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Endocrine, Metabolic & Immune Disorders - Drug Targets

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ISSN (Print): 1871-5303
ISSN (Online): 2212-3873

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Research Article

Assessment of Alternative Medicine Use, Costs, and Predictors of Medication Adherence among Diabetes Mellitus Patients in Palestine

Author(s): Rami Mosleh*, Ala’ U’wais, Anas Hamdan, Mustafa Ghanim and Yazun Jarrar

Volume 24, Issue 4, 2024

Published on: 18 October, 2023

Page: [441 - 454] Pages: 14

DOI: 10.2174/1871530322666220523114806

Price: $65

Abstract

Background: Diabetes Mellitus (DM) is considered the fourth leading cause of death in Palestine, with a prevalence of 9.1% in patients aged 20-79 years, and has increased to 20.6% in 2020.

Aims: This study aims to estimate DM costs, compare DM total health care cost among patient characteristics and DM management (e.g. anti-diabetic medications and alternative medicine), as well as assess MA and its predictors including patient characteristics, DM management, alternative medicine use, and DM costs.

Methods: A cross-sectional study was conducted for the past one year among 479 diabetic patients, selected by convenience sampling and snowball sampling methods via electronic post of an online questionnaire, including a web link to the questionnaire page in a Google Form via email or public social media pages and applications. Data on patients’ socio-demographic and clinical characteristics, medication profile, use of medicinal plants as alternative medicine, costs, and Medication Adherence (MA) were collected. The Statistical Package for Social Sciences (SPSS v. 25) was used to perform a descriptive, Kolmogorov-Smirnov test, univariate analysis, Mann-Whitney or Kruskal- Wallis test, multiple linear regression, binary logistic regression, and multiple logistic regression analysis. A p-value < 0.05 was considered statistically significant.

Results: More than half of the participants were male and living in villages (50.7%, 59.1%, respectively). Approximately 51.4% received Oral Hypoglycemic Drugs (OHDs) and only 16.1% received insulin. The participants receiving ≤3 medications daily acquired the highest percentage (55.7%), and less than half received medicinal plants as an alternative medicine for the management of DM. The estimated total DM health care cost per year incurred by patients and family members was Israeli Shekel 988,276 (US Dollar 307,590). More than half of the participants were considered adherent with the Eight–Item Morisky Medication Adherence Scale (MMAS–8) score ≥6. It is noteworthy that the use of alternative medicine was significantly associated with total health care cost and MA. Furthermore, DM duration was significantly associated with MA. These results are worth taking into consideration.

Conclusion: This study reflects the need for strengthening the patient-health care professionals’ relationship, and to enhance the role of preventive education, and the importance of awareness about MA, DSCMBs, and the use of alternative medicine based on evidence-based strategies to improve MA, glycemic control, meanwhile reducing the costs incurred by patients and family members.

Keywords: Medication Adherence, Alternative Medicine, Cost, Treatment, Type I Diabetes, Type II Diabetes

