Conclusion Recommendations 0 CONCLUSION RECOMMENDATION
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Improving Knowledge Of Type 2 Diabetes Mellitus Patients On Oral Hypoglycaemic Agents
ABSTRACT
Improving Knowledge Of Type 2 Diabetes Mellitus Patients On Oral Hypoglycaemic Agents
Mohd Rohaizad Zamri
1
, Umi Hani Mohd Asmawi
1
, Mohd Fadhil Samsuri
2
, Liliwati Ismail
2
, Amar-Singh HSS
3,6
, Sondi Sararaks
4
, Ranjit Kaur Praim Singh
5
, Asmah Zainal Abidin
5
, Ruzzita Mustaffa
2
, Sabab Hashim
6
1 Hospital Teluk Intan 2 Hilir Perak Health Office
3 Clinical Research Centre Perak 4 Institute for Health Systems Research
5 Perak State Health Department 6 Hospital Raja Permaisuri Bainun Ipoh
Introduction
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 is similar in District of Hilir Perak, where in 2004 the number of diabetic patients was 4952 and has increased
to 5063 in February 2005.
In outpatient department of Hospital Teluk Intan itself, there is 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. 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.
To improve knowledge among diabetic patients on oral hypoglycemic agent OHA in outpatient departments in Hilir Perak District by implementing intervention program.
Methodology
An interventional experimental study on type 2 diabetic patients on OHA treatment was conducted from November 2006 to August 2007 in outpatient department in District of
Hilir Perak Hospital Teluk Intan and 3 health clinics. This study consists of three phases. Phase 1 was baseline data collection using a standard structured questionnaire, Phase 2
was development of an intervention package to educate patient. The package consists of standardized structured guidelines Buku Panduan OHA Untuk Pesakit Diabetes Mellitus
Jenis 2 Appendix 1, OHA Chart Appendix 2, medication explanation checklist Appendix 3, reminder stickers for OHA envelopes Appendix 4 and pamphlets Appendix 5. Phase
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Improving Knowledge Of Type 2 Diabetes Mellitus Patients On Oral Hypoglycaemic Agents
3 was implementation of the package done continuously everyday and followed by post- intervention study using the same questionnaire. Two post-intervention studies were
done in May and August to evaluate effectiveness of the program.
Results
There was a significant difference between two different settings hospital and health clinics in baseline socio-demographic characteristics and clinical profile age and number
of co-morbidities p-value = 0.003, ethnicity and duration of illness p value 0.001. The intervention produced significant improvement across all socio-demographic factors
p-value 0.001, in both settings, more prominently in health clinics. In hospital setting, patients with socio-demographic factor of lower educational level showed significant
improvement of knowledge after intervention, but in health clinics, solely diabetics showed improvement in knowledge after intervened.
Conclusion
Patients’ baseline knowledge regarding OHA is poor. The intervention module is effective showed by significant improvement in overall knowledge for both hospital and health
clinics. However, improvement in health clinic is more than in hospital.
Recommendations
Continuation of this intervention package is highly recommended to a more extended scope regardless of socio-demographic background. The application of reminder sticker
shall be continued and extended to all health centers because it provides complete and specific information on OHA. Intervention shall stress more in elderly age 60 years
old in general and in specific, OHA names are stressed for those who cannot read with perhaps a different approach.