Factors Associated with Medical and Dental Compliance for Adults with Diabetes Mellitus

Background: Over the few decades, diabetes has become one of the most common chronic conditions in the U.S and worldwide. With the increasing number of incidences of diabetes and the cost associated with the treatment, adherence to treatment regimens is one key factor, which immensely affects the success of the diabetes treatment. The American Diabetes Association recommends annual preventive care for diabetes in terms of self-care practices such as daily blood glucose check and daily foot check. An eye examination with pupil dilation and a dental checkup are also recommended as part of annual care for diabetic patients. Considering the effect and the importance of various factors on the emergence of this chronic disease, the purpose of this study was to investigate the demographic and socioeconomic factors impacting the treatment compliance in patients with diabetes. Objective: To identify the factors associated with the medical and dental compliance among patients with diabetes. Methods: The analysis was conducted using the Behavioral Risk Factor Surveillance System (BRFSS) data. Both Univariate and Multivariable logistic regressions were used to assess the relationship between the factors (independent) and medical compliance or dental compliance (dependent) among diabetes patients with account for survey design using the SURVEYLOGISTIC procedure in SAS. Results: The Odds of following medical compliance for diabetic care were higher for female (OR=1.21; 95%CI=1.02-1.43), older patients with age of 65 or older, non-White patients (non-Hispanic Black: OR=1.26; 95%CI=1.02-1.54; Hispanic: OR=1.33; 95%CI=1.02-1.74; Other Non-Hispanic: OR=1.15; 95%CI= 0.76-1.73), married, and with college degree and health coverage plan. Additionally, patients, who had alcoholic beverages within last 30 days (OR=0.67; 95%CI=0.54-0.82) and with good general health status (OR=0.84; 95%CI=0.70-0.99), had lower odds to follow medical compliance. For annual dentist visit, females had higher odds of dental compliance (OR=1.23; 95%CI=1.12-1.35) as compared to male. Older people (65+) were less compliant as compared to younger patients. Patients with BMI less than 30 had higher odds to visit dentist during past 12 months. All race groups had lower odds to visit dentist annually as compared to white people. Patients with income less than $50000, current (OR=0.60; 95%CI=0.53-0.68) and former smokers (OR=0.81; 95%CI=0.74-0.90) had lower odds to visit dentist. Diabetes patients with college degree, with good health status (OR=1.35; 95%CI=1.23-1.48) and with health coverage plan (OR=1.64; 95%CI=1.31-2.06) had higher odds to follow dental compliance of diabetes. Conclusion: There are significant disparities in following medical compliance and dental compliance among diabetes patients with different demographic and social-economic variables. A success in reducing or eliminating these disparities will help to improve health outcome relevant to diabetes management. Providers of diabetes care can play a key role in diminishing these disparities through understanding and addressing patient factors such as health literacy and focusing on improved patient communication and cultural competence

COACHING SUPPORT INTERVENTION TO IMPROVE COMPLIANCE MANAGEMENT OF TYPE 2 DIABETES MELLITUS

Introduction: Diabetes mellitus (DM) is not curable, but can be managed with four pillars of the DM management. Comply with this rule for life must be so many stressors for patients who fail to comply. Patient compliance to the management of the disease is one indicator of the success of a treatment. Coaching support is the one of method to help, managing, improving, DM type 2 patient and family compliance. The aim of this study was to prove influence of coaching support in improving compliance management of type 2 diabetes mellitus. Method: Quasi experiment with pretest-posttest control group design was carried out this study. The subjects were 60 patient of diabetes mellitus type 2 were selected bysimple random sampling, and purposive sampling divided in to two group, control group and treatment group. Data were collected by thecompliancequestionaire. Coaching Support was given to treatment group during two weeks. Data were analyzed by statistic software, using paired t test for pre-posttest and independent t test, and multiple linear regressionwith p-value <0,05 was considered significant. Result: The analysis showed that there was a significant difference in compliance between the control group and the group treated with p-value = 0.000. Intervention coaching support is the most influential variable for the compliance of patients with type 2 diabetes mellitus with 0,000 sig. Discussion: Coaching support able to increase patient compliance support with type 2 diabetes Coaching can be done either because the respondent and family proactive, and will better patient compliance measurement tool type 2 diabetes mellitus is more developed for further research. Keywords: coaching support, patient of type 2 diabetes mellitus, complianc

