Adherence In Diabetic Patients Research Articles

Knowledge, Attitude, and Practice of Adult Diabetics Regarding Diabetic Foot Ulcers: A Cross-Sectional Study in Saudi Arabia.

Background Diabetic foot ulcers (DFUs) are one of the most common and fatal complications of diabetic patients with uncontrolled diabetes mellitus (DM) that may end with their feet amputation. These complications can be prevented through the adherence of diabetic patients to their diabetes management plan and by educating them about risk factors, complications of diabetic foot, and proper foot care. To develop effective health education programs to educate diabetic patients and caregivers regarding diabetic foot and its effective care, we should first identify gaps in patients' knowledge and perception of diabetic foot and evaluate their practice of foot care. Objectives This study aimed to evaluate knowledge and attitude toward DFUs and the practice of foot care among adult diabetic patients attending Al-Qunfudah Diabetes Center, Saudi Arabia, from October 2022 to March 2023. Methods A total of 403 adult diabetic patients were recruited in this cross-sectional study during their attendance at the diabetes center in Al-Qunfudah district, Saudi Arabia. The study researchers conducted a physical face-to-face interview with each diabetic patient using a validated questionnaire with closed-ended questions to collect their responses regarding their knowledge and attitude toward DFUs and their behavior toward foot care. The collected data were analyzed using IBM SPSS Statistics for Windows, version 23 (released 2015; IBM Corp., Armonk, New York, United States). Results Out of 403 diabetics, 50.4% (n = 203) had inadequate knowledge (knowledge score < 80%), 46.4% (n = 187) had negative attitudes (attitude score < 80%) toward DFUs, and the majority could not practice foot care well, with 77.7% (n = 313) giving a practice score less than 80%. Seventy patients (17.4%) self-reported a history of DFUs. Predictors of good knowledge about DFUs among diabetics include age between 30 and 59 years (odds ratio (OR) = 2.942, confidence interval (CI) 95% = 1.695-2.107, p < 0.001), marriage (OR = 3.101, CI 95% = 1.893-5.079, p < 0.001), working (OR = 5.325, CI 95% = 3.019-9.389, p < 0.001), diploma education (OR = 8.205, CI 95% = 3.332-20.203, p < 0.001), managing DM with oral drugs (OR = 2.219, CI 95% = 1.399-3.519, p < 0.001), and having no DFUs (OR = 2.712, CI 95% = 1.557-4.723, p < 0.001). Males were more likely to practice foot care well (OR = 1.925, CI 95% = 1.142-3.245, p = 0.013). Primary education (OR = 3.421, CI 95% = 1.655-7.073, p < 0.001) predicted appropriate foot care. Patients with DM for one to five years (OR = 1.995, CI 95% = 1.139-3.493, p = 0.016) and those on diet and metformin (OR = 2.133, CI 95% = 1.134-4.011, p = 0.019) were expected to have better foot care than other diabetics. Conclusion Diabetic patients in the Al-Qunfudah district of Saudi Arabia had inadequate knowledge and negative attitudes toward DFUs, and their foot care behaviors were inadequate. Furthermore, DFUs were self-reported in around 17% of diabetic patients. Specialized training programs are recommended to enhance knowledge regarding DFUs among diabetics and motivate and train them and caregivers on how to conduct proper foot care. These educational programs should target all diabetics, with an emphasis on those with DFUs, females, non-working patients, individuals who have had DM for a longer time, and illiterate diabetics. To understand the factors behind patients' negative attitudes toward diabetic foot, future qualitative research is required.

The mediating effect of self-efficacy on the relationship between social support and medication adherence in adults with type 2 diabetes.

