Advanced search

Vol 10, No 4 (2021)
Research paper
Published online: 2021-05-27

open access

View PDF Download PDF file
Page views 1295
Article views/downloads 716
Get Citation

Connect on Social Media

Connect on Social Media

The effect of educational intervention on medication adherence behavior in patients with type 2 diabetes: application of social marketing model

Zahra Najafpour1, Isa Mohammadi Zeidi2, Rohollah Kalhor2
DOI: 10.5603/DK.a2021.0040
Clin Diabetol 2021;10(4):359-369.

Abstract

Background: Patient’s adherence to the medication regimen leads to successful treatment in diabetic patients and a reduction in the severity of complications. Educational intervention is needed to improve behavior and change attitudes in diabetic patients. The aim of this study was to determine the effect of educational intervention based on social marketing on promoting medication adherence behavior in type 2 diabetic patients. Materials and methods: Using random sampling, 110 diabetic patients covered by health centers in Qazvin in the form of experimental and control groups participated in a randomized controlled trial. Data collection tools included demographic questions and valid scales related to psychological constructs and drug adherence. The intervention program consisted of 5 group training sessions for 90-60 minutes based on the initial needs assessment and the theoretical framework of the social marketing model for the experimental group. Also, a purposeful educational pamphlet, two sessions of telephone counseling, and educational messages via mobile phone were provided in addition to the group training program for patients in the experimental group. Data were analyzed using SPSS software version 25 and independent sample t-test, Chi-square test, One-way ANOVA, and covariance analysis. Results: The mean age of study participants was (54.12 ± 8.22) years. Also, the average duration of diabetes was 5-10 years and 50% had primary education. The correlation between attitude, self-efficacy, and subjective norm with medication adherence behavior was significant (p <0.05). After the intervention based on the social marketing model, the mean of the constructs of attitude (39), self-efficacy (31), awareness (66), subjective norm (85), and medication adherence (49) increased significantly in the experimental group. Conclusion: Educational intervention based on social marketing could have a significant effect on improving medication adherence behavior. The design of cognitive-behavioral interventions based on social marketing is recommended to promote the health behaviors of diabetic patients.

