Saudi Pharmaceutical Journal (2014) xxx, xxx–xxx
King Saud University
Saudi Pharmaceutical Journal www.ksu.edu.sa www.sciencedirect.com
ORIGINAL ARTICLE
Evaluation of T2DM related knowledge and practices of Omani patients Zeyana S. Al Bimani, Shah Alam Khan *, Pratap David Department of Pharmacy, Oman Medical College, Muscat, Oman Received 13 October 2013; accepted 14 December 2013
KEYWORDS Diabetes mellitus; KP; Oman
Abstract Background: The prevalence of diabetes mellitus (DM) has increased alarmingly mainly due to the life style changes and obesity factor. Approximately 10% of the Omani population is suffering from this chronic disease and according to World Health Organization, number of subjects living with diabetes in Oman will rise from 75,000 in 2000 to 217,000 in 2025. It has been well established that data on KP of diabetic patients reveal aspects of education that need to be reinforced and addressed in order to improve diabetes management. Objective: The aim of this cross sectional study was to assess the diabetes mellitus type 2 related knowledge and practices (KP) of Omani adult patients. Materials and methods: Diabetic patients were recruited using the convenient sampling method from Outpatient diabetes clinic of various primary health care centers and private hospitals in Muscat region of Sultanate of Oman. KP of patients who agreed to participate in the study were assessed by administering a self designed questionnaire containing 15 close ended or multiple choice type questions in face-to face interviews. The collected data were analyzed by SPSS software. Results and discussion: 106 patients with T2DM participated in this study (42 men and 64 women). Majority of them were; married (83%), above 50 years (64.2%), on oral hypoglycemic (56.6%), having family history of diabetes (66%). The mean ± SD knowledge score of participants was found to be 4.92 ± 1.22 out of maximum possible score of 8. Conclusion: Omani patients seemed aware and displayed satisfactory diabetes knowledge and good practices except adherence to regular exercise. We recommend to design and develop diabetes educational programs that could help Omani patients in diabetes management and improvement of quality of life. ª 2013 Saudi Pharmaceutical Journal. Production and hosting by Elsevier B.V. All rights reserved.
* Corresponding author. Tel.: +968 24504608 (165). E-mail address: [email protected] (S.A. Khan). Peer review under responsibility of King Saud University.
Production and hosting by Elsevier
1. Introduction Diabetes mellitus, a chronic metabolic disorder requires a significant amount of money for its management and thus puts considerable burden on healthcare services (Zimmet et al., 2001). Its prevalence is increasing worldwide at an alarming rate especially in low and middle income nations. The total
1319-0164 ª 2013 Saudi Pharmaceutical Journal. Production and hosting by Elsevier B.V. All rights reserved. http://dx.doi.org/10.1016/j.jsps.2013.12.006
Please cite this article in press as: Al Bimani, Z.S. et al., Evaluation of T2DM related knowledge and practices of Omani patients. Saudi Pharmaceutical Journal (2014), http://dx.doi.org/10.1016/j.jsps.2013.12.006
2 number of diabetics is projected to rise from 285 million in 2010 to 438 million in 2030, while in developing countries the prevalence is projected to double between 2000 and 2030 (Shaw et al., 2010). Sultanate of Oman is located in the Southeastern portion of the Arabian Peninsula. It has undergone tremendous socioeconomic development over the past four decades but alongside diabetes has emerged as one of the most prevalent and growing health problems in the Sultanate of Oman that may be due to life style changes and obesity factor (Ministry of Health, 2003). Approximately 10% of the Omani population is currently living with diabetes and as per WHO estimates, number of diabetics in Oman will rise from 75,000 in 2000 to 217,000 in 2025 (Dunia et al., 2013). Patients of type 2 diabetes mellitus (T2DM) are at higher risk of developing cardiovascular and other secondary complications if the disease is not well controlled (Mooradian, 2003). Generally these patients experience a high incidence of morbidity and mortality as compared to non diabetics. Many studies conducted elsewhere in the world have shown that the knowledge and awareness about the disease can have positive influence on attitude and practices of patients that could lead to better management of diabetes and eventually good quality of life. A patient when involved in self management of disease through guidance, education and awareness programs becomes more compliant toward life style changes and drug therapy which help both the practitioner and patient to achieve the treatment goals. However, a knowledge, attitude and practice gap exists in type 2 diabetes mellitus management that does not allow patients and healthcare professionals to implement life style changes that could reduce the morbidity and mortality associated with diabetes (Serrano and Jacob, 2010). A study conducted by Badrudin et al. in 2002, highlighted the importance of proper education and awareness program in changing the attitude of the public toward diabetes (Badrudin et al., 2002). McMurray et al. have clearly showed that diabetes education and care management can significantly improve the patient outcomes, glycemic control and quality of life in diabetic patients (McMurray et al., 2002). Kheir et al. in 2011 evaluated