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Toletti G, Boaretto A, Di Loreto C, Fornengo R, Gigante A, Perrone G. Enhancing diabetes therapy adherence: a comprehensive study on glucometer usability for type 2 diabetes patients. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2024; 5:1328181. [PMID: 38807703 PMCID: PMC11130397 DOI: 10.3389/fcdhc.2024.1328181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 04/22/2024] [Indexed: 05/30/2024]
Abstract
Background Self-monitoring of blood glucose (SMBG) is a vital practice for type 2 diabetes (T2DM), and glucometers have the potential to improve therapy adherence. However, characteristics of glucometers improving their usability are underexplored. A knowledge gap exists regarding patients under 65, warranting further research for diabetes care improvement. Thus, this study aims to gather insights on glucometer accessibility, by analyzing the case of the Accu-Chek® Instant glucometer by Roche Diabetes Care GmbH. Methods Starting from a previous study having the objective of investigating devices' features able to improve SMBG in over 65 T2DM patients, using the same device, we enlarged the scale, designing a survey that collected answers from 1145 patients of the Center and South of Italy, both under and over 65. 957 answers were analyzed, according to a threshold of 50% completion of the answers. Results Our results show the major characteristics presented in Accu-Chek® Instant are appreciated differently between patients under 65 and over 65, and between patients with or without previous experience with a glucometer. Discussions and conclusions It emerged how Accu-Chek® was perceived as more user-friendly among individuals under 65 compared to those aged 65 and over, where more people had prior experience, indicating how such a glucometer can be particularly helpful for naive patients. The study provides valuable insights to the academic discourse on glucometer features and their influence on therapy adherence.
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Affiliation(s)
- Giovanni Toletti
- Department of Management, Economics and Industrial Engineering, Politecnico di Milano, Milan, Italy
| | | | - Chiara Di Loreto
- Unità Operativa Semplice Diabetologia - Distretto Del Perugino - Usl Umbria 1, Perugia, Italy
| | - Riccardo Fornengo
- Struttura Semplice Dipartimentale di Diabetologia e Malattie Metaboliche, Azienda Sanitaria Locale (ASL) TO4, Ospedale Civico di Chivasso, Chivasso, Italy
| | - Alfonso Gigante
- Struttura complessa Diabetologia, Ospedale Cesare Zonchello, Nuoro, Italy
| | - Giovanni Perrone
- Servizio Territoriale di Diabetologia Polo Sanitario Reggio Calabria Sud, Reggio Calabria, Italy
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Wang J, Tan F, Wang Z, Yu Y, Yang J, Wang Y, Shao R, Yin X. Understanding Gaps in the Hypertension and Diabetes Care Cascade: Systematic Scoping Review. JMIR Public Health Surveill 2024; 10:e51802. [PMID: 38149840 PMCID: PMC10907944 DOI: 10.2196/51802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 10/22/2023] [Accepted: 12/27/2023] [Indexed: 12/28/2023] Open
Abstract
BACKGROUND Hypertension and diabetes are global health challenges requiring effective management to mitigate their considerable burden. The successful management of hypertension and diabetes requires the completion of a sequence of stages, which are collectively termed the care cascade. OBJECTIVE This scoping review aimed to describe the characteristics of studies on the hypertension and diabetes care cascade and identify potential interventions as well as factors that impact each stage of the care cascade. METHODS The method of this scoping review has been guided by the framework by Arksey and O'Malley. We systematically searched MEDLINE, Embase, and Web of Science using terms pertinent to hypertension, diabetes, and specific stages of the care cascade. Articles published after 2011 were considered, and we included all studies that described the completion of at least one stage of the care cascade of hypertension and diabetes. Study selection was independently performed by 2 paired authors. Descriptive statistics were used to elucidate key patterns and trends. Inductive content analysis was performed to generate themes regarding the barriers and facilitators for improving the care cascade in hypertension and diabetes management. RESULTS A total of 128 studies were included, with 42.2% (54/128) conducted in high-income countries. Of them, 47 (36.7%) focused on hypertension care, 63 (49.2%) focused on diabetes care, and only 18 (14.1%) reported on the care of both diseases. The majority (96/128, 75.0%) were observational in design. Cascade stages documented in the literature were awareness, screening, diagnosis, linkage to care, treatment, adherence to medication, and control. Most studies focused on the stages of treatment and control, while a relative paucity of studies examined the stages before treatment initiation (76/128, 59.4% vs 52/128, 40.6%). There was a wide spectrum of interventions aimed at enhancing the hypertension and diabetes care cascade. The analysis unveiled a multitude of individual-level and system-level factors influencing the successful completion of cascade sequences in both high-income and low- and middle-income settings. CONCLUSIONS This review offers a comprehensive understanding of hypertension and diabetes management, emphasizing the pivotal factors that impact each stage of care. Future research should focus on upstream cascade stages and context-specific interventions to optimize patient retention and care outcomes.