To evaluate the status of medication adherence in diabetic patients and its effective factors. A cross-sectional descriptive study was conducted with 170 diabetic patients in Iran. Participants were assessed for medication adherence, self-efficacy, and social support. Descriptive statistics, bivariate analyses, and multiple stepwise regression were conducted to explore predictors for medication adherence. Regression analysis showed that 48% of medication adherence changes stemmed from the four variables including social support, self-efficacy, income, and education levels, (R2adj = 0.480, F = 39.943, p < 0.001). According to the model, the highest effects were related to income level (β = 0.332, t = 5.493, p ⩽ 0.001) and self-efficacy (β = 0.330, t = 4.789, p ⩽ 0.001), respectively. Based on the final model, only the social support variable showed no significant relationship with adherence (β = 0.002, t = 0.032, p = 0.947). Social support and self-efficacy were related to medication adherence in diabetic patients, and social support can improve medication adherence in patients with diabetes by affecting self-efficacy. Healthcare workers who interact with individuals with diabetes should take into account the factors mentioned above when designing health promotion interventions to address the needs of these individuals.

Adherence of Diabetic Patients to Healthy Lifestyle and Medication and Its Impact on Glycemic Control, Complications of Diabetes and Quality of Life: A Hospital Based Cross-Section Study in Benha City, Egypt

Adherence of Diabetic Patients to Healthy Lifestyle and Medication and Its Impact on Glycemic Control, Complications of Diabetes and Quality of Life: A Hospital Based Cross-Section Study in Benha City, Egypt

Is integrating video into tech-based patient education effective for improving medication adherence? – A review

Abstract Patient education is a crucial part of the efforts to improve the level of medication adherence. Successful diabetes self-management will be achieved if health practitioners (doctors, pharmacists, nurses, and other health-related professionals) provide education to their patients. One of the multimedia platforms that are now popular in patient education and health promotion is video. This study primarily aimed to review published research examining integration of video-based digital interventions into tech-based patient education methods to promote medication adherence in diabetic patients. All of the articles presented in this review were collected from the PubMed, Science Direct, and Sage Publication databases. This review compared study samples, intervention characteristics (length of intervention and learning media), and adherence outcomes, as well as additional outcomes across the studies. Of the 304 articles reviewed, seven studies that met the criteria were found and included in the review. Overall, 57.14% of the integrated video-based interventions demonstrated improved medication adherence and 42.86% demonstrated improvement in other related health outcomes. The interventions were 7 weeks to 6 months in length and were in the form of storytelling with videos, smartphone apps, educational programs, or web-based education. It can be concluded that video-based digital interventions aimed to improve medication adherence in diabetic patients are promising. For optimum outcomes, this study highly suggests that a combination of video (synchronous and asynchronous) and a good patient education program is an ideal form of intervention for patients with type 2 diabetes. Regarding the education platform, the intervention could be humanoid robots, storytelling, mobile health (mHealth) apps, websites, robot-enhanced diabetes care, and other related tech-based programs or even conventional models.

The Effect of Insulin Administration on Medication Adherence in Type 2 Diabetes Mellitus Patients with Neurological Complications

Background: Medication adherence is essential to achieving controlled blood sugar in diabetic patients. Insulin generally provides better glycemic control but is considered painful and requires special techniques. Insulin administration in patients with neurological complications requires particular consideration because these complications can cause physical and cognitive barriers. Objective: This study analyses the effect of insulin administration on medication adherence in diabetic patients with neurological complications and the influence of various confounding variables (baseline characteristics, medical and medication history). Methods: This observational study was conducted with a cross-sectional design at a government hospital in East Jakarta from September 2021 to January 2022. The sample was type 2 diabetes mellitus patients with neurological complications who received antidiabetics for at least six months. The neurological complications include central nervous disorders (such as stroke) and peripheral nervous disorders (such as neuropathy). The independent variable was insulin administration, while the dependent variable was adherence, measured using subjective methods [Adherence to Refills and Medications Scale (ARMS)] and objective methods (Medication Refill Adherence (MRA) and HbA1c]. Results: Of 175 respondents, based on the three methods (MRA, ARMS, HbA1c), 13 respondents (7.4%) were adherent, namely one respondent (1.8%) in the insulin group and 12 respondents (10.1%) in the non-insulin group. Insulin administration affects adherence to antidiabetics by 0.123 times (95% CI: 0.015 - 1.024), or patients who use insulin have 87.7% lower adherence controlled by antidiabetic changes and the total number of medicines used. Conclusion: Insulin administration significantly affects medication adherence in diabetes mellitus patients with neurological complications.

