Abstract
Background
The prevalence of type 2 diabetes mellitus (DMT2) in Indonesia increased significantly from 6.9% (2013) to 8.5% (2018), putting Indonesia in top six countries in the world with maximum DMT2 patients. Patients with uncontrolled DMT2 are at risk for complications. As such, insulin is often administered to keep the levels under control. Unfortunately, poor adherence to insulin therapy is common, reflecting some factors that may affect the therapy. The aim of this study was to identify and analyze the characteristics of patients contributing to adherence to insulin therapy among DMT2 outpatients using the Health Belief Model (HBM) approach.
Methods
A cross-sectional survey was conducted on a sample of 84 DMT2 outpatients in a private hospital in Surabaya between April and May 2019. Respondents were selected using the accidental sampling technique. Data were analyzed using descriptive analysis and chi-square.
Results
The level of respondents’ adherence was high (73.8%). There was no significant relationship between sex, age, level of education, occupation, and duration of use and patient adherence. Using the HBM approach, this study showed a significant relationship between the five components of HBM (perceived susceptibility, perceived severity, perceived benefit, perceived barrier and perceived self-efficacy) and patient adherence.
Conclusions
Patient adherence was influenced primarily by patient belief to the therapy of insulin. The characteristics of patients had no effect on adherence, yet further research is recommended to examine such adherence to a different population.
Acknowledgments
The authors express their gratitude to Surabaya PHC Hospital for providing the opportunity to conduct research. The authors also appreciate DM patients who were willing to be respondents in this study.
Research funding: Research funds obtained from researchers' private funds.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: Authors state no conflict of interest.
Informed consent: Informed consent was obtained from all individuals included in this study.
Ethical approval: The Health Research Ethics Committee of Surabaya PHC Hospital issued a statement passing the ethical review with No. 004/KEPK/RSPS-2019, issued on April 16, 2019, by the Chairman of the KEPK PHC Hospital Surabaya.
References
[1] American Diabetes Association. Standards of medical care in diabetes 2017. Diabetes Care. 2017;40:S1–S134.10.2337/dci17-0007Search in Google Scholar PubMed
[2] Ogurtsova K, da Rocha Fernandes JD, Huang Y, Linnenkamp U, Guariguata L, Cho NH, Cavan D, Shaw JE, Makaroff LE. IDF Diabetes Atlas: Global estimates for the prevalence of diabetes for 2015 and 2040. Diabetes Res Clin Pract. 2017;128:40–50.10.1016/j.diabres.2017.03.024Search in Google Scholar PubMed
[3] Badan Penelitian dan Pengembangan Kesehatan Kementerian RI. Riset Kesehatan Basic Health Research. Jakarta: Ministry of Health of the Republic of Indonesia, 2018.Search in Google Scholar
[4] Hartanto D, Mulyani R. Correlation of Insulin-Based Therapy Compliance with Therapy Effectiveness in Type 2 Diabetes Mellitus Patients at Ulin Hospital Banjarmasin. Jurnal Ilmiah Ibnu Sina. 2017;2:287–95.Search in Google Scholar
[5] Perkeni. Consensus on the Management and Prevention of Type 2 Diabetes Mellitus in Indonesia. Jakarta: Perkeni, 2015:11–4.Search in Google Scholar
[6] Fatimah RN. Diabetes Mellitus Type 2. J Majority. 2015;4:93–101.Search in Google Scholar
[7] Srikartika VM, Cahya AD, Hardiati RS. Analysis of Factors Affecting Compliance with Drug Use for Type 2 Diabetes Mellitus Patients. Jurnal Manajemen dan Pelayanan Farmasi. 2016;6:205–212.Search in Google Scholar
[8] Gamayanti V, Ratnasari NL, Bhargah A. The pattern of insulin use in patients with Type 2 Diabetes Mellitus in disease poly in the State General Hospital July-August 2018. Intisari Sains Medis. 2018;9:68–73.Search in Google Scholar
[9] Ulum Z, Kusnanto X, Widyawati IY. Compliance Medication for Type 2 Diabetes Mellitus Patients Based on Health Belief Model (HBM) Theory in the Work Area of Mulyorejo Public Health Center in Surabaya. Jurnal Keperawatan Airlangga.2015;4:1–11.Search in Google Scholar
[10] Given CW, Given BA, Gallim RS, Condon JW. Development of scale to measure belief of diabetic patients. Res Nurs Health 1983;6:127–41.10.1002/nur.4770060306Search in Google Scholar PubMed
[11] Van der Ven NC, Adèr H, Weinger K, Van der Ploeg HM, Yi J, Snoek FJ, et al. The confidence in diabetes self-care scale. Diabetes Care 2003;26:713–8.10.1037/t59182-000Search in Google Scholar
[12] Cerkoney KA, Hart LK. The relationship between the health belief model and compliance of persons with diabetes mellitus. Diabetes Care. 1980;3:594–598.10.2337/diacare.3.5.594Search in Google Scholar PubMed
[13] Nanda OD, Wiryanto RB, Triyono EA. Relationship between antidiabetic drugs consumption and blood glucose level regulation for diabetes mellitus female patients. Research Study. 2018;2:340–348.Search in Google Scholar
[14] Krisnawati B, Hari KY, Budi M. Gender differences in the incidence of metabolic syndrome in urban populations in Indonesia. Jurnal Kesehatan Masyarakat Nasional. 2012;7:219–25.Search in Google Scholar
[15] Restuning PD. Diabetes Education in Improving the Effectiveness of Compliance with Setting Diet in Type 2 Diabetes Mellitus. Artikel Penelitian. 2015;15(1):37–41.Search in Google Scholar
[16] Notoatmodjo S. Health Education and Behavior. Jakarta: PT Rineka Cipta, 2010.Search in Google Scholar
[17] Rasdianah N, Martodiharjo S, Andayani TM, Hakim L. Overview of Treatment Compliance for Patients with Type 2 Diabetes Mellitus in Yogyakarta community Health centers. Jurnal Farmasi Klinik Indonesia. 2016;5:249–257.Search in Google Scholar
[18] Vazini H, Barati M. The health belief model and self-care behaviors among type 2 diabetic patients. Iran J Diabetes Obes 2014;6:107–13.Search in Google Scholar
[19] Buglar ME, White KM, Robinson NG. The role of self-efficacy in dental patients’ brushing and flossing: test an extended Health Belief Model. Patient Educ Couns 2010;78:269–72.10.1016/j.pec.2009.06.014Search in Google Scholar PubMed
[20] Chairunisa C, Arifin S, Rosida L. Factors Related to Compliance Behavior Taking Anti-Diabetes Medication in Patients with Type 2 Diabetes Mellitus. Homeostasis. 2019;2:1–12.Search in Google Scholar
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