Keywords: Social MarketingType 2 Diabetesmedication adherenceEducationAttitude

Article available in PDF format

View PDF Download PDF file

References

  1. Hajat C, Stein E. The global burden of multiple chronic conditions: A narrative review. Prev Med Rep. 2018; 12: 284–293.
    CrossRefPubMed
  2. Cho NH, Shaw JE, Karuranga S, et al. IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Res Clin Pract. 2018; 138: 271–281.
    CrossRefPubMed
  3. Almutairi N, Hosseinzadeh H, Gopaldasani V. The effectiveness of patient activation intervention on type 2 diabetes mellitus glycemic control and self-management behaviors: A systematic review of RCTs. Prim Care Diabetes. 2020; 14(1): 12–20.
    CrossRefPubMed
  4. IDF. Diabetes Atlas: international diabetes federation; 2019 [9th edition].
  5. Karuranga S, Duke L. Tackling the complications of diabetes. Diabetes Res Clin Pract. 2018; 141: 294–296.
    CrossRefPubMed
  6. Saeedi P, Salpea P, Karuranga S, et al. IDF Diabetes Atlas Committee. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9 edition. Diabetes Res Clin Pract. 2019; 157: 107843.
    CrossRefPubMed
  7. Williams R, Karuranga S, Malanda B, et al. Global and regional estimates and projections of diabetes-related health expenditure: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Pract. 2020; 162: 108072.
    CrossRefPubMed
  8. Neuenschwander M, Ballon A, Weber KS, et al. Role of diet in type 2 diabetes incidence: umbrella review of meta-analyses of prospective observational studies. BMJ. 2019; 366: l2368.
    CrossRefPubMed
  9. Akbarzadeh A, Salehi A, Molavi Vardanjani H, et al. Epidemiology of Adult Diabetes Mellitus and its Correlates in Pars Cohort Study in Southern Iran. Arch Iran Med. 2019; 22(11): 633–639.
    PubMed
  10. Fatemh N, Diabetes statistics in Qazvin province 2018. http://vch.qums.ac.ir/.
  11. Hurtado M, Vella A. What is type 2 diabetes? Medicine. 2019; 47(1): 10–15.
    CrossRef
  12. Davies MJ, Kristunas CA, Alshreef A, et al. The impact of an intervention to increase uptake to structured self-management education for people with type 2 diabetes mellitus in primary care (the embedding package), compared to usual care, on glycaemic control: study protocol for a mixed methods study incorporating a wait-list cluster randomised controlled trial. BMC Fam Pract. 2019; 20(1): 152.
    CrossRefPubMed
  13. Hashemi SM, Bouya S. Treatment Adherence in Diabetic Patients: An Important but Forgotten Issue. Journal of Diabetes Nursing. 2018; 6(1): 341–51.
  14. Marušić S, Meliš P, Lucijanić M, et al. Impact of pharmacotherapeutic education on medication adherence and adverse outcomes in patients with type 2 diabetes mellitus: a prospective, randomized study. Croat Med J. 2018; 59(6): 290–297.
    PubMed
  15. Kazemi MR, Hosseini M, Safi MH. The effect of self-care education based on short message service on self-efficacy and adherence to the medication regimen in adolescents with epilepsy referred to Iran epilepsy association of in 2016. Nursing Education. 2017; 6(4): 48–55.
  16. Fernandez-Lazaro CI, García-González JM, Adams DP, et al. Adherence to treatment and related factors among patients with chronic conditions in primary care: a cross-sectional study. BMC Fam Pract. 2019; 20(1): 132.
    CrossRefPubMed
  17. Guénette L, Breton MC, Guillaumie L, et al. Psychosocial factors associated with adherence to non-insulin antidiabetes treatments. J Diabetes Complications. 2016; 30(2): 335–342.
    CrossRefPubMed
  18. Tan JP, Cheng KK, Siah RCJ. A systematic review and meta-analysis on the effectiveness of education on medication adherence for patients with hypertension, hyperlipidaemia and diabetes. J Adv Nurs. 2019; 75(11): 2478–2494.
    CrossRefPubMed
  19. Dashtian M, Eftekhar Ardebili H, Karimzadeh Shirazi K, et al. Predicting factors affecting medication adherence and physical activity in patients with type-2 diabetes mellitus based on the theory of planned behavior. Journal of School of Public Health and Institute of Public Health Research. 2017; 15(2): 133–146.
  20. Firestone R, Rowe CJ, Modi SN, et al. The effectiveness of social marketing in global health: a systematic review. Health Policy Plan. 2017; 32(1): 110–124.
    CrossRefPubMed
  21. Zarei A, Feyz D, Rad M. Designing a model of factors affecting the implementation of integrated social marketing mix in health care. JHA. 2016 ; 19(66).
  22. Shams M. Social Marketing for Health: Theoretical and Conceptual Considerations. Selected Issues in Global Health Communications. 2018: 43–55.
    CrossRef
  23. Kalra S, Sahay R. Timely insulin use: Need for social marketing. Indian J Endocrinol Metab. 2016; 20(5): 586–589.
    CrossRefPubMed
  24. Samad N, Samad N, Abdallah S. Use of social marketing in diabetes control in the UAE context. International Journal of Healthcare Management. 2017; 11(1): 1–7.
    CrossRef
  25. Rogers EA, Fine SC, Handley MA, et al. Engaging Minority Youth in Diabetes Prevention Efforts Through a Participatory, Spoken-Word Social Marketing Campaign. Am J Health Promot. 2017; 31(4): 336–339.
    CrossRefPubMed
  26. Rezaei-Pandari H, Keshavarz-Mohammadi N. Social marketing approach in health care: A review study. Iranian Journal of Health Education and Health Promotion. 2014; 2(2): 109–30.