Evaluate the Compliance of Diabetes Patients in Taking Medication Diabetes Mellitus in Puskesmas Between Makassar City

Diabetes mellitus is a disease in which the sufferer's body cannot automatically control the level of sugar (glucose) in the blood. In a healthy body, the pancreas releases the hormone insulin, which is responsible for transporting sugar through the blood to the muscles and other tissues to supply energy. Glucose normally circulates in a certain amount in the blood. Glucose is formed in the liver (hepar) from the food consumed. The purpose of this study was to determine the level of adherence of diabetic patients in taking DM medication at the Antara Public Health Center in Makassar City. The method used in this research is descriptive, namely research that includes surveys with data collection techniques in the form of questionnaires. This research was conducted at the Antara Public Health Center, Makassar City. This research was conducted in June 2021 by distributing questionnaires to 58 respondents or the public according to the criteria. The results of this study indicate that the evaluation of diabetes patient compliance in taking diabetes mellitus medication at the Makassar City Public Health Center obtained a percentage of adherence, namely 80.09%, so that it is included in the high compliance level category.

DIABETIC PATIENTS’ COMPLIANCE WITH TREATMENT DURING COVID-19 PANDEMIC PERIOD

Objective: Diabetes mellitus is a chronic, complex disease with many components that must be managed. Treatment success depends on excellent treatment compliance. In this study, we aimed to evaluate the treatment adherence of diabetic patients during the COVID-19 (Coronavirus Disease) pandemic and the factors affecting this condition. Material and Methods: The study was carried out on 474 diabetic patients with a questionnaire consisting of questions based on The Medication Compliance Questionnaire (MCQ) and the World Health Organization (WHO) 2003 compliance guideline. Results: The rate of non-compliance with the treatment based on the MCQ scale was 82.3%. Non-compliance with treatment was significantly associated with oral antidiabetic (OAD) drug use, smoking status, glycosylated hemoglobin (HbA1c) &lt;7%, and patient comments of “I don’t have regular doctor follow-up,” “I can’t communicate well with my doctor,” “My blood glucose is not at the target value,” and “My medications are not comfortable enough for use”(p=0.011; 0.010; 0.014; 0.011; 0.002; 0.019; 0.001). Patients under insulin treatment or with an HbA1c value of ≥7% were found to be more compliant with the treatment. Conclusion: Unlike the classical results, the incompatibility of diabetic patients with HbA1c &lt;7% and under OADs with the treatment was emphasized. Patients using insulin and with advanced duration of diabetes were more compliant with the treatment in the stressful period of the COVID-19 pandemic. Lack of follow-up by the doctor and low patient effort to communicate with the doctor have been decisive factors in the non-compliance.

Factors Associated With Adherence to Treatment Regimen in Patients With Type 2 Diabetes in Sari, Iran

Background &amp; Aims: As a chronic disease with many complications, diabetes requires adherence to treatment regimen. Despite the importance of adherence, it is not done completely in these patients. Non-adherence to treatment has many personal and social consequences. Adherence in diabetic patients can lead to mortality reduction and success in the treatment of diabetes. Considering that adherence to the treatment regimen is challenging among diabetic patients and less attention has been paid to it in Iran, the present study aims to identify the factors related to adherence to treatment regimen among diabetic patients in Sari, Iran. Materials &amp; Methods: This descriptive cross-sectional study was conducted in 2021 on 226 adults with Type 2 diabetes referred to Baghban clinic affiliated to Mazandaran University of Medical Sciences in Sari, Iran who were selected using a continuous sampling method. Data were collected using a demographic form and the diabetes activities questionnaire. Questionnaires were prepared online using Google Forms. Data analysis was performed in SPSS software, version 26. Results: The mean age of participants was 53.06±10.81 years. Most of them were female (61.9%) and married (85.8%) with a high school diploma (26.5%) and moderate economic status (69%). Economic status, age, and BMI had a significant relationship with adherence to treatment regimen (P&lt;0.05); Economic status and age had a positive significant relationship while BMI had a negative significant relationship with adherence to treatment regimen. Diabetic patients with better economic status, higher age, and lower BMI had better adherence. Conclusion: This study provides a basis for expanding knowledge of adherence to treatment regimens in diabetic patients in Iran. It is necessary for healthcare providers, especially nurses, to pay attention to the factors related to adherence to treatment in diabetic patients in providing care and education to them to have better treatment.