Cure or control: complying with biomedical regime of diabetes in Cameroon

<p>Abstract</p> <p>Background</p> <p>The objective of the study was to explore the cultural aspect of compliance, its underlying principles and how these cultural aspects can be used to improve patient centred care for diabetes in Cameroon.</p> <p>Methods</p> <p>We used participant observation to collect data from a rural and an urban health district of Cameroon from June 2001 to June 2003. Patients were studied in their natural settings through daily interactions with them. The analysis was inductive and a continuous process from the early stages of fieldwork.</p> <p>Results</p> <p>The ethnography revealed a lack of basic knowledge about diabetes and diabetes risk factors amongst people with diabetes. The issue of compliance was identified as one of the main themes in the process of treating diabetes. Compliance emerged as part of the discourse of healthcare providers in clinics and filtered into the daily discourses of people with diabetes. The clinical encounters offered treatment packages that were socially inappropriate therefore rejected or modified for most of the time by people with diabetes. Compliance to biomedical therapy suffered a setback for four main reasons: dealing with competing regimes of treatment; coming to terms with biomedical treatment of diabetes; the cost of biomedical therapy; and the impact of AIDS on accepting weight loss as a lifestyle measure in prescription packages. People with diabetes had fears about and negative opinions of accepting certain prescriptions that they thought could interfere with their accustomed social image especially that which had to do with bridging their relationship with ancestors and losing weight in the era of HIV/AIDS.</p> <p>Conclusion</p> <p>The cultural pressures on patients are responsible for patients' partial acceptance of and adherence to prescriptions. Understanding the self-image of patients and their background cultures are vital ingredients to improve diabetes care in low-income countries of Sub-Sahara Africa like Cameroon.</p

EDUKASI DIET DIABETES MELLITUS BERBASIS APLIKASI BERPENGARUH TERHADAP PENGETAHUAN PASIEN RAWAT JALAN DIABETES MELLITUS TIPE 2

Background: There are 4 pillars of diabetes mellitus management, namely education, medical nutrition therapy (meal planning), physical exercise and pharmacological intervention. The failure of Diabetes Mellitus patients in treatment is caused by various factors, including not having a good diet, so a special approach is needed for Diabetes Mellitus patients through nutrition education based on the Diabetes Mellitus Diet Application to increase knowledge and dietary compliance of Diabetes Mellitus patients. Objective: To determine the effect of application-based Diabetes Mellitus diet education on knowledge and dietary compliance in Type 2 Diabetes mellitus patients. Methods: Quasi-experimental research design was pre-post test control group design with 45 case groups and 45 control groups. Sampling was purposive sampling using inclusion and exclusion criteria. Research at the Outpatient Polyclinic of RSUD KRMT Wongsonegoro Semarang City, in August-October 2019. Data analysis used Paired t test, the analysis is significant if the p value is less than 0.05 with a significance range of 95%. Result: Increasing knowledge but unable to improve dietary compliance with confounding factors is education and significantly different (p = 0.000). Conclusion : It affects the patient's diet knowledge but does not affect dietary adherence, so that it can guarantee the quality of life of Diabetes Mellitus Patients, therefore this activity needs to be carried out and the application can be applied especially to patients and families and hospital institutions as a medium for education

Hasil Guna Edukasi Diabetes Menggunakan Telemedicine terhadap Kepatuhan Minum Obat Diabetisi Tipe 2

Angka insiden dan prevalensi diabetes melitus tipe 2 di berbagai penjuru dunia cenderung mengalami peningkatan. WHO memprediksi Indonesia mengalami kenaikan jumlah pasien dari 8,4 juta pada tahun 2000 menjadi sekitar 21.3 juta pada tahun 2030. Kepatuhan pengobatan pasien dengan diabetes melitus umumnya rendah. Telemedicine dapat digunakan sebagai media edukasi diabetes melalui pesan multimedia. Penelitian bertujuan untuk mengetahui hasil guna edukasi diabetes menggunakan telemedicine terhadap kepatuhan minum obat penyandang diabetes melitus tipe 2. Desain penelitian ini adalah quasi experiment pretest-post-test with control group design. Subjek penelitian adalah 56 pasien diabetes melitus tipe 2 yang terdiri dari 28 pasien kelompok perlakuan dan 28 pasien kelompok kontrol. Edukasi diabetes diberikan 8 kali selama 1 bulan. Penilaian tingkat kepatuhan minum obat menggunakan Morisky Medication Adherence Scales (MMAS‐8). Uji analisis statistik dengan wilcoxon signed rank test terhadap kepatuhan minum obat sebelum dan sesudah perlakuan, baik pada kelompok perlakuan dan kontrol, diperoleh nilai p = 0,539 pada kelompok perlakuan dan p = 0,071 pada kelompok kontrol. Hasil uji beda rerata perubahan kepatuhan pengobatan antar kedua kelompok dengan mann-whitney test diperoleh nilai p = 0,098. Edukasi diabetes dengan telemedicine tidak efektif terhadap peningkatan kepatuhan minum obat pada pasien diabetes melitus tipe 2.The incidence and prevalence rate of diabetes mellitus type 2 in various parts of the world tends to increase. WHO predicts Indonesia has increased the number of diabetician from 8.4 million in 2000 to about 21.3 million in 2030. Medication compliance in patient with chronic disease especially diabetes mellitus is generally low. Telemedicine can be used as a media for diabetes education via multimedia messaging. The study aims to determine the effectiveness of diabetes education using telemedicine to diabetician type 2 medication compliance. This study was quasi experiment with pretest-post-test control group design. The subjects were 56 patients with type 2 diabetes melitus comprising 28 patients in treatment group and 28 patients in control group. Diabetes education is given eight times for 1 month. The evaluation of level of medication compliance using Morisky Medication Adherence Scales (MMAS-8). Statistical analysis test by wilcoxon signed rank test against medication compliance, both, before and after treatment, in the treatment and control group, obtained p = 0.539 in the treatment group and p = 0.071 in the control group. Test results for mean changes in medication compliance between both groups with mann-whitney test obtained p value = 0.098. Diabetes education using telemedicine is not effective to increase medication compliance in patient with diabetes melitus type 2