the knowledge, attitude, practice (KAP) and psychological status of adult Qatari patients with type 2 diabetes mellitus to study the role of these factors on the ability of the patients to manage their diabetes and to achieve desirable health outcomes (Kheir et al., 2011). They found significant differences in the attitude and knowledge between educational levels and therefore, concluded that providing education and other support programs to diabetics could be more effective if the KAP of the patients are understood before conducting these programs. This study was conducted to assess the knowledge and practices of selected adult Omani patients with T2DM in Muscat region. The findings of this study could help in identifying population knowledge gap and their behavior toward diabetes which might help in designing effective educational program for prevention and progression of this dreaded disease in the country. 2. Methodology This cross sectional study was conducted during Oct 2011– June 2012 at the Outpatient diabetes clinic of various primary
Z.S. Al Bimani et al. health centers and private hospitals in Muscat region of Sultanate of Oman to evaluate the knowledge and general practices of Omani patients diagnosed with T2DM. 2.1. Study sample Eligibility for enrollment into the study was considered if the patient was an adult (30 years old or above), Omani national, diagnosed with T2DM at least two years before and willing to participate in the study. All the participants were ensured confidentiality. The objective and protocol of the study were explained to all participants and a verbal consent was obtained from 106 T2DM patients who agreed to participate in the study. 2.2. Data collection A questionnaire containing 15 closed ended or multiple choice type questions on KP of patients (8 and 7, questions respectively) was developed to investigate the level and relationship between knowledge and general practices of T2DM patients. One point was awarded for each correct answer. The designed questionnaire was administered to 5 patients in a pilot study for the validity of the suitability of content, clarity and flow of questions. Necessary corrections and modifications were made based on the results of the pilot study. The questionnaire was prepared in English but prior to use in the study, was translated from its original English version to Arabic and was administered in face-to-face interviews to collect the data. 2.3. Ethical consideration This study protocol and designed questionnaire were approved by the college research committee of Oman Medical College. Also all the enrolled patients were ensured confidentiality. 2.4. Statistical analysis The collected data were analyzed by using SPSS- ver. 20 software. One way Analysis of variance (ANOVA) was used for determining significant differences between groups. Pearson chi square test was done to evaluate and compare knowledge between educational levels and genders, age groups with variables such as use of herbal drugs, missed dose and diet control. P values
King Saud University
Saudi Pharmaceutical Journal www.ksu.edu.sa www.sciencedirect.com
ORIGINAL ARTICLE
Evaluation of T2DM related knowledge and practices of Omani patients Zeyana S. Al Bimani, Shah Alam Khan *, Pratap David Department of Pharmacy, Oman Medical College, Muscat, Oman Received 13 October 2013; accepted 14 December 2013
KEYWORDS Diabetes mellitus; KP; Oman
Abstract Background: The prevalence of diabetes mellitus (DM) has increased alarmingly mainly due to the life style changes and obesity factor. Approximately 10% of the Omani population is suffering from this chronic disease and according to World Health Organization, number of subjects living with diabetes in Oman will rise from 75,000 in 2000 to 217,000 in 2025. It has been well established that data on KP of diabetic patients reveal aspects of education that need to be reinforced and addressed in order to improve diabetes management. Objective: The aim of this cross sectional study was to assess the diabetes mellitus type 2 related knowledge and practices (KP) of Omani adult patients. Materials and methods: Diabetic patients were recruited using the convenient sampling method from Outpatient diabetes clinic of various primary health care centers and private hospitals in Muscat region of Sultanate of Oman. KP of patients who agreed to participate in the study were assessed by administering a self designed questionnaire containing 15 close ended or multiple choice type questions in face-to face interviews. The collected data were analyzed by SPSS software. Results and discussion: 106 patients with T2DM participated in this study (42 men and 64 women). Majority of them were; married (83%), above 50 years (64.2%), on oral hypoglycemic (56.6%), having family history of diabetes (66%). The mean ± SD knowledge score of participants was found to be 4.92 ± 1.22 out of maximum possible score of 8. Conclusion: Omani patients seemed aware and displayed satisfactory diabetes knowledge and good practices except adherence to regular exercise. We recommend to design and develop diabetes educational programs that could help Omani patients in diabetes management and improvement of quality of life. ª 2013 Saudi Pharmaceutical Journal. Production and hosting by Elsevier B.V. All rights reserved.
* Corresponding author. Tel.: +968 24504608 (165). E-mail address: [email protected] (S.A. Khan). Peer review under responsibility of King Saud University.