  27. Mohammadi Zeidi I, Morshedi H, Shokohi A. Predicting psychological factors affecting regular physical activity in hypertensive patients: Application of health action process approach model. Nurs Open. 2021; 8(1): 442–452.
    CrossRefPubMed
  28. Negarandeh R, Mahmoodi H, Noktehdan H, et al. Teach back and pictorial image educational strategies on knowledge about diabetes and medication/dietary adherence among low health literate patients with type 2 diabetes. Prim Care Diabetes. 2013; 7(2): 111–118.
    CrossRefPubMed
  29. Yang A, Wang B, Zhu G, et al. Validation of Chinese version of the Morisky medication adherence scale in patients with epilepsy. Seizure. 2014; 23(4): 295–299.
    CrossRefPubMed
  30. Alidosti M, Tavassoli E. Investigating Health literacy, knowledge and self-efficacy in patients with type 2 diabetes referring to health centers in shahrekord. Journal of Health Literacy. 2019; 3(4): 36–45.
  31. Zamani N, Ahmadi Tabatabaei SV, Khanjani N, et al. The effect of educational intervention based on the health belief model on medication adherence among patients with diabetes referred to a diabetes center in Zarand, Kerman. Health and Development Journal. 2017; 6(2): 97–109.
  32. Sleath B, Carpenter DM, Blalock SJ, et al. Development of a new diabetes medication self-efficacy scale and its association with both reported problems in using diabetes medications and self-reported adherence. Patient Prefer Adherence. 2016; 10: 1003–1010.
    CrossRefPubMed
  33. Haghayegh A, Ghasemi N, Neshatdoost H, et al. Psychometric properties of Diabetes Management Self-Efficacy Scale (DMSES). Iranian Journal of Endocrinology and Metabolism. 2010; 12(2): 111–95.
  34. Gholamaliei B, Karimi-Shahanjarini A, Roshanaei G, et al. Medication Adherence and its Related Factors in Patients with Type II Diabetes. Journal of Education and Community Health. 2017; 2(4): 3–12.
    CrossRef
  35. Kassahun T, Gesesew H, Mwanri L, et al. Diabetes related knowledge, self-care behaviours and adherence to medications among diabetic patients in Southwest Ethiopia: a cross-sectional survey. BMC Endocr Disord. 2016; 16(1): 28.
    CrossRefPubMed
  36. Mohamadinejad F, Pedram Ra, Aliasgharpour M, et al. Effect of patient education program on self-efficacy in patients with diabetes. Iranian Journal of Nursing Research. 2015; 10(1): 35–41.
  37. Huang YM, Shiyanbola OO, Chan HY, et al. Patient factors associated with diabetes medication adherence at different health literacy levels: a cross-sectional study at a family medicine clinic. Postgrad Med. 2020; 132(4): 328–336.
    CrossRefPubMed
  38. Kang Y, Hur Y. Medication Adherence and Its Associated Factors in Laotians With Type 2 Diabetes Mellitus. Clin Nurs Res. 2020; 29(5): 331–338.
    CrossRefPubMed
  39. Nelson LA, Wallston KA, Kripalani S, et al. Assessing barriers to diabetes medication adherence using the Information-Motivation-Behavioral skills model. Diabetes Res Clin Pract. 2018; 142: 374–384.
    CrossRefPubMed
  40. Huang Z, Tan E, Lum E, et al. Correction: A Smartphone App to Improve Medication Adherence in Patients With Type 2 Diabetes in Asia: Feasibility Randomized Controlled Trial. JMIR Mhealth Uhealth. 2020; 8(4): e18411.
    CrossRefPubMed
  41. Gonzalez JS, Tanenbaum ML, Commissariat PV. Psychosocial factors in medication adherence and diabetes self-management: Implications for research and practice. Am Psychol. 2016; 71(7): 539–551.
    CrossRefPubMed
  42. Jannuzzi FF, Rodrigues RC, Cornélio ME, et al. Beliefs related to adherence to oral antidiabetic treatment according to the Theory of Planned Behavior. Rev Lat Am Enfermagem. 2014; 22(4): 529–537.
    CrossRefPubMed
  43. Baghikar S, Benitez A, Fernandez Piñeros P, et al. Factors Impacting Adherence to Diabetes Medication Among Urban, Low Income Mexican-Americans with Diabetes. J Immigr Minor Health. 2019; 21(6): 1334–1341.
    CrossRefPubMed
  44. AlShayban DM, Naqvi AA, Alhumaid O, et al. Association of Disease Knowledge and Medication Adherence Among Out-Patients With Type 2 Diabetes Mellitus in Khobar, Saudi Arabia. Front Pharmacol. 2020; 11: 60.
    CrossRefPubMed
  45. Nazir SU, Hassali MA, Saleem F, et al. Disease related knowledge, medication adherence and glycaemic control among patients with type 2 diabetes mellitus in Pakistan. Prim Care Diabetes. 2016; 10(2): 136–141.
    CrossRefPubMed

About cookies

Necessary cookies

Allways active

These cookies are necessary for the proper display and operation of the website. Blocking them may cause the website to malfunction.

Analytical cookies

As part of our website, we use analytical tools, such as Google Analytics, that allow us to verify website traffic. These tools may require the use of cookies.

Community cookies

These are cookies associated with the social networks we use. Accepting them will allow us to associate your visit to the site with our social media profiles.

Marketing cookies

These are cookies responsible for carrying out advertising and marketing activities - consenting to their use will allow us to target you with advertisements based on your previous activities within our website.

Clinical Diabetology

About Via Medica Advertising
Bookstore (Ikamed) TVMed
News
Copyright © 2023 Via Medica Regulations Cookie policy Privacy policy Legal Notice