Assessment of Diabetic Patients' Adherence to Diabetic Retinopathy Screening and the Influencing Factors in Al-Ahsa, Saudi Arabia

BackgroundDiabetic retinopathy (DR) is one of the diabetic complications that leads to the loss of vision. Most diabetic patients will have DR that is varying in its severity under the effect of many factors such as type of diabetes, duration of diabetes, and poor glycemic control. This study aimed to assess the level of adherence of diabetic patients to diabetic retinopathy screening (DRS) and to identify the influencing factors of adherence among diabetic patients in Al Ahsa, Saudi Arabia.MethodsA cross-sectional study was conducted via a self-administered questionnaire among diabetic patients who were attending the primary health-care centers in Al Ahsa, Saudi Arabia, from July to August 2021. This questionnaire included five sections: sociodemographic data, diabetic profile, assessment of the knowledge, attitude toward DRS, and barriers to DRS.ResultsA total of 397 diabetic patients were involved in the study. Diabetic ocular complications were reported among 35.3% of the patients. The most commonly reported diabetic eye complication was cataract (37.1%; 52) followed by retinopathy (36.4%). Among the participants, 32.2% had a good awareness level regarding DR. In addition, 46.9% of diabetic patients have DRS. The most reported barriers were having no visual or eye problems, difficulty getting an appointment, and the cost and lack of information about the screening procedure (50.9%, 50.1%, 42.1%, and 39.8%, respectively). ConclusionImprovement of patients’ knowledge is a significant step to enhancing adherence to DRS. The availability of screening programs and well-established ophthalmology clinics in primary healthcare centers in addition to trained physicians will help to overcome the barriers of DRS.

HPR47 Impact of Zero-Dollar Copayment and Premium Changes on Medication Adherence in Diabetic Patients in an Employee Health Group

Value-based insurance design (VBID) lowers out-of-pocket costs for drugs known to improve medical outcomes. Previous studies have evaluated VBID programs that only reduced copays for select medications. The objective of this study was to assess the impact of a zero-dollar copayment policy and lower premiums on adherence in an employee group.

The Effect of Education with an Automatic SMS Reminder System on Type 2 Diabetes Patients’ Medication Adherence

Background: Diabetes is one of the most common metabolic diseases leading to debilitating complications. One of the most important causes of complications in diabetic patients is non-adherence to the medication regimen due to forgetfulness and negligence. Objectives: This study aimed to investigate the effect of education with an automatic SMS reminder system on type 2 diabetes patients’ medication adherence. Methods: This quasi-experimental study was performed on 120 patients with type 2 diabetes referring to the Diabetes Clinic in Zahedan in 2021. The participants were randomly assigned to the control and intervention groups. The participants in the intervention group were reminded to take their medications using the automatic SMS service. The data were collected using a demographic information questionnaire and the Morisky Medication Adherence Scale (MMAS). The MMAS items were completed by the participants in both groups before the intervention and one month after the intervention. The collected data were analyzed using SPSS-26 software at a significance level of 0.05. Results: The results indicated that the mean scores of medication adherence in the two intervention and control groups before training with the automatic SMS reminder system were not significantly different (P = 0.052). However, after the intervention, the mean score of medication adherence for the patients in the intervention group was significantly higher than that of the patients in the control group (P = 0.001). Conclusions: Drug reminders using the automated SMS reminder system can improve medication adherence in diabetic patients.

