Discussions of Results DISCUSSIONS
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by Thomson FJ et al 1991 – 88 patients taking OHA denied any knowledge of hypoglycemia. 54 of the OHA groups have been associated with severe and
prolonged hypoglycemia.
In outpatient department in hospital, patients with lower education level, namely those who had primary school as their maximum education patients with no
formal education were included, was found to have significant improvement of knowledge after continuous intervention done. This is quite odd as patients
with higher education level, namely those who had secondary education as their minimum education, was expected to yield better result than the former group.
However, in this study, it was the other way around. This was most probably due to premature judgment by healthcare providers that patients with higher education
level did not need intensive counseling and attention in terms of explanation compared to those with lower educational level.
This stereotype misconception among healthcare providers led to different approaches to patients. Those with higher education level would be explained
in a faster way and less time spent with them educating about OHA, healthcare providers were prone to use complicated terminologies rather than simple ones,
and less repetition of information was done.
However, in health clinics, the intervention gave out better effects on patients who were having diabetes mellitus as their sole morbidity. However, this improvement
was not statistically sustained with significance until P2. It could be seen that this group of patients would benefit from the intervention as we hoped.
Out of seven areas of question regarding knowledge of OHA, health clinics improved significantly in question on physical OHA properties, frequency and correct action if
missed medication. However, most of the improvement only can be seen in those who on single OHA. Obviously, patient with less medication are able to concentrate
more on their medication and subsequently will be less confused.
In the other hand, Hospital OPD patients only showed significant improvement in knowledge regarding correct side effect of the OHA. This improvement was
significant in the entire patient regardless of their number of OHA. This was because this specific area was very poorly understood prior to intervention, thus intervened,
this area improved so much. Other areas was not so bad in the beginning, therefore a little rise was not significant but still good.
However, question pertaining to the name of the consumed OHA did not show improvement. This was because this study had a significant amount of patients who
were poorly educated primary schooled and no formal education. Therefore, they had a problem in memorizing name since they could not even read the material
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given to them, namely OHA charts, reminder stickers and let alone the six pages pamphlets.
A study was done in Taiwan entitled Community Education Program on Medication Use with similar methodology single group pre and post comparison study. This
study showed that medication knowledge at baseline was positively correlated with education level and negatively correlated with age. This was also seen in our
study for baseline knowledge, those who were more than 60 years old performed less 39.7 scored 4 and above as compared to those who were less than 60 years
old 60.3 scored 4 and above.
The same study in Taiwan Huang Y. M. et al. 2006 revealed that female were more aware drug-related information than were males. This was also seen in our study,
in which female with good knowledge on their own OHA with percentage of 62.1 during baseline study, 58.0 during P1 and 61.9 during P2. On the other hand,
male scored only 37.9 during baseline, 42.0 in P1 and 38.1 in P2.
A drastic and promising result was seen in the percentage of patients who had good knowledge scored 4 and above across all socio-demographic factors in both
hospital and health clinics in general. Almost all comparisons showed average p value of 0.001. This result was very similar to the study in Taiwan, in which at the
end of the program, the participant showed a significant improvement in medication knowledge p value 0.001 Huang Y. M. et al. 2006.
A decline in knowledge was seen p value 0.193 in P1 and 0.920 in P2 in hospital patients specifically those who were sole diabetics. However, statistical validity of
this specific group was questionable since the total number of sample for each was too small 30, which is 27 during baseline, 21 in P1 and 15 in P2.