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Siddiqui F, Hewitt C, Jennings H, Coales K, Mazhar L, Boeckmann M, Siddiqi N. Self-management of chronic, non-communicable diseases in South Asian settings: A systematic mixed-studies review. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0001668. [PMID: 38190368 PMCID: PMC10773968 DOI: 10.1371/journal.pgph.0001668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 11/14/2023] [Indexed: 01/10/2024]
Abstract
Self-management is crucial in mitigating the impacts of a growing non-communicable disease (NCD) burden, particularly in Low and Middle-Income countries. What influences self-management in these settings, however, is poorly understood. We aimed to identify the determinants of self-management in the high NCD region of South Asia and explore how they influence self-management. A systematic mixed-studies review was conducted. Key electronic databases [MEDLINE (1946+), Embase (1974+), PsycInfo (1967+) and CINAHL (EBSCOhost)] in March 2022 (and updated in April 2023) were searched for studies on the self-management of four high-burden NCD groups: cardiovascular diseases, type 2 diabetes, chronic respiratory diseases and depression. Study characteristics and quantitative data were extracted using a structured template, and qualitative information was extracted using NVivo. Quality appraisal was done using the Mixed Methods Assessment Tool (MMAT). Quantitative findings were organised using the Commission on Social Determinants of Health (CSDH) framework and synthesised narratively, supported by effect direction plots. Qualitative findings were thematically synthesised. Both were integrated in a mixed synthesis. Forty-four studies (26 quantitative, 16 qualitative and 2 mixed-methods studies) were included, the majority of which were conducted in urban settings and among individuals with diabetes and cardiovascular diseases. Higher age, education, and income (structural determinants), health-related knowledge, social support and self-efficacy (psychosocial determinants), longer illness duration and physical comorbidity (biologic determinants), and the affordability of medicine (health-system determinants) were key determinants of self-management. Qualitative themes highlighted the role of financial adversity and the social and physical environment in shaping self-management.A complex interplay of structural and intermediary social determinants shapes self-management in South Asian settings. Multi-component, whole-systems approaches could boost self-management in these settings. Key areas include empowerment and education of patients and wider community, design and delivery of bespoke behavioural interventions and a stronger emphasis on supporting self-management in healthcare settings.
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Affiliation(s)
- Faraz Siddiqui
- Department of Health Sciences, Mental Health and Addictions Research Group, University of York, York, United Kingdom
| | - Catherine Hewitt
- Department of Health Sciences, Mental Health and Addictions Research Group, University of York, York, United Kingdom
- Department of Health Sciences, York Trials Unit, University of York, York, United Kingdom
| | - Hannah Jennings
- Department of Health Sciences, Mental Health and Addictions Research Group, University of York, York, United Kingdom
- Hull York Medical School, York, United Kingdom
| | - Karen Coales
- Department of Health Sciences, Mental Health and Addictions Research Group, University of York, York, United Kingdom
| | - Laraib Mazhar
- Penn State University College of Medicine, Hershey, Pennsylvania, United States of America
| | - Melanie Boeckmann
- Department of Global Health, Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany
| | - Najma Siddiqi
- Department of Health Sciences, Mental Health and Addictions Research Group, University of York, York, United Kingdom
- Hull York Medical School, York, United Kingdom
- Bradford District Care NHS foundation trust, Bradford, United Kingdom
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Alsaidan AA, Thirunavukkarasu A, Alhassan HH, Bin Ahmed IA, Alnasiri AS, Alhirsan WM, Alazmi NNM, Alkhlaf AK, Alderbas JM, Alkhaldi MA. Evaluation of Self-Management Behaviors and Its Correlation with the Metabolic Syndrome among the Type 2 Diabetes Mellitus Patients of Northern Saudi Arabia. J Clin Med 2023; 13:118. [PMID: 38202125 PMCID: PMC10779580 DOI: 10.3390/jcm13010118] [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: 11/25/2023] [Revised: 12/16/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
