The impact of an educational intervention on medication adherence self-efficacy in patients with type 2 diabetes in hail, Saudi Arabia
Main Article Content
Keywords
Medication adherence, self-efficacy, Type 2 Diabetes, patient education
Abstract
Introduction: Medication adherence self-efficacy is vital for improving therapeutic outcomes in patients with Type 2 Diabetes Mellitus (T2DM). Limited data exist on medication adherence self-efficacy among T2DM patients and its relationship with sociodemographic factors. This study examined the effect of an educational intervention on medication adherence self-efficacy using the Self-Efficacy for Appropriate Medication Use Scale (SEAMS). Methods: This controlled before-and-after study was conducted at five public hospitals in Hail City, Saudi Arabia. Data were collected pre-intervention (February–May) and post-intervention (August–October). The intervention group received an educational program structured around the American Association of Diabetes Educators 7 Self-Care Behaviors™ (AADE7) framework over six months (12 sessions, every two weeks), delivered via workshops, online modules, and printed materials. A multidisciplinary team guided participants through healthy eating, physical activity, monitoring, problem-solving, medication adherence, reducing risks, and healthy coping. A total of 377 patients completed the study. Results: Baseline findings showed that only 17.8% of patients felt “very confident” in taking medications correctly. Over 72% reported feeling only “somewhat confident” about taking medications on busy workdays, and more than half were somewhat confident when managing medications without reminders. Post-intervention, confidence levels improved significantly, with the proportion feeling “very confident” about taking multiple medications daily rising from 17.8% to 47.7%. Patients also reported enhanced confidence in managing medications during busy days and without reminders. Additionally, patients with a shorter duration of diabetes (<5 years) demonstrated better adherence. Conclusion: The educational intervention significantly increased medication adherence self-efficacy among T2DM patients. These findings highlight the importance of structured, behavior-focused education in improving patients’ confidence and adherence to medication regimens.
References
2. Tinajero D, Malik VS. Burden and trends of type 2 diabetes in the Middle East and North Africa region. Curr Diab Rep. 2021;21(5):18-24.
3. International Diabetes Federation. Diabetes facts & figures. https://www.idf.org/aboutdiabetes/what-is-diabetes/facts-figures.html. Accessed January 18, 2022.
4. Hua J, Huang B, Liu S, Sun Z. Trends in the burden of type 2 diabetes and its risk factors in Saudi Arabia. J Endocrinol Metab Diabetes South Afr. 2024;29(1):30-36.
5. Ginzburg L. Diabetes. In: The Open Encyclopedia of Anthropology. Riddhi Bhandari (Ed). Online. http://doi.org/10.29164/23diabetes. Accessed December 18, 2024.
6. Al-Quwaidhi AJ, Pearce MS, Sobngwi E, Critchley JA, O’Flaherty M. Comparison of type 2 diabetes prevalence estimates in Saudi Arabia from a validated Markov model against the International Diabetes Federation and other modelling studies. Diabetes Res Clin Pract. 2014;103(3):496-503.
7. Theofilou P. Self-Efficacy for Appropriate Medication Use Scale (SEAMS): Translation and cultural adaptation in Greece. Age. 2023;65:8-31.
8. Cramer JA. A systematic review of adherence with medications for diabetes. Diabetes Care. 2004;27(5):1218-1224.
9. Denicolo S, Perco P, Thoeni S, Mayer G. Non-adherence to antidiabetic and cardiovascular drugs in type 2 diabetes mellitus and its association with renal and cardiovascular outcomes: A narrative review. J Diabetes Complications. 2021;35(7):107931.
10. Presley B, Groot W, Pavlova M. Pharmacy-led interventions to improve medication adherence among adults with diabetes: a systematic review and meta-analysis. Res Social Adm Pharm. 2019;15(9):1057-1067.
11. Majeed A, Rehman M, Hussain I, Imran I, Saleem MU, Saeed H, Rasool MF. The impact of treatment adherence on quality of life among type 2 diabetes mellitus patients—Findings from a cross-sectional study. Patient Prefer Adherence. 2021;15:475-481.