Disruptive factors of treatment adherence of diabetic patients in downtown Sfax from Tunisia – a community pharmacy-based survey

Disruptive factors of treatment adherence of diabetic patients in downtown Sfax from Tunisia – a community pharmacy-based survey

The relationship between illness perception and medication adherence in patients with diabetes mellitus type II: illness perception and medication adherence

SummaryIntroductionOne of the most well-known chronic diseases in the world is diabetes. Disease perception is the patient’s organized cognitive representation of his or her illness and can affect treatment adherence. The aim of this study was to investigate the relationship between illness perception and adherence to the medical regimen in patients with type II diabetes mellitus (T2DM).MethodsThis cross-sectional study was performed among 260 patients with type II diabetes referred to Gonabad Diabetes Clinic by systematic random sampling in 2019. Data collection tools were demographic questionnaire, Morisky medication Adherence Scale (MMAS-8), and Brief illness Perception Questionnaire (BIPQ). Data were analyzed by SPSS 20 software. And using descriptive statistics, Pearson correlation coefficient. P < 0.05 was considered significant.ResultsThe results showed that the mean score of illness perception of type II diabetes was 46.39 ± 9.45 (range 0-70) and the mean score of medication Adherence was 2.93 ± 1.9 (range 0-8). The results of Pearson correlation test showed a significant relationship between illness perception and medication Adherence (P < 0.001, r = 0.199). Also, the regression model showed that the dimensions of disease comprehension and personal control from illness perception were significantly related to medication Adherence of type II diabetic patients (P < 0.001).ConclusionBased on the results of this study on the relationship between illness perception and medical adherence in diabetic patients, it is suggested that in order to understand the increase in adherence to therapy, the perception of the disease should be increased through education to patients. Patients’ illness beliefs are candidates for a psycho-educational intervention that should be targeted at improved disease management practices and better adherence to recommended healthy behaviors.

Low Socio-Economic Level: A Major Obstacle to Therapeutic Observation (Survey of 125 Diabetic Patients)

Introduction: Diabetic patients adhering to their treatment are less likely to face complication from their disease. For this reason, we studied the compliance of diabetics with their treatment. Materials and Method: This was a comprehensive cross-sectional study of adherence in diabetic patients. All patients meeting the inclusion criteria were enrolled in the study. This study took place at a private pharmacy called “pharmacy Elhadj Seydou Nourou Tall” located in the city of Pikine during the period from April 1 to September 30, 2019. Results: In total, the study population was composed of 125 diabetics; frequency of 8.47%. The average age was 62.5 years and there were more women (58.4%). Of the patients, 87% had a low socioeconomic level and 72% a low educational level. Only 65.6% of the patients knew their diabetes type. Even though 97.6% of the patients were confident in the treatment but due to financial reasons 20.8% did not adhere to the prescribed treatment and 16.8% to their diets. Moreover, 15.2% of the patients had changed the dosage of the prescribed medication, 44.4% had forgotten to take their medication regularly. 78.4% of them thought they were taking too much medication. No factors were found to be statistically associated with poor adherence, but the proportion of poor adherence patients was higher in patients over 60 years of age, with low socio-economic status and low education. Conclusion: Low socio-economic status is the main barrier to good adherence. Recommendations have been formulated to improve this adherence.