Self-management behavior among diabetes patients is essential to monitor blood sugar levels, make necessary lifestyle changes, and help patients reduce their risk of complications from diabetes. We assessed the prevalence of metabolic syndrome (MS) and its association with self-management behavior and sociodemographic characteristics among 310 patients with type 2 diabetes mellitus (T2DM) attending different diabetes care centers in northern Saudi Arabia. We evaluated the self-management behaviors of patients with T2DM using a validated Arabic version of the Summary of Diabetes Self-Care Activities Scale. Regarding MS, we applied the National Cholesterol Education Program (NCEP) Adult Treatment Plan-3 (ATP-3) guidelines. A logistic regression analysis was used to identify the predictors of MS. We found that more than one-third (36.5%) of patients had MS according to the NCEP ATP-3 criteria. The prevalence of MS was significantly associated with unsatisfactory self-management behaviors. Regarding sociodemographic predictors for MS, we found a significant association between gender (ref: female: Adjusted OR (AOR) = 1.89, 95%CI = 1.17-2.95, p = 0.007) and body mass index (ref.: normal range: AOR = 2.98, 95%CI = 1.31-5.07, p = 0.003). Our findings suggest a tailor-made multifaceted intervention to improve the self-management behaviors of T2DM patients, which, in turn, can reduce MS.
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Affiliation(s)
- Aseel Awad Alsaidan
- Department of Family and Community Medicine, College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia;
| | - Ashokkumar Thirunavukkarasu
- Department of Family and Community Medicine, College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia;
| | - Hassan H. Alhassan
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Sakaka 72388, Saudi Arabia;
| | - Ibrahim Abdullah Bin Ahmed
- Department of Family Medicine, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh 11432, Saudi Arabia;
| | - Anas Salem Alnasiri
- King Abdulaziz Specialist Hospital, Ministry of Health, Sakaka 72345, Saudi Arabia;
| | - Wejdan Madallah Alhirsan
- College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia; (W.M.A.); (N.N.M.A.); (A.K.A.); (M.A.A.)
| | - Nouf Nashmi M. Alazmi
- College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia; (W.M.A.); (N.N.M.A.); (A.K.A.); (M.A.A.)
| | - Abdalaziz Khaled Alkhlaf
- College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia; (W.M.A.); (N.N.M.A.); (A.K.A.); (M.A.A.)
| | - Jumanah Mohammed Alderbas
- College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia; (W.M.A.); (N.N.M.A.); (A.K.A.); (M.A.A.)
| | - Motaz Abdulsalam Alkhaldi
- College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia; (W.M.A.); (N.N.M.A.); (A.K.A.); (M.A.A.)
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Studer CM, Linder M, Pazzagli L. A global systematic overview of socioeconomic factors associated with antidiabetic medication adherence in individuals with type 2 diabetes. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:122. [PMID: 37936205 PMCID: PMC10631092 DOI: 10.1186/s41043-023-00459-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/21/2023] [Indexed: 11/09/2023]
Abstract
BACKGROUND Antidiabetic medication adherence is a key aspect for successful control of type 2 diabetes mellitus (T2DM). This systematic review aims to provide an overview of the associations between socioeconomic factors and antidiabetic medication adherence in individuals with T2DM. METHODS A study protocol was established using the PRISMA checklist. A primary literature search was conducted during March 2022, searching PubMed, Embase, Web of Science, as well as WorldCat and the Bielefeld Academic Search Engine. Studies were included if published between 1990 and 2022 and included individuals with T2DM. During primary screening, one reviewer screened titles and abstracts for eligibility, while in the secondary screening, two reviewers worked independently to extract the relevant data from the full-text articles. RESULTS A total of 15,128 studies were found in the primary search, and 102 were finally included in the review. Most studies found were cross-sectional (72) and many investigated multiple socioeconomic factors. Four subcategories of socioeconomic factors were identified: economic (70), social (74), ethnical/racial (19) and geographical (18). The majority of studies found an association with antidiabetic medication adherence for two specific factors, namely individuals' insurance status (10) and ethnicity or race (18). Other important factors were income and education. CONCLUSIONS A large heterogeneity between studies was observed, with many studies relying on subjective data from interviewed individuals with a potential for recall bias. Several socioeconomic groups influencing medication adherence were identified, suggesting potential areas of intervention for the improvement of diabetes treatment adherence and individuals' long-term well-being.