Production and hosting by Elsevier
1. Introduction Diabetes mellitus, a chronic metabolic disorder requires a significant amount of money for its management and thus puts considerable burden on healthcare services (Zimmet et al., 2001). Its prevalence is increasing worldwide at an alarming rate especially in low and middle income nations. The total
1319-0164 ª 2013 Saudi Pharmaceutical Journal. Production and hosting by Elsevier B.V. All rights reserved. http://dx.doi.org/10.1016/j.jsps.2013.12.006
Please cite this article in press as: Al Bimani, Z.S. et al., Evaluation of T2DM related knowledge and practices of Omani patients. Saudi Pharmaceutical Journal (2014), http://dx.doi.org/10.1016/j.jsps.2013.12.006
2 number of diabetics is projected to rise from 285 million in 2010 to 438 million in 2030, while in developing countries the prevalence is projected to double between 2000 and 2030 (Shaw et al., 2010). Sultanate of Oman is located in the Southeastern portion of the Arabian Peninsula. It has undergone tremendous socioeconomic development over the past four decades but alongside diabetes has emerged as one of the most prevalent and growing health problems in the Sultanate of Oman that may be due to life style changes and obesity factor (Ministry of Health, 2003). Approximately 10% of the Omani population is currently living with diabetes and as per WHO estimates, number of diabetics in Oman will rise from 75,000 in 2000 to 217,000 in 2025 (Dunia et al., 2013). Patients of type 2 diabetes mellitus (T2DM) are at higher risk of developing cardiovascular and other secondary complications if the disease is not well controlled (Mooradian, 2003). Generally these patients experience a high incidence of morbidity and mortality as compared to non diabetics. Many studies conducted elsewhere in the world have shown that the knowledge and awareness about the disease can have positive influence on attitude and practices of patients that could lead to better management of diabetes and eventually good quality of life. A patient when involved in self management of disease through guidance, education and awareness programs becomes more compliant toward life style changes and drug therapy which help both the practitioner and patient to achieve the treatment goals. However, a knowledge, attitude and practice gap exists in type 2 diabetes mellitus management that does not allow patients and healthcare professionals to implement life style changes that could reduce the morbidity and mortality associated with diabetes (Serrano and Jacob, 2010). A study conducted by Badrudin et al. in 2002, highlighted the importance of proper education and awareness program in changing the attitude of the public toward diabetes (Badrudin et al., 2002). McMurray et al. have clearly showed that diabetes education and care management can significantly improve the patient outcomes, glycemic control and quality of life in diabetic patients (McMurray et al., 2002). Kheir et al. in 2011 evaluated the knowledge, attitude, practice (KAP) and psychological status of adult Qatari patients with type 2 diabetes mellitus to study the role of these factors on the ability of the patients to manage their diabetes and to achieve desirable health outcomes (Kheir et al., 2011). They found significant differences in the attitude and knowledge between educational levels and therefore, concluded that providing education and other support programs to diabetics could be more effective if the KAP of the patients are understood before conducting these programs. This study was conducted to assess the knowledge and practices of selected adult Omani patients with T2DM in Muscat region. The findings of this study could help in identifying population knowledge gap and their behavior toward diabetes which might help in designing effective educational program for prevention and progression of this dreaded disease in the country. 2. Methodology This cross sectional study was conducted during Oct 2011– June 2012 at the Outpatient diabetes clinic of various primary
Z.S. Al Bimani et al. health centers and private hospitals in Muscat region of Sultanate of Oman to evaluate the knowledge and general practices of Omani patients diagnosed with T2DM. 2.1. Study sample Eligibility for enrollment into the study was considered if the patient was an adult (30 years old or above), Omani national, diagnosed with T2DM at least two years before and willing to participate in the study. All the participants were ensured confidentiality. The objective and protocol of the study were explained to all participants and a verbal consent was obtained from 106 T2DM patients who agreed to participate in the study. 2.2. Data collection A questionnaire containing 15 closed ended or multiple choice type questions on KP of patients (8 and 7, questions respectively) was developed to investigate the level and relationship between knowledge and general practices of T2DM patients. One point was awarded for each correct answer. The designed questionnaire was administered to 5 patients in a pilot study for the validity of the suitability of content, clarity and flow of questions. Necessary corrections and modifications were made based on the results of the pilot study. The questionnaire was prepared in English but prior to use in the study, was translated from its original English version to Arabic and was administered in face-to-face interviews to collect the data. 2.3. Ethical consideration This study protocol and designed questionnaire were approved by the college research committee of Oman Medical College. Also all the enrolled patients were ensured confidentiality. 2.4. Statistical analysis The collected data were analyzed by using SPSS- ver. 20 software. One way Analysis of variance (ANOVA) was used for determining significant differences between groups. Pearson chi square test was done to evaluate and compare knowledge between educational levels and genders, age groups with variables such as use of herbal drugs, missed dose and diet control. P values
