Factors associated with adherence to diabetes care recommendations among children and adolescents with type 1 diabetes: a facility-based study in two urban diabetes clinics in Uganda

被引:16
作者
Kyokunzire, Catherine [1 ]
Matovu, Nicholas [2 ,3 ]
机构
[1] Makerere Univ, Sch Publ Hlth, Dept Community Hlth & Behav Sci, Coll Hlth Sci, Kampala, Uganda
[2] Minist Hlth Uganda, Div Noncommunicable Dis, Dept Community Hlth, POB 7272, Kampala, Uganda
[3] Global Hlth Corps Fellowship Program 2017 2018, New York, NY USA
关键词
adherence; type; 1; diabetes; Kampala; children; adolescents; Uganda; QUALITY-OF-LIFE; GLYCEMIC CONTROL; SOCIAL SUPPORT; BLOOD-GLUCOSE; MANAGEMENT; MELLITUS; IMPACT; OUTCOMES; YOUTH; DIET;
D O I
10.2147/DMSO.S156858
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Purpose: The purpose of this study was to determine the level of adherence and the factors associated with adherence to diabetes care recommendations among type 1 diabetic children and adolescents at two urban diabetes clinics in Kampala, Uganda. Research design and methods: A facility-based cross-sectional study was carried out among 200 children and adolescents with type 1 diabetes at two major diabetes clinics in Kampala. Caretakers of the children and adolescents were interviewed using pretested questionnaires to provide information on sociodemographic characteristics, diabetes care, knowledge, attitudes, and adherence to diabetes care recommendations in type 1 diabetes. Prevalence rate ratios (PRRs) at the 95% confidence interval (CI) were used to establish the factors associated with adherence using modified Poisson regression, with robust standard errors. The data were analyzed by using STATA Version 13.0. Results: The overall prevalence of adherence to diabetes care recommendations was at 37%. However, evaluating adherence to specific treatment parameters showed that 52%, 76.5%, and 29.5% of the children and adolescents adhered to insulin, blood glucose monitoring, and dietary recommendations, respectively. In the final adjusted model, active diet monitoring (adjusted PRR [APRR]: 1.95; 95% CI: 1.01, 3.78), being under care of a sibling (APRR: 1.66; 95% CI: 1.61, 1.71), being under care of a married caretaker (APRR: 1.10; 95% CI: 1.05, 1.14) and a separated or divorced caretaker (APRR: 1.60; 95% CI: 1.12, 2.27), taking three or less tests of blood glucose per day (APRR: 0.63; 95% CI: 0.42, 0.95), and having a caretaker with poor knowledge about diabetes (APRR: 0.49; 95% CI: 0.43, 0.57) and who is inactive in supervision of insulin injections (APRR: 0.58; 95% CI: 0.56, 0.60) were associated with adherence to type 1 diabetes care recommendations. Conclusion: Adherence to type 1 diabetes care recommendations is still low among this population. The results suggest that reinforcing caretaker involvement could be vital in improving adherence to diabetes care recommendations in this population.
引用
收藏
页码:93 / 104
页数:12
相关论文
共 38 条
[1]   Health related quality of life and family impact of type 1 diabetes among adolescents in Saudi Arabia [J].
AlBuhairan, Fadia ;
Nasim, Maliha ;
Al Otaibi, Ahlam ;
Shaheen, Naila A. ;
Al Jaser, Saleh ;
Al Alwan, Ibrahim .
DIABETES RESEARCH AND CLINICAL PRACTICE, 2016, 114 :173-179
[2]  
Almeida AC, 2013, TYPE 1 DIABETES, P447
[3]   MEASURING THE ATTITUDES OF PATIENTS TOWARDS DIABETES AND ITS TREATMENT [J].
ANDERSON, RM ;
DONNELLY, MB ;
DEDRICK, RF .
PATIENT EDUCATION AND COUNSELING, 1990, 16 (03) :231-245
[4]  
[Anonymous], 2013, Adherence to Long-Term Therapies: Evidence for Action, DOI DOI 10.4028/WWW.SCIENTIFIC.NET/AMM.321-324.1779
[5]   Practical steps to improving the management of type 1 diabetes: recommendations from the Global Partnership for Effective Diabetes Management [J].
Aschner, P. ;
Horton, E. ;
Leiter, L. A. ;
Munro, N. ;
Skyler, J. S. .
INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, 2010, 64 (03) :305-315
[6]   Adherence challenges in the management of type 1 diabetes in adolescents: prevention and intervention [J].
Borus, Joshua S. ;
Laffel, Lori .
CURRENT OPINION IN PEDIATRICS, 2010, 22 (04) :405-411
[7]  
Daniel, 1999, BIOSTATISTICS FDN AN
[8]   Diabetes mellitus in childhood: an emerging condition in the 21st century [J].
Della Manna, Thais ;
Setian, Nuvarte ;
Diaz Savoldelli, Roberta ;
Rondina Guedes, Dulce ;
Kuperman, Hilton ;
Menezes Filho, Hamilton Cabral ;
Steinmetz, Leandra ;
Cominato, Louise ;
Dichtchekenian, Vae ;
Damiani, Durval .
REVISTA DA ASSOCIACAO MEDICA BRASILEIRA, 2016, 62 (06) :594-601
[9]   Improving patient adherence: a three-factor model to guide practice [J].
DiMatteo, M. Robin ;
Haskard-Zolnierek, Kelly B. ;
Martin, Leslie R. .
HEALTH PSYCHOLOGY REVIEW, 2012, 6 (01) :74-91
[10]   Social support and patient adherence to medical treatment: A meta-analysis [J].
DiMatteo, MR .
HEALTH PSYCHOLOGY, 2004, 23 (02) :207-218