Efektivitas Konseling DM dalam Meningkatkan Kepatuhan dan Pengendalian Gula Darah pada Diabetes Melitus Tipe 2

Background. Diabetes mellitus (DM) is a chronic metabolic disease characterized by elevated levels of glucose in the blood. Poor adherence to treatment of patients with type 2 diabetes causes uncontrolled blood glucose soincreasing the risk of various complications. One major factor is the failure of a treatment noncompliance to therapy is planned. Counseling is one way to improve the knowledge , attitudes and patient compliance.Objective. This study aimed to evaluate the eff ectiveness of counseling in improving compliance and diabetes control blood sugar in patients with type 2 diabetes.Research Design. This study is an experimental study with a quasi experiment design with pre and post test control group design prospectively performed in Dr Soeradji Tirtonegoro Klaten from March to December 2014. Thesample consisted of 44 respondents, with 22 intervention and 22 control group. The measurement results were analyzed using the paired t test to test blood sugar levels 2 hours post- prandial ( GDPP ) and Mac Nemar test for levels of patient compliance.Results. The analysis showed there are signifi cant diff erence before and after adherence counseling in the intervention group (p diet =0.001; p control =  0.002; p = 0.000 pill count; GDPP p = 0.000 ) and have not signifi cant diff erence in the exercise group (p value =0.549)Conclusions. This study indicates that counseling is very eff ective in improvingdiabetes diet compliance, control and pill count and post prandial blood sugar complianceb(GDPP) and are not eff ective in improvingbexercise compliance of patients .Keywords: counseling, compliance, diabetes mellitu

Patient and provider acceptance of telecoaching in type 2 diabetes : a mixed-method study embedded in a randomised clinical trial

Background: Despite advances in diagnosis and treatment of type 2 diabetes, suboptimal metabolic control persists. Patient education in diabetes has been proved to enhance self-efficacy and guideline-driven treatment, however many people with type 2 diabetes do not have access to or do not participate in self-management support programmes. Tele-education and telecoaching have the potential to improve accessibility and efficiency of care, but there is a slow uptake in Europe. Patient and provider acceptance in a local context is an important precondition for implementation. The aim of the study was to explore the perceptions of patients, nurses and general practitioners (GPs) regarding telecoaching in type 2 diabetes. Methods: Mixed-method study embedded in a clinical trial, in which a nurse-led target-driven telecoaching programme consisting of 5 monthly telephone sessions of +/- 30 min was offered to 287 people with type 2 diabetes in Belgian primary care. Intervention attendance and satisfaction about the programme were analysed along with qualitative data obtained during post-trial semi-structured interviews with a purposive sample of patients, general practitioners (GPs) and nurses. The perceptions of patients and care providers about the intervention were coded and the themes interpreted as barriers or facilitators for adoption. Results: Of 252 patients available for a follow-up analysis, 97.5 % reported being satisfied. Interviews were held with 16 patients, 17 general practitioners (GPs) and all nurses involved (n = 6). Themes associated with adoption facilitation were: 1) improved diabetes control; 2) need for more tailored patient education programmes offered from the moment of diagnosis; 3) comfort and flexibility; 4) evidence-based nature of the programme; 5) established cooperation between GPs and diabetes educators; and 6) efficiency gains. Most potential barriers were derived from the provider views: 1) poor patient motivation and suboptimal compliance with "faceless" advice; 2) GPs' reluctance in the area of patient referral and information sharing; 3) lack of legal, organisational and financial framework for telecare. Conclusions: Nurse-led telecoaching of people with type 2 diabetes was well-accepted by patients and providers, with providers being in general more critical in their reflections. With increasing patient demand for mobile and remote services in healthcare,the findings of this study should support professionals involved in healthcare policy and innovation

