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Improving Knowledge Of Type 2 Diabetes Mellitus Patients On Oral Hypoglycaemic Agents
every part of the body. Total annual diabetes cost in the USA approximately USD135 billion.
The goal of diabetes care is to manage the disease so that the patient can lead as near to normal life as possible. Healthcare providers nowadays are encountering a
vast number of diabetic patients in Malaysia and the prevalence is increasing every year and so does the use and number of oral hypoglycaemic agents.
The National Health and Morbidity Survey had shown an increase in the number of type 2 diabetic patients from 6.3 in 1986 to 8.3 in 1996 Malaysian Consensus
Clinical Practice Guidelines 2004. The situation was similar in District of Hilir Perak, where in 2004 the number of diabetic patient was 4952 and has increased to 5063
in February 2005.
In outpatient department Hospital Teluk Intan itself, there are a total of 2967 diabetic patients registered up to June 2006 Daftar Diabetes 2005
2006. PKD Hilir Perak. Compliance towards medication is regarded as a major problem in healthcare.
Better understanding of the problem is needed in order to improve the medication compliancy of patients Norehan Abdullah 2002. It has been generally accepted
that educational programs can be beneficial in the treatment of a number of chronic disease such as diabetes. The findings of one study has shown a positive short
and long term impact of a structured educational intervention on the patient’s knowledge of issues related to hypertension Cuspidi C et al., 2000. One outcome
study in Pakistan emphasizes the need for diabetes education at all levels, both for the patients as well as the health care providers to counter the pandemic of diabetes-
related complication globally Jabbar A et al., 2001. Many studies have shown that diabetic patient education activities should be directed primarily at stimulating
adherence to the drug dosage and awareness of side effect Timmer JW et al. 1999; Donnan et al. 2002 A study in Hospital Taiping revealed 25 of patients are non-
compliant towards their medication due to poor knowledge Ng C. B., 2002 and another 46 in a similar study in Kedah. In additional, it was showed that among
all medication used in Malaysia, sulphonylureas were the most widely used 21.157 DDD1000 population per day Malaysian Statistic of Medicine 2004.
1.2 Problem Statement
Patient’s knowledge regarding their medication is one of the crucial elements in ensuring compliance as part of knowledge on the disease itself. Most of the
medical personnel are facing difficulties to implement effective measures to improve patient’s understanding towards their medication as it involves multiple limitations
and obstacles with absence of a systematic and unified module for patient education.
Apart from this reason, together with certain limitations, it would be appropriate for this study to further focus in educating patients on their medication in order
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to improve compliance and subsequently help in controlling the morbidity and mortality from diabetes mellitus.
It is well known that medications are not taken correctly as directed. Some patient may not obtain maximal therapeutic benefit because of poor adherence to their
treatment plans Vivian EM, 2007. Compliance towards medication is regarded as a major problem in healthcare, and a better understanding of the problem is needed
in order to improve the medication taking behavior of patients Norehan Abdullah 2002. A study in Hospital Taiping revealed 25 of patients are non-compliant
towards their medication due to poor knowledge Ng C. B., 2002. Another similar study done in Kedah revealed 46 of patients with non-compliance due to the very
same reason.
Another study was done to assess knowledge about oral hypoglycemic agents among patients with diabetes and non-specialist healthcare professionals. This study
found that patients’ and professionals’ knowledge of oral hypoglycemic agents is poor. More appropriate advice and information to patients from prescribers may
improve patient understanding and hence compliance Browne D. L. et al. 2000.
In order to achieve recommended glycaemic control, The Global Partnership for Effective Diabetes Management proposed 10 key practical recommendations. The
10
th
step was implementing a multi- and interdisciplinary team approach to diabetes management to encourage patient education and self-care and share responsibility
for patients achieving glucose goals Prato S. D. et al. 2005. This recommendation proves the importance of patients’ education program that we did now.
A study was done by Timmer JW et al. 1999 indicates patient education activities directed at users of OHA are desirable in the community. According to the result,
patient education activities should be directed primarily at stimulating adherence to the dosage regimen and increasing awareness of side effects. Preconditions
that should be considered when implementing these activities were structural cooperation with medical officer and diabetic nurses and pharmacist.
From analysis, there are many contributing factors that affect patient’s knowledge on Oral Hypoglycemic Agent OHA today. Both patient and healthcare provider are
two major groups contributing to this problem.
One tablet per day administration was associated with greater adherence than multiple tablets. Poor adherence is a major obstacle in the treatment of type 2
diabetes Donnan P. T. 2002.
Common patient factors contributing to this problem are educational level, socioeconomic status, lack of awareness or motivation, physical or cognitive
impairment and age. Common healthcare provider factors are inadequate
