title: Diabetes knowledge, medication adherence and glycemic control among patients with type 2 diabetes.
abstract: BACKGROUND
  Most of interventions that have attempted to improve medication adherence in type 2 diabetes have been educational; on the assumption that knowledge regarding diabetes might affect patients' adherence to their treatment regimen.
  
  
  OBJECTIVE
  The purpose of the study was to investigate any association of knowledge and medication adherence with glycemic control in patients with type 2 diabetes mellitus. Setting The study was conducted at the Diabetes Outpatients Clinic, Hospital Pulau Penang.
  
  
  METHODS
  A cross-sectional study was conducted with a convenience sample of 540 adult patients with type 2 diabetes attending the clinic. A questionnaire including previously validated Michigan Diabetes Knowledge Test and Morisky Medication Adherence Scale was used and the patients' medical records were reviewed for haemoglobin A1C (HbA1C) levels and other disease-related information. A total of 35 (6.48%) patients were excluded after data collection due to lack of HbA1C results.
  
  
  RESULTS
  Five hundred and five patients were included in the final analysis, with a mean age of 58.15 years (SD = 9.16), 50.7% males and median HbA1C of 7.6 (IQR was 6.7-8.9). The median total knowledge score was 7.0 (IQR was 5.0-10.0) while the median adherence score was 6.5 (IQR was 4.75-7.75). Significant correlations were found between the three variables (HbA1C, knowledge and adherence). A significantly higher score for knowledge and adherence (P < 0.05) was found in those patients with lower HbA1C. Higher diabetes knowledge, higher medication adherence and using mono-therapy were significant predictors of good glycemic control in the multivariate analysis.
  
  
  CONCLUSIONS
  Patients' knowledge about diabetes is associated with better medication adherence and better glycemic control. In addition to other factors affecting medication adherence and glycemic control, healthcare providers should pay attention to knowledge about diabetes that the patients carry towards medication adherence.
authors.affiliation: Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800, Penang, Malaysia. harithqazaz73@yahoo.com
authors.forename: Harith Kh
authors.initials: HKh
authors.lastname: Al-Qazaz
authors.forename: Syed A
authors.initials: SA
authors.lastname: Sulaiman
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Hassali
authors.forename: Asrul A
authors.initials: AA
authors.lastname: Shafie
authors.forename: Shameni
authors.initials: S
authors.lastname: Sundram
authors.forename: Rana
authors.initials: R
authors.lastname: Al-Nuri
authors.forename: Fahad
authors.initials: F
authors.lastname: Saleem
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000187:drug effects; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D011795:Surveys and Questionnaires; D016903:Drug Monitoring
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents
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