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Affiliation(s)
- Jie Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Fangqin Tan
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Zhenzhong Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yiwen Yu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jingsong Yang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yueqing Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Ruitai Shao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xuejun Yin
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
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Maryem A, Younes I, Yassmine M, Morad G, Karima B, Amal K, Noureddine EK, Mohamed I, Mohamed K, Chahboune M. Translation, cultural adaptation and validation of the General Medication Adherence Scale (GMAS) in moroccan patients with type-2 diabetes. BMC Nurs 2023; 22:302. [PMID: 37667249 PMCID: PMC10476372 DOI: 10.1186/s12912-023-01457-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 08/22/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND The objective of the study was to cross-culturally adapt and validate the General Medication Adherence Scale (GMAS) in patients with type-2 diabetes in Morocco. METHODS The study was a cross-sectional study conducted between September 12 and October 12, 2022, and included patients with type-2 diabetes from a primary health care network. To measure the different psychometric parameters of the construct, data analysis was performed using SPSS v20. The study was approved by the Moroccan Association for Research and Ethics. RESULTS A total of 284 patients were included in the study; the results of the different psychometric parameters were largely acceptable. Indeed, the improvement of the goodness-of-fit of the model in relation to the independence model was evaluated by the comparative fit index (CFI), which was higher than 0.95, as well as the normalized fit index (NFI), which expresses the percentage of the general covariance between the variable demonstrated via the tested model when the null model is taken as reference and was also higher than 0.95 in this study. Additionally, the Tucker Louis Index (TLI) or Unstandardized Fit Index, which measures the increase in goodness of fit when moving from the reference model to the model under study, had a value of > 0.95. The correlations between the items were good; indeed, the Kaiser-Meyer-Olkin (KMO) index was > 0.7. The translated tool presents good internal consistency; thus, Cronbach's α had a value of approximately 0.804 (> 0.7). CONCLUSIONS The version of the GMAS tool adapted to the Moroccan context has very acceptable psychometric values. This means that Moroccan researchers and health professionals can use it as an instrument to measure adherence among individuals with type-2 diabetes.
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Affiliation(s)
- Arraji Maryem
- Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Hassan First University of Settat, Settat, 26000, Morocco.
