Impact of family support improvement behaviors on anti diabetic medication adherence and cognition in type 2 diabetic patients

Abstract

BackgroundGlycaemic control is the main goal of treatment for type 2 diabetic patients. Hyperglycaemia may result in cognitive decline. More family support may increase medication adherence and decrease glycaemic level. The purpose of this study was to determine the impact of family support improvement behavior on anti diabetic medication adherence and cognition in type 2 diabetic patients.MethodThe randomized control trial study was conducted on 91 patients from an outpatient diabetes clinic. They were randomly divided to intervention (n = 45) and control (n = 46) group. Data on the patients’ demographic information and their family gathered using a questionnaire, For two groups Morisky Medication Adherence Scale (MMAS), drug administration part of Diabetes Social Support Questionnaire – family version (DSSQ), Number Connection Test (NCT) were applied and hemoglobin A1C was measured two times in the onset of study and three months later for control group and before and after intervention for intervention group. The key family members of the intervention group were taught according to their educational needs in small groups.ResultIn intervention group mean of NCT score was significantly decreased after intervention (P = 0.006) however in the control group there was no significant difference after three months. In intervention group a significant correlation was noted between DSSQ scores and MMAS scores after intervention(r =0.67, P < 0.001) but, there was no significant correlation in the control group.ConclusionFamily support instruction based on the educational needs of family members, may improve medication adherence through direct effect and cognitive status with indirect effect.

A Systematic Review: Family Support Integrated To Diabetes Self-Management among Glycemic Uncontrolled Type II DM Patients

“…This review verified that five studies follow-up the program by using a face-to-face follow-up (12,15,17,(22)(23)(24)33) . Three studies were noticed to follow-up the program by using the telephone method (13,14,25,26,32) .…”

“…We found that DSME based individual program was conducted into 40.9% of the studies (12,13,16,20,23,25,29,30,32) and 59.1% of the studies offered the DSME in a combination of individual and group education (12,14,15,17,20,21,27,31,32,34) . In general, The individual or group-based program provided the intervention of several strategies, including personalized counseling, feedback regarding goal-setting and problem-solving, support for self-care practice from family members, and the follow-up session.…”

“…(12,15,18,19,21,22,24,32,33) . In addition, several outcomes have a positive effect on psychosocial (35) , self-efficacy (14,24) , dietary and physical behavior aspects (19) , perceived support (15) , knowledge (32) , medication adherence and quality of life (32) . The improvement in several outcomes has clearly confirmed the importance of family involvement in diabetes self-management education.…”

“…Those studies confirmed that higher level of support is significantly influencing the blood glucose monitoring at home (13,14,17,20,24,34) . For medication taking behavior, seven studies demonstrated that regularly medication adherence was conducted under the family support (14,15,(18)(19)(20)(21) . Furthermore, this review confirmed that the increasing of self-awareness on foot inspections is correlated to foot ulcer prevention (13,34) .…”

“…Four studies used food model, picture, illustration, foot picture (14,18,20,24) . Diabetes handout/booklet (diet, exercise, medication, eye, and foot self-care) been used to spread the knowledge (15,16,19,21,30,32,36) . In addition, four studies (13,14,20,34) used video and DVD to show the successfully of self-care behaviors practice among diabetes patients.…”