Illness Perceptions, HbA1c, And Adherence In Type 2 Diabetes In Saudi Arabia
Received 31 August 2019
Accepted for publication 11 October 2019
Published 25 October 2019 Volume 2019:13 Pages 1839—1850
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Cristina Weinberg
Peer reviewer comments 3
Editor who approved publication: Dr Johnny Chen
Mohsen Alyami,1 Anna Serlachius,1 Ibrahim Mokhtar,2 Elizabeth Broadbent1
1Department of Psychological Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand; 2Diabetes and Endocrine Centre, Department of Internal Medicine, King Khaled Hospital, Ministry of Health, Najran, Saudi Arabia
Correspondence: Elizabeth Broadbent
Department of Psychological Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland Hospital- Building 599, 2 Park Road, Grafton, Auckland 1023, New Zealand
Tel +64 9 3737599
Fax +64 9 3737013
Purpose: Little is known about predictors of adherence to diabetes medication in Saudi Arabia. This study aimed to investigate whether illness perceptions, beliefs about medicine, and God locus of health control beliefs were associated with adherence to medication and glycaemic control (HbA1c) in Saudi patients with type 2 diabetes (T2D).
Patients and methods: A convenience sample of 115 adults with T2D were recruited from a diabetes outpatient clinic. Validated self-reported measures of adherence to medication, illness perceptions, beliefs about medicine, and God locus of health control were administered. Patients’ most recent HbA1c levels were extracted from medical records. Multivariable logistic and linear regressions were used to examine the association between illness perceptions, beliefs about medicine and adherence to medication and HbA1c.
Results: More than two thirds of patients (69%) reported poor adherence to medication. All illness perceptions domains, beliefs about medicine, and God locus of health control beliefs were associated with adherence. Multivariable logistic regression revealed that older age (OR= 3.76, p= 0.023), worse consequences perceptions (OR= 0.21, p= 0.011), worse illness identity (OR= 0.23, p= 0.010), and greater illness coherence (OR= 3.24, p= 0.022) were independent predictors of adherence. Two thirds of patients (67%) had suboptimal HbA1c; and perceptions of a cyclical timeline and lower insulin effectiveness were associated with higher HbA1c. In multiple linear regression, perceptions of a cyclical timeline (β= 0.19, p= 0.040) were an independent significant predictor of HbA1c.
Conclusion: In Saudi Arabia, patients’ perceptions of T2D, beliefs about medicine, and God locus of control beliefs are associated with adherence. These results inform the development of interventions based on the Common-Sense Model (CSM) to encourage improved adherence and glycaemic control among Saudi patients with T2D. Further research with larger and more diverse samples is warranted to expand the generalizability of these findings.
Keywords: type 2 diabetes, adherence, glycaemic control, illness perceptions, Saudi Arabia
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