Adherence of diabetic patients to treatment in Al Ahsa during COVID-19 pandemic

Adherence of diabetic patients to treatment in Al Ahsa during COVID-19 pandemic

A SYSTEMATIC REVIEW ON SELF-REPORTED QUESTIONNAIRES TO ASSESS MEDICATION ADHERENCE IN DIABETIC PATIENTS

Adherence to pharmacological therapies are keys to effective treatments in diabetic patients. Previous reviews found that most adherence measurement studies on chronic diseases used a self-reported scale. However, there is no consensus on the best scale to measure adherence in diabetic patients. The purpose of this systematic review was to identify the potential self-reported scale that could be considered for measuring medication adherence in diabetic patients and to provide recommendations for researchers or clinicians to determine appropriate adherence self-reported scales in diabetic patients. This review follows general guidelines in the implementation of systematic reviews. After further review, it was found that 33 studies met all inclusion criteria from 4 databases (Wiley, Science Direct, Scopus, and PubMed). The articles were done by the PRISMA, while the keywords were determined by the PICO method. Most research was conducted in Asia (69.7%) and America (18.2%) on patients with type 2 diabetes (81.3%), patients in hospitals (54.5%), suffering for 1–6 months (54.5%), and using a cross-sectional study design (78.8%). HbA1c clinic data (57.6%) were used in most studies as biological markers of adherence. The measurement scales of medication adherence in diabetic patients are MMAS-8 (57,.5%), MMAS-4 (12.1%), BMQ (9%), MCQ (6%), ARMS (3%), ARMS-D (3%), GMAS (3%), LMAS-14 (3%), and MARS-5 (3%). This review provides information on the different self-reported scales most widely used in diabetic medication adherence research. Various aspects need to be considered before choosing the scale of adherence.

The Relationship Between Underlying Factors and Treatment Adherence in Women With Gestational Diabetes

Background and Aim: The adherence of diabetic patients to the recommended treatment regimens is among the major challenges in diabetes control. Dietary adherence is low in pregnant women with gestational diabetes. Non-compliance can reduce the beneficial effects of treatment, symptoms, and signs, increase complications, or even cause death. Therefore, further research on the determinants of follow-up behaviors is essential. Methods &amp; Materials: This was a descriptive-analytical study. In total, 260 women with gestational diabetes treated with diet referring to healthcare centers, and Imam Reza (AS), Ghaem, and Umm Al-Banin Hospitals in Mashhad City, Iran participated in this research. The study subjects were selected using convenience, multistage, class, and cluster sampling methods. The required data were collected using a demographic and pregnancy profile questionnaire and a researcher-made questionnaire of adherence to the treatment regimen. The obtained data were analyzed by inferential statists and regression tests in SPSS v. 16. Ethical Considerations: This study was registered with ethics code of IR.MUMS.NURSE.REC.1397.091 in the ethics committee of Mashhad University of Medical Sciences. Results: The regression analysis results indicated that dietary adherence, blood glucose monitoring, and exercise adherence scores presented a significant and positive effect on the total treatment adherence score (P&lt;0.001). Furthermore, education (P=0.044), unwanted (P=0.006), or unplanned pregnancy (P=0.21) provided a positive and significant effect on the overall score of treatment adherence. Women with a history of diabetes in first-degree relatives (P=0.010) and those with a history of miscarriage (P=0.021) obtained higher scores of total treatment adherence. Conclusion: According to the present study findings, some demographic and pregnancy characteristics can affect the rate of adherence to the treatment regimen in women with gestational diabetes. Healthcare providers need to pay attention to the impact of these factors in improving adherence to patients’ treatment regimens.

The psychosocial barriers to medication adherence of patients with type 2 diabetes: a qualitative study

BackgroundThe adherence of diabetic patients to their medication regimen is associated with many psychosocial factors that are still unknown. Therefore, the present study aims to identify the psychosocial barriers to medication adherence of patients with type2 diabetes (T2D).MethodologyThis descriptive qualitative study was done in Isfahan, Iran by conducting in-depth unstructured interviews with 23 purposively selected patients with T2D and 10 healthcare providers (HCPs). The participants were interviewed face-to-face between November 2017 and June 2018 at the patient’s home, a Health Care Center, or at the diabetes clinic. Data analysis was performed using MAXQDA-10 software and the conventional content analysis.ResultsThe analysis of the data led to six categories of perceived psychosocial barriers: 1) fear, concern and distress, 2) exhaustion and burnout, 3) the children’s issues being the priority, 4) poor financial support, 5) communication challenges, and 6) poor work conditions.ConclusionsThis study identified some of the psychosocial barriers to medication adherence of patients with T2D, which will be of great help to researchers and HCPs in designing and implementing effective interventions to overcome these barriers and change patient self-care behaviors and increase their medication adherence.

