Reason for refusal of insulin therapy among type 2 diabetes mellitus patients in primary care clinic in Bangalore

ObjectiveThe prevalence of type 2 diabetes mellitus (T2DM) is increasing globally and there is critical need develop interventions to improve health outcomes among older people. The Group Appointments in Primary Care (GAP) study was a randomised controlled trial designed to test the efficacy of a group and team-based medical visit programme to lower haemoglobin A1c among patients with T2DM. We aimed to understand the barriers and facilitators to implement the GAP intervention within a primary care setting, with an emphasis on patient experience.Research design and methodsThis was a qualitative exploratory study. Data were gathered from semistructured interviews conducted with the first cohort of GAP study participants (n=15) at baseline and intervention completion. GAP participants were aged >65, diagnosed with T2DM and from one primary care clinic. The interview questions identified the patient perspectives and factors relating to their attendance at seven group medical visits that were part of the intervention programme. Data were analysed using framework analysis.ResultsWe identified four themes that captured participants’ experiences: (1) Education: learning with professionals, learning with one another; (2) Social Support: common interests, common problems; (3) Setting: ease of location, ease of conversation and (4) Impact: expectations met, empowerment gained. The GAP intervention increased participants’ self-reported diabetes literacy and self-management skills.ConclusionsWe learnt that: accessible community centres, not primary care offices, were the ideal location for GAP; the consistent leadership of the primary care physician was valued by participants; and, the content related to exercise and healthy diet were viewed as impactful. Also, learning was achieved through content delivered by clinical experts, and by T2DM experts with lived experience—the GAP peers. Our findings highlight the important role of group learning.Trial registration numberNCT02002143

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Diabetes literacy and knowledge among patients with type 2 diabetes mellitus attending a primary care clinic in Seremban, Malaysia

Malaysian Journal of Nutrition ◽

10.31246/mjn-2019-0031 ◽

2020 ◽

Vol 25 (3) ◽

pp. 435-444

Author(s):

Ching Li Lee ◽

◽

Siew Swee Winnie Chee ◽

Kanimolli Arasu ◽

Siew Kim Kwa ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Primary Care ◽

Type 2 Diabetes Mellitus ◽

Primary Care Clinic ◽

Care Clinic ◽

Diabetes Literacy

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Quality of Life and Associated Factors among Primary Care Asian Patients with Type 2 Diabetes Mellitus

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16193561 ◽

2019 ◽

Vol 16 (19) ◽

pp. 3561 ◽

Cited By ~ 4

Author(s):

Hardesh Dhillon ◽

Rusli Bin Nordin ◽

Amutha Ramadas

Keyword(s):

Quality Of Life ◽

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Primary Care ◽

Type 2 Diabetes Mellitus ◽

Medication Adherence ◽

Well Being ◽

Care Clinic

Diabetes complications, medication adherence, and psychosocial well-being have been associated with quality of life (QOL) among several Western and Asian populations with diabetes, however, there is little evidence substantiating these relationships among Malaysia’s unique and diverse population. Therefore, a cross-sectional study was conducted in a Malaysian public primary care clinic among 150 patients diagnosed with type 2 diabetes mellitus (T2DM). Structured and validated questionnaires were used to investigate the associations between demographic, clinical, and psychological factors with QOL of the study participants. Approximately three-quarters of patients had a good-excellent QOL. Diabetes-related variables that were significantly associated with poor QOL scores included insulin containing treatment regimens, poor glycemic control, inactive lifestyle, retinopathy, neuropathy, abnormal psychosocial well-being, higher diabetes complication severity, and nonadherence (p < 0.05). The main predictors of a good-excellent QOL were HbA1c ≤ 6.5% (aOR = 20.78, 95% CI = 2.5175.9, p = 0.005), normal anxiety levels (aOR = 5.73, 95% CI = 1.8–18.5, p = 0.004), medication adherence (aOR = 3.35, 95% CI = 1.3–8.7, p = 0.012), and an aDCSI score of one and two as compared to those greater than or equal to four (aOR = 7.78, 95% CI = 1.5–39.2, p = 0.013 and aOR = 8.23, 95% CI = 2.1–32.8, p = 0.003), respectively. Medication adherence has also been found to be an effect modifier of relationships between HbA1c, depression, anxiety, disease severity, and QOL. These predictors of QOL are important factors to consider when managing patients with T2DM.

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Type 2 Diabetes Mellitus in Ambulatory Adult Nigerians: Prevalence and Associated Family Biosocial Factors in a Primary Care Clinic in Eastern Nigeria: A Cross-sectional Study

British Journal of Medicine and Medical Research ◽

10.9734/bjmmr/2015/18783 ◽

2015 ◽

Vol 9 (3) ◽

pp. 1-12 ◽

Cited By ~ 3

Author(s):

Gabriel Iloh ◽

A. Amadi ◽

C. Ebirim

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Primary Care ◽

Primary Care Clinic ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Care Clinic ◽

Associated Family

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The Association Between Health Literacy and Quality of Life and Its Associated Factors Among Adults with Type 2 Diabetes Mellitus in Public Primary Care Clinic

Journal of Clinical and Health Sciences ◽

10.24191/jchs.v5i1.9822 ◽

2020 ◽

Vol 5 (1) ◽

pp. 60

Author(s):

Nur Amirah Shibraumalisi ◽

Nafiza Mat Nasir ◽

Mazapuspavina Md Yasin ◽

Mohamad Rodi Isa

Keyword(s):

Quality Of Life ◽

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Primary Care ◽

Type 2 Diabetes Mellitus ◽

Health Literacy ◽

Care Clinic ◽

The Mean

Introduction: Low health literacy (HL) is one of the contributing factors that leads to negative diabetic outcome. Quality of life (QOL) is a state of complete physical, mental and social wellbeing. There is limited evidence on association of HL and QOL among type 2 diabetes mellitus (T2DM), therefore the objectives of this study were to identify the HL and QOL status, to determine the association between HL and QOL and factors associated with QOL among T2DM patients. Methods: This was a cross sectional study involving patients with T2DM from two public primary care clinics. HL and QOL were measured using translated and validatedHLS – Asia Q16 and DQoL-BCI questionnaires respectively among T2DM patients. Results: The mean HL score was 12.39 (3.34), 17.7 % had “inadequate HL”, 25.7% had “problematic HL” and 56.6% had “sufficient HL”. The mean DQoL-BCI score was 32.09 (6.51). Lower QOL level was negatively associated with age (b -0.140; CI: -0.190, - 0.090; p<0.001), not obese (b -1.476; CI: -2.605, - 0.347; p<0.011), and HL level (b -0.425; CI: -0.59, - 0.259; p<0.001). Lower QOL level was positively associated with uncontrolled glycaemic status (HbA1c >6.5%)(b 1.308; CI: -0.042, 2.659; p<0.058), treatment with insulin (b 4.163; CI:1.538, 6.788; p<0.002) and combination treatment of insulin and oral hypoglycaemic agents (OHA) (b 2.450; CI:1.145, 3.756; p<0.001). Conclusions: This study demonstrated that age, body mass index, HL, glycaemic control, treatment with OHA and insulin were significantly associated with QOL. This suggest the importance of identifying high risk patients with poor QOL for targeted intervention.

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