Hubungan Tingkat Pengetahuan Tentang Diet Diabetes Mellitus Dengan Kepatuhan Kontrol Gula Darah pada Pasien Diabetes Mellitus Tipe II Di Wilayah Kerja Puskesmas Baki Sukoharjo

Diabetes mellitus is a group of metabolic diseases with hyperglycemia characteristic occurs due to insulin secretion abnormality, insulin performance or both of them. Trouble something often occurs in diabetics is how to keep blood glucose levels under control. The main pillar of diabetes treatment is the importance of education for client and family, sports, types of medicines used by client and dietary regulation.Achievement in diabetes mellitus treatment depends on diabetes mellitus patient is about adequate knowledge in order to change the attitude in conducting treatment with sugar - low diet and prevents complication so that they can live more prosperous, healthy and having quality. This research aims to determine relationship level of knowledge about diabetes mellitus diet with blood sugar control compliance in the second type patient of diabetes mellitus in Puskesmas Baki Sukoharjo. This research uses correlation descriptive by using cross-sectional design. The population of the second type patients of diabetes mellitus is 155 peoples. It was taken as sample loads of 61 peoples by using proportional random sampling technique. Independent variable in this research is level of knowledge about diabetes mellitus diet. Besides, dependent variable is compliance of blood sugar control. This research applies questioner as instrumental research. In this research, analysis Chi-square (X2) as technique of analyzing the data. There search finding shows them ostrespondents have a level of knowledge about diabetes mellitus diet is quite (44.3%), the majority of respondents classified discipline to control blood sugar as many as 52.5%. Furthermore, there is relationship of significant level of knowledge about diabetes mellitus diet and blood sugar control compliance in the second type patient of diabetes mellitus in Puskesmas Baki, Sukoharjo. It is advisable for diabetes mellitus patients to keep their health by keeping the disease condition. It means that discipline to control blood sugar, motivating to seek the information about diabetes mellitus and following some programs hospital held

Interventions To Improve Patients' Compliance With Therapies Aimed At Lowering Glycated Hemoglobin (hba1c) In Type 1 Diabetes: Systematic Review And Meta-analyses Of Randomized Controlled Clinical Trials Of Psychological, Telecare, And Educational Interventions

Brazilian records on glycemic control in patients with type 1 diabetes show treatment efficacy. Poor patient adherence to therapeutic proposals influences these results and can be associated with social, psychological, and economic aspects, besides others factors. The aim of this study was to evaluate the efficacy of psychological, telecare, and educational interventions to improve treatment compliance among patients with type 1 diabetes. Compliance was assessed indirectly using reduction of glycated hemoglobin (HbA1c) as the principal outcome measure. Methods: Systematic review and meta-analyses of randomized controlled clinical trials (RCTs) were performed using Medline, Embase, Cochrane and Scopus databases up to April 2015. The following medical subject headings were used: Diabetes Mellitus, Type 1, Patient Compliance or Adherence, Hemoglobin A, glycated, and Randomized Controlled Trial. The principal outcome was change in HbA1c between baseline and follow-up. Where appropriate, trials were combined in meta-analysis using fixed effects models. Results: From 191 articles initially identified, 57 were full text reviewed, and 19 articles met the inclusion criteria providing data from 1782 patients (49.4 % males, age 18 years). The RCTs (2 to 24 months in duration) were divided into four groups according to type of intervention: psychology (seven studies; 818 patients), telecare (six studies; 494 patients); education (five studies; 349 patients), and psychoeducation (one study; 153 patients). All studies reported some type of adherence measurement of the interventions. Decrease in HbA1c was observed after psychology (MD -0.310; 95 % CI, -0.599 to -0.0210, P = 0.035) but not after telecare (MD -0.124 %; 95 % CI, -0.268, 0.020; P = 0.090) or educational (MD -0.001; 95 % CI, -0.202, 0.200; P = 0.990) interventions. Conclusion: Psychological approaches to improve adherence to diabetes care treatment modestly reduced HbA1c in patients with type 1 diabetes; telecare and education interventions did not change glycemic control. However, the limited number of studies included as well as their methodological quality should be taken into account. © 2016 Viana et al.17