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Affiliation(s)
- Christian Ming Studer
- Department of Chemistry and Applied Biosciences, Institute for Pharmaceutical Sciences, ETH Zurich, Zurich, Switzerland
| | - Marie Linder
- Centre for Pharmacoepidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Laura Pazzagli
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
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Paudel G, Vandelanotte C, Dahal PK, Biswas T, Yadav UN, Sugishita T, Rawal L. Self-care behaviours among people with type 2 diabetes mellitus in South Asia: A systematic review and meta-analysis. J Glob Health 2022; 12:04056. [PMID: 35916498 PMCID: PMC9346342 DOI: 10.7189/jogh.12.04056] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background The burden of Type 2 Diabetes Mellitus (T2DM) in South Asian countries is increasing rapidly. Self-care behaviour plays a vital role in managing T2DM and preventing complications. Research on self-care behaviours among people with T2DM has been widely conducted in South Asian countries, but there are no systematic reviews that assess self-care behaviour among people with T2DM in South Asia. This study systematically assessed the studies reporting self-care behaviours among people with T2DM in South-Asia. Methods Adhering to the PRISMA guidelines, we searched six bibliographic databases (Scopus, PubMed, CINAHL, Embase, Web of Science, and PsychInfo) to identify the relevant articles published between January 2000 through March 2022. Eligibility criteria included all observational and cross-sectional studies reporting on the prevalence of self-care behaviours (ie, diet, physical activity, medication adherence, blood glucose monitoring, and foot care) conducted in South Asian countries among people with T2DM. Results The database search returned 1567 articles. After deduplication (n = 758) and review of full-text articles (n = 192), 92 studies met inclusion criteria and were included. Forward and backward reference checks were performed on included studies, which resulted in an additional 18 articles. The pooled prevalence of adherence to blood glucose monitoring was 65% (95% CI = 49-80); 64% for medication adherence (95% CI = 53-74); 53% for physical activity (95% CI = 39-66); 48% for diet (95% CI = 38-58); 42% for foot care (95% CI = 30-54). About a quarter of people with T2DM consumed alcohol (25.2%, IQR = 13.8%-38.1%) and were using tobacco products (18.6%, IQR = 10.6%-23.8%). Conclusions Our findings suggest that the prevalence of self-care behaviours among people with T2DM in South Asia is low. This shows an urgent need to thoroughly investigate the barriers to the practising of self-care and design and implement interventions to improve diabetes self-care behaviour among people with T2DM in South Asia.
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Affiliation(s)
- Grish Paudel
- School of Health, Medical and Applied Sciences, Central Queensland University, Sydney, Australia
| | - Corneel Vandelanotte
- Appleton Institute, Physical Activity Research Group, Central Queensland University, Rockhampton, Australia
| | - Padam K Dahal
- School of Health, Medical and Applied Sciences, Central Queensland University, Sydney, Australia
| | - Tuhin Biswas
- The Australian Research Council Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Brisbane, Queensland, Australia
| | - Uday N Yadav
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia.,Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
| | - Tomohiko Sugishita
- Section of Global Health, Division of Public Health, Department of Public Health, Tokyo Women's Medical University, Tokyo, Japan
| | - Lal Rawal
- School of Health, Medical and Applied Sciences, Central Queensland University, Sydney, Australia.,Appleton Institute, Physical Activity Research Group, Central Queensland University, Rockhampton, Australia.,Translational Health Research Institute (THRI), Western Sydney University, Sydney Australia
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