Impact of Community Pharmacy Diabetes Care Program on Knowledge and Glycemic Control: An Unexplored Opportunity for Community Pharmacists in Pakistan

Background: Effective management of diabetes mellitus depends on efficacy of therapy as well as patient adherence to medication therapy and non-pharmacological approaches. One of the most important tools to improve patient adherence is counseling. Community pharmacists can effectively contribute to patient care as they have the expertise and accessibility to do the task appropriately. Objective: The objective of the study was to evaluate the impact of pharmacist counseling on glucose control and medication adherence of diabetic patients attending community pharmacies in Pakistan. Method: A randomized, controlled, single blinded, pre-post intervention study design was used. The respondents included patients diagnosed with both diabetes mellitus (Type I or II) visiting community pharmacies for purchasing their regular medicine. Simple random sampling technique by lottery method was used to select community pharmacies to be included in-group A (intervention n=4) and group B (control n=4). The total number of patients were 40 in each group while estimating a drop-out rate of 25%. Convenience sampling technique was used to select patients visiting community pharmacies. Patients in the intervention group received special counseling. Blood glucose was checked after every 15 days for a period of six months. Pre-validated tools such as diabetes knowledge questionnaire 24 and brief medication questionnaire were used. Data was cleaned, coded and analyzed in SPSS 21. Wilcoxon test (p≥0.05) was used to compare pre-post intervention knowledge regarding diabetes and. Mann-Whitney test (p≥0.05) was used to find differences among medication adherence among control and intervention groups as well as pre and post intervention. Results: The results of the present study showed that respondents having diabetes since the past 1-3 years had comparatively better knowledge scores (18.8, 3±2.04) after intervention. Mean knowledge scores regarding diabetes mellitus among intervention group at baseline was (16.02, ±2.93) which was improved after six months (19.97, ±2.66). Significant difference was observed (p≤0.05) in pre-post intervention knowledge regarding diabetes management. Knowledge of patients was improved regarding different aspects of diabetes management after counseling by community pharmacists. The fasting blood glucose improved at three months (9.32, ±1.92) and after six months (8.95, ±1.45) in intervention group. Conclusion: The results of the current study concluded that counseling by community pharmacist has a positive impact on blood glucose management among diabetic and patients. Educational programs should be initiated by community pharmacists as this can lead to improvement in glycemic control and enhance the image of pharmacist as a key health care member in management of chronic diseases.

Comparison of the Effectiveness of Compassion-Focused Therapy and Attachment-Based Compassion Therapy on Blood Glucose Level and Medication Adherence in Diabetics

Background and Objectives: Diabetes is one of the most rampant chronic diseases that is accompanied by numerous psychological problems. The present study aimed to compare the effectiveness of compassion-focused therapy (CFT) and attachment-based compassion therapy (ABCT) on blood glucose level and medication adherence in diabetic patients. Materials and Methods: This quasi-experimental study was conducted based on a pretest and posttest design. At first, using the available voluntary sampling method, a number of 45 individuals were selected from 300 diabetic patients referred to Alborz Diabetes Association, Alborz, Iran. They were randomly divided into two experimental and one control groups. At the outset, in addition to the hemoglobin (Hb) A1c blood test, they completed a medication adherence questionnaire. Afterward, the first experimental group participated in eight two-h sessions of the compassionate therapy training course, and the second experimental group participated in 10 90-min sessions of the ABCT training course. All three groups received standard treatment for diabetic patients. At the end of the treatment, the HbA1c levels of blood in all three groups were re-evaluated, and again all patients completed the medication adherence questionnaire at the post-test stage. It should be mentioned that the collected data were analyzed using the analysis of covariance. Results: Based on the results, CFT and ABCT could reduce blood glucose level (HbA1c) (F=5.13, P&lt;0.008, Eta= 0.20) and increase medication adherence (F=2.82, P&lt;0.035, Eta= 0.12) in both of the experimental groups. Conclusion: The CFT and ABCT can be effective in improving medication adherence and blood glucose control (HbA1c) in diabetic patients. Therefore, it is suggested to provide such training together with other medical interventions as part of comprehensive therapy of diabetes.