Non-adherence to self-care practices & medication and health related quality of life among patients with type 2 diabetes: a cross-sectional study

BMC Public Health

Liaquat Ali³  Md Abdul Hafez²  Ferdous Ara⁴  Shirin J Mumu¹  Farzana Saleh⁴ 

[1] Department of Epidemiology, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh;Department of Biostatistics, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh;Department of Biochemistry and Cell Biology, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh;Department of Community Nutrition, Bangladesh University of Health Sciences (BUHS), 125/1 Darussalam Mirpur-1, Dhaka-1216, Bangladesh

关键词: Type 2 diabetes;    Bangladesh;    Health related quality of life;    Medication;    Self-care practices;    Non-adherence;   

Others  :  1131451
DOI  :  10.1186/1471-2458-14-431

 received in 2013-07-19, accepted in 2014-04-30,  发布年份 2014

【 摘 要 】

Background

Non-adherence to lifestyle modification among diabetic patients develops the short-term risks and the long-term complications as well as declines the quality of life. This study aimed to find out the association between non-adherence to self-care practices, medication and health related quality of life (HR-QoL) among type 2 diabetic patients.

Methods

At least 1 year diagnosed patients with type 2 diabetes (N = 500), age>25 years were conveniently selected from the Out-Patient Department of Bangladesh Institute of Health Sciences Hospital. Patients’ self-care practices were assessed via interviewer-administered questionnaires using an analytical cross-sectional design. HRQoL was assessed by an adapted and validated Bangla version of the EQ-5D (EuroQol Group, 2009) questionnaire which has five domains- mobility, self-care, usual activities, pain/discomfort and anxiety/depression and two levels on each dimension. EQ-5D responses were further translated into single summery EQ-5D index using UK TTO value set. Patients’ were considered as non-adhered to self-care practices according to the guidelines of Diabetic Association of Bangladesh. Multivariable linear regression was used to assess the association between non-adherence towards self-care practices and HRQoL.

Results

Among the study patients, 50.2% were females and mean ± SD age was 54.2 (±11.2) years. Non-adherence rate were assessed for: blood glucose monitoring (37%), diet (44.8%), foot care (43.2%), exercise (33.2%) and smoking (37.2%). About 50.4% patients had problem in mobility, 28.2% in self-care, 47.6% in usual activities, 72.8% in pain/discomfort and 73.6% in anxiety/depression. On chi-squared test, significant association was found between non adherence to foot care and problem with mobility, self-care and usual activities (p < 0.05). Significant association was also found between non-adherence to exercise and poor mobility, self- care, usual activities, pain and anxiety (p < 0.05). Non-adherence to diet was associated with poor mobility (p < 0.05). In multivariable linear regression non-adherence to foot care (p = 0.0001), exercise (p = 0.0001), and smoking (p = 0.047) showed significant association with EQ-5D index after adjusting co-variates.

Conclusions

In this study, patients who have a non-adherence rate also have a lower quality of life.

【 授权许可】

   
2014 Saleh et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Venkat KMN: Diabetes-a common, growing, serious and potentially preventable public health problem. Diabetes Res Clin Pract 2000, 50:77-84.
• [2]Unwin N, Whiting D, Guariguata L, Ghyoot G, Gan D (Eds): IDF Diabetes ATLAS. Brussels: International Diabetes Federation; 2012.
• [3]Lahiry S: Cost of diabetes care in the out-patient department of a tertiary care hospital in Bangladesh. http://hdl.handle.net/10852/30127/2006 webcite
• [4]Bonomi AE, Patrick DL, Bushnell DM, Martin M: Validation of the United States’ version of the world health organization quality of life (WHOQOL) instrument. J Clin Epidemiol 2000, 53:19-23.
• [5]Christine K, David S: Diabetes. In Adherence to Long-term Therapies: Evidence for Action. 1st edition. Edited by Kaplan S. Switzerland: World Health Organization; 2003:71.
• [6]Mumu SJ, Saleh F, Ara F, Afnan F, Ali L: Non-adherence to life-style modification and its factors among type 2 diabetic patients. Indian J Public Health 2014, 58(1):40-44.
• [7]Martínez YV, Prado-Aguilar CA, Rascón-Pacheco RA, Valdivia-Martínez JJ: Quality of life associated with treatment adherence in patients with type 2 diabetes: a cross-sectional study. BMC Health Serv Res 2008, 8:164. BioMed Central Full Text
• [8]Aghamollaei T, Eftekhar H, Shojaeizadeh D, Mohammad K, Nakhjavani M, Ghofrani Pour F: Behavior, metabolic control and health-related quality of life in diabetic patients at Bandar Abbas diabetic clinic. Iranian J Publ Health 2003, 32(3):54-59.
• [9]Hanko’ B, Ka’zme’r M, Kumli P, Hra’gyel Z, Samu A, Vincze Z, Zelko R: Self-reported medication and lifestyle adherence in Hungarian patients with type 2 diabetes. Pharm World Sci 2007, 29:58-66.
• [10]Ose D, Miksch A, Urban E, Natanzon I, Szecsenyi J, Kunz UC, Freund T: Health related quality of life and comorbidity. A descriptive analysis comparing EQ-5D dimensions of patients in the German disease management program for type 2 diabetes and patients in routine care. BMC Health Serv Res 2011, 11:179. BioMed Central Full Text
• [11]EuroQol Group: EuroQol - a new facility for the measurement of health related quality of life. Health Policy 1990, 16:199-208.
• [12]Dolan P: Modeling valuations for Euroqol health states. Med Care 1997, 35:1095-1108.
• [13]Mahatab H, Latif ZA, Pathan MF (Eds): Clinical Management of Diabetes Mellitus in Bangladesh, Principles and Guidelines. Dhaka: Clinical Research Group, Bangladesh Endocrine Society; 2012.
• [14]WHO expert consultation: Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 2004, 363:157-163.
• [15]Mandal PK, Mallik S, Manna N, Sardar JC, Ghosh P, Chakraborty D, Roy AKS, Dasgupta S: Non-adherence to lifestyle modification: a study among diabetic patients in a Tertiary care hospital, Kolkata, India. Turkish J Family Med Primary Care 2012, 6(4):51-55.
• [16]Kamel NM, Badawy YA, Merdan LA: Diabetics’ knowledge of the disease and their management behavior. East Mediterr Health J 1999, 5(5):967-973.