12. Williams JL, Walker RJ, Smalls BL, Campbell JA, Egede LE. Effective interventions to improve medication adherence in type 2 diabetes: a systematic review. Diabetes Manag (Lond). 2014;4(1):29-48.
13. Okuboyejo S, Mbarika V, Omoregbe N. The effect of self-efficacy and outcome expectation on medication adherence behavior. J Public Health Afr. 2018;9(3):e1001.
14. Shen Z, Shi S, Ding S, Zhong Z. Mediating effect of self-efficacy on the relationship between medication literacy and medication adherence among patients with hypertension. Front Pharmacol. 2020;11:569092.
15. Chen J, Tian Y, Yin M, Lin W, Tuersun Y, Li L, He F. Relationship between self-efficacy and adherence to self-management and medication among patients with chronic diseases in China: a multicentre cross-sectional study. J Psychosom Res. 2023;164:111105.
16. Huang YM, Shiyanbola OO, Chan HY. A path model linking health literacy, medication self-efficacy, medication adherence, and glycemic control. Patient Educ Couns. 2018;101(11):1906-1913.
17. Daniali SS, Darani FM, Eslami AA, Mazaheri M. Relationship between self-efficacy and physical activity, medication adherence in chronic disease patients. Adv Biomed Res. 2017;6:63.
18. Barker JM, Faasse K. Influence of side effect information on patient willingness to take medication: consequences for informed consent and medication adherence. Intern Med J. 2023;53(9):1692-1696.
19. Powers MA, Bardsley J, Cypress M, Duker P, Funnell MM, Fischl AH, Vivian E. Diabetes self-management education and support in type 2 diabetes: a joint position statement of the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics. Clin Diabetes. 2017;35(2):70-80.
20. Mustapa A, Justine M, Manaf H. Effects of patient education on the quality of life of patients with type 2 diabetes mellitus: A scoping review. Malays Fam Physician. 2022;17(3):22-30.
21. Alhazzani H, AlAmmari G, AlRajhi N, Sales I, Jamal A, Almigbal TH, AlRuthia Y. Validation of an Arabic version of the self-efficacy for appropriate medication use scale. Int J Environ Res Public Health. 2021;18(22):11983.
22. Wu J, Shen J, Tao Z, Song Z, Chen ZL. Self-efficacy as moderator and mediator between medication beliefs and adherence in elderly patients with type 2 diabetes. Patient Prefer Adherence. 2023;17:217-226.
23. Risser J, Jacobson TA, Kripalani S. Development and psychometric evaluation of the Self-efficacy for Appropriate Medication Use Scale (SEAMS) in low-literacy patients with chronic disease. J Nurs Meas. 2007;15(3):203-219.
24. Sendekie AK, Netere AK, Kasahun AE, Belachew EA. Medication adherence and its impact on glycemic control in type 2 diabetes mellitus patients with comorbidity: A multicenter cross-sectional study in Northwest Ethiopia. PLoS One. 2022;17(9):e0274971. https://doi.org/10.1371/journal.pone.0274971. Accessed December 18, 2024.
25. Jannoo Z, Khan NM. Medication adherence and diabetes self-care activities among patients with type 2 diabetes mellitus. Value Health Reg Issues. 2019;18:30-35.
26. Krzemińska S, Laurinc M, Bąk E, Soósová MS, Kupczak-Wiśniowska B. Adherence to therapeutic recommendations in patients with type 2 diabetes. J Educ Health Sport. 2024;64:53826-53826.
27. Tokdemir G, Kav S. The effect of structured education to patients receiving oral agents for cancer treatment on medication adherence and self-efficacy. Asia Pac J Oncol Nurs. 2017;4(4):290-298.
28. Kwakye AO, Kretchy IA, Peprah P, Mensah KB. Factors influencing medication adherence in co-morbid hypertension and diabetes patients: A scoping review. Explor Res Clin Soc Pharm. 2024;13:100426.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.