| | - Iderdar Younes
- Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Hassan First University of Settat, Settat, 26000, Morocco
| | - Mourajid Yassmine
- Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Hassan First University of Settat, Settat, 26000, Morocco
| | - Guennouni Morad
- Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Hassan First University of Settat, Settat, 26000, Morocco
- Higher School of Education and Training, Science and Technology Team, Chouaîb Doukkali University of El Jadida, El Jadida, Morocco
| | - Boumendil Karima
- Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Hassan First University of Settat, Settat, 26000, Morocco
| | - Korrida Amal
- High Institute of Nursing Professions and Health Techniques (ISPITS), Agadir, Morocco
- Research Laboratory of Innovation in Health Sciences (LARISS), Faculty of Medicine and Pharmacy, Ibn Zohr University, Agadir, Morocco
| | - El Khoudri Noureddine
- Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Hassan First University of Settat, Settat, 26000, Morocco
| | - Ifleh Mohamed
- Faculty of Medicine and Pharmacy, Laboratory of Hematology, Mohammad V University, Rabat, Morocco
| | - Khalis Mohamed
- Mohammed VI Center of Research and Innovation, Rabat, Morocco
- International School of Public Health, Mohammed VI University of Health Sciences, Casablanca, Morocco
- Higher Institute of Nursing Professions and Technical Health, Rabat, Morocco
- Laboratory of Biostatistics, Clinical, and Epidemiological Research, Faculty of Medicine and Pharmacy, Department of Public Health, Mohamed V University in Rabat, Rabat, Morocco
| | - Mohamed Chahboune
- Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Hassan First University of Settat, Settat, 26000, Morocco
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Dehghani Tafti A, Fatehpanah A, Salmani I, Bahrami MA, Tavangar H, Fallahzadeh H, Tehrani AA, Bahariniya S, Tehrani GA. COVID-19 pandemic has disrupted the continuity of care for chronic patients: evidence from a cross-sectional retrospective study in a developing country. BMC PRIMARY CARE 2023; 24:137. [PMID: 37393225 PMCID: PMC10314396 DOI: 10.1186/s12875-023-02086-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 06/20/2023] [Indexed: 07/03/2023]
Abstract
BACKGROUND Any disruption in continuity of care for patients with chronic conditions can lead to poor outcomes for the patients as well as great damage for the community and the health system. This study aims to determine the continuity of care for patients with chronic conditions such as hypertension and diabetes during COVID-19 pandemic. METHODS Through a cross-sectional retrospective study, data registered in six health centers in Yazd, Iran were analyzed. Data included the number of patients with chronic conditions (hypertension and diabetes) and average daily admission during a year before COVID-19 pandemic and the similar period after COVID-19 outbreak. The experience of continuity of care was assessed applying a validated questionnaire from a sample of 198 patients. Data analysis was done using SPSS version 25. Descriptive statistics, independent T-Test and Multivariable regression were used for analysis. FINDINGS Results indicate that both visit load of the patients with chronic conditions (hypertension and diabetes) and their average daily admission were decreased significantly during a year after COVID-19 pandemic compared to the similar period before COVID-19 outbreak. The moderate average score of the patients` experience towards continuity of care during the pandemic was also reported. Regression analysis showed that age for the diabetes patients and insurance status for the hypertension patients affect the COC mean scores. CONCLUSION COVID-19 pandemic causes serious decline in the continuity of care for patients with chronic conditions. Such a deterioration not only can lead to make these patients` condition worse in a long-term period but also it can make irreparable damages to the whole community and the health system. To make the health systems resilient particularly in disasters, serious attention should be taken into consideration among them, developing the tele-health technologies, improving the primary health care capacity, designing the applied responsive models of continuity of care, making multilateral participations and inter-sectoral collaborations, allocating sustainable resources, and enabling the patients with selfcare skills are more highlighted.
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Affiliation(s)
- Abbasali Dehghani Tafti
- Department of Health in Disater and Emergencies, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Azadeh Fatehpanah
- Department of Health in Disater and Emergencies, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Ibrahim Salmani
- Department of Health in Disater and Emergencies, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Amin Bahrami
- Healthcare Management Department, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossien Tavangar
- School of Nursing and Midwifery, Nursing and Midwifery Care Research Center, Shahid Sadoughi University of Medical Science, Yazd, Iran
| | - Hossien Fallahzadeh
- Center for Healthcare Data Modeling, Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Ali Ahmadi Tehrani
- Pharmaceutical Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Sajjad Bahariniya
- Health Services Management Department, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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