7% (Al Hayek et al, 2013). Most participants (n=1,095; 78%) presented with poor glycaemic control (x ̅ =8.64,±1.93).…”