title: The relationship between patients' knowledge of diabetes therapeutic goals and self-management behaviour, including adherence.
abstract: Background The Middle East region has one the highest prevalence rates of diabetes in the world. Little is known about the determinants of adherence and the role of knowledge in diabetes self-management within these populations. Objective To investigate the relationship between patients knowledge of diabetes therapeutic targets with adherence to self-care measures in a sample of patients with type 2 diabetes in Kuwait. Setting Primary care chronic care clinics within the Ministry of Health of Kuwait. Methods A cross sectional survey was carried out with 238 patients from six clinics. A multistage stratified clustered sampling method was used to first randomly select the clinics and the patients.
  
  
  METHODS
  Self-reported adherence to three behaviours: medication taking, diet and physical activity. Results Respondents were able to correctly report a mean (SD) of 1.6 (1.3) out of 5 of the pre-specified treatment targets. Optimal adherence to physical activity, diet and medications was reported in 25, 33 and 47 % of the study cohort, respectively. A structural equation model analysis showed better knowledge of therapeutic goals and own current levels translated into better adherence to medications, diet and physical activity. Conclusion Knowledge of therapeutic goals and own recent levels is associated with adherence to medications, diet, or physical activity in this Kuwaiti cohort of patients with diabetes. Low adherence to self-care management and poor overall knowledge of diabetes is a big challenge to successful diabetes care in Kuwait.
authors.affiliation: Faculty of Pharmacy, Kuwait University, P. O. Box 24923, 13110, Safat, Kuwait. mohdw@hsc.edu.kw.
authors.forename: Mohammad
authors.identifier: http://orcid.org/0000-0002-5009-0185
authors.initials: M
authors.lastname: Waheedi
authors.affiliation: Faculty of Pharmacy, Kuwait University, P. O. Box 24923, 13110, Safat, Kuwait.
authors.forename: Abdelmoneim
authors.initials: A
authors.lastname: Awad
authors.affiliation: College of Pharmacy, University of Illinois and Hind T. Hatoum & Company, Chicago, USA.
authors.forename: Hind T
authors.initials: HT
authors.lastname: Hatoum
authors.affiliation: Finnish Medicines Agency, Kuopio, Finland.
authors.forename: Hannes
authors.initials: H
authors.lastname: Enlund
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000453:epidemiology; D019468:Disease Management; D005260:Female; D006040:Goals; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007730:Kuwait / Q000453:epidemiology; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D011897:Random Allocation; D012648:Self Care / Q000379:methods*
chemical_list: D007004:Hypoglycemic Agents
keywords: Adherence; Diet; Kuwait; Medications; Physical activity; Therapeutic goals