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[1]
Sweileh, W.M.; Zyoud, S.H.; Abu Nab’a, R.J.; Deleq, M.I.; Enaia, M.I.; Nassar, S.M.; Al-Jabi, S.W. Influence of patients’ disease knowledge and beliefs about medicines on medication adherence: Findings from a cross-sectional survey among patients with type 2 diabetes mellitus in Palestine. BMC Public Health, 2014, 14(1), 94.
[http://dx.doi.org/10.1186/1471-2458-14-94] [PMID: 24479638]
[2]
Alhawari, H.; Jarrar, Y.; AlKhatib, M.A.; Alhawari, H.; Momani, M.; Zayed, A.; Alkamhawi, R.; Zihlif, M. The association of 3-hydroxy-3-methylglutaryl-CoA reductase, apolipoprotein e, and solute carrier organic anion genetic variants with atorvastatin response among Jordanian patients with type 2 diabetes. Life (Basel), 2020, 10(10), E232.
[http://dx.doi.org/10.3390/life10100232] [PMID: 33027917]
[3]
Saeedi, P.; Petersohn, I.; Salpea, P.; Malanda, B.; Karuranga, S.; Unwin, N.; Colagiuri, S.; Guariguata, L.; Motala, A.A.; Ogurtsova, K.; Shaw, J.E.; Bright, D.; Williams, R. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res. Clin. Pract., 2019, 157, 107843.
[http://dx.doi.org/10.1016/j.diabres.2019.107843] [PMID: 31518657]
[4]
Zhang, P.; Zhang, X.; Brown, J.; Vistisen, D.; Sicree, R.; Shaw, J.; Nichols, G. Global healthcare expenditure on diabetes for 2010 and 2030. Diabetes Res. Clin. Pract., 2010, 87(3), 293-301.
[http://dx.doi.org/10.1016/j.diabres.2010.01.026] [PMID: 20171754]
[5]
Williams, R.; Karuranga, S.; Malanda, B. Global and regional estimates and projections of diabetes-related health expenditure: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Pract, 2020, 162, 108072.
[6]
Ejeta, A.; Abdosh, T.; Hawulte, B.; Lamessa, A.; Belete Fite, M.; Fekadu, G. Diabetes concordant comorbidities and associated factors among adult diabetic out-patients at hiwot fana specialized university hospital, harar, eastern ethiopia: A cross-sectional study. Diabetes Metab. Syndr. Obes., 2021, 14, 2281-2289.
[http://dx.doi.org/10.2147/DMSO.S308553] [PMID: 34045877]
[7]
Polonsky, W.H.; Henry, R.R. Poor medication adherence in type 2 diabetes: Recognizing the scope of the problem and its key contributors. Patient Prefer. Adherence, 2016, 10, 1299-1307.
[http://dx.doi.org/10.2147/PPA.S106821] [PMID: 27524885]
[8]
Pednekar, P.; Heller, D.A.; Peterson, A.M. Association of medication adherence with hospital utilization and costs among elderly with diabetes enrolled in a state pharmaceutical assistance program. J. Manag. Care Spec. Pharm., 2020, 26(9), 1099-1108.
[http://dx.doi.org/10.18553/jmcp.2020.26.9.1099] [PMID: 32857648]
[9]
Gonzalez, J.S.; Tanenbaum, M.L.; Commissariat, P.V. Psychosocial factors in medication adherence and diabetes self-management: Implications for research and practice. Am. Psychol., 2016, 71(7), 539-551.
[http://dx.doi.org/10.1037/a0040388] [PMID: 27690483]
[10]
Bannister, M.; Berlanga, J. Effective utilization of oral hypoglycemic agents to achieve individualized HbA1c targets in patients with type 2 diabetes mellitus. Diabetes Ther., 2016, 7(3), 387-399.
[http://dx.doi.org/10.1007/s13300-016-0188-5] [PMID: 27502496]
[11]
Hori, S.; Mihaylov, I.; Vasconcelos, J.C.; McCoubrie, M. Patterns of complementary and alternative medicine use amongst outpatients in Tokyo, Japan. BMC Complement. Altern. Med., 2008, 8(1), 14.
[http://dx.doi.org/10.1186/1472-6882-8-14] [PMID: 18433476]
[12]
Chaudhury, A.; Duvoor, C.; Reddy Dendi, V.S.; Kraleti, S.; Chada, A.; Ravilla, R.; Marco, A.; Shekhawat, N.S.; Montales, M.T.; Kuriakose, K.; Sasapu, A.; Beebe, A.; Patil, N.; Musham, C.K.; Lohani, G.P.; Mirza, W. Clinical review of antidiabetic drugs: Implications for type 2 diabetes mellitus management. Front. Endocrinol. (Lausanne), 2017, 8, 6.
[http://dx.doi.org/10.3389/fendo.2017.00006] [PMID: 28167928]
[13]
Nigussie, S.; Birhan, N.; Amare, F.; Mengistu, G.; Adem, F.; Abegaz, T.M. Rate of glycemic control and associated factors among type two diabetes mellitus patients in Ethiopia: A cross sectional study. PLoS One, 2021, 16(5), e0251506.
[http://dx.doi.org/10.1371/journal.pone.0251506] [PMID: 33974654]
[14]
(WHO) WHO. Guidelines on second-and third-line medicines and type of insulin for the control of blood glucose levels in non-pregnant adults with diabetes mellitus. 2018. Available from: https://apps. who.int/iris/rest/bitstreams/1136354/retrieve (Accessed November 11, 2021).
[15]
Eshtayeh, M.; Draghmeh, A.; Zyoud, S.H. A comparative evaluation of medicine package inserts for oral antidiabetic agents in Palestine. BMC Public Health, 2019, 19(1), 1037.
[http://dx.doi.org/10.1186/s12889-019-7379-8] [PMID: 31375089]
[16]
Odeyemi, S.; Bradley, G. Medicinal plants used for the traditional management of diabetes in the Eastern Cape, South Africa: Pharmacology and toxicology. Molecules, 2018, 23(11), E2759.
[http://dx.doi.org/10.3390/molecules23112759] [PMID: 30366359]
[17]
Al-Qerem, W.; Jarab, A.S.; Badinjki, M.; Hyassat, D.; Qarqaz, R. Exploring variables associated with medication non-adherence in patients with type 2 diabetes mellitus. PLoS One, 2021, 16(8), e0256666.
[http://dx.doi.org/10.1371/journal.pone.0256666] [PMID: 34424940]
[18]
Kerkenbush, N.L. A comparison of self-documentation in diabetics: Electronic versus paper diaries. AMIA Annu. Symp. Proc., 2003, 887.
[PMID: 14728392]
[19]
Borges, N.B.; Ferraz, M.B.; Chacra, A.R. The cost of type 2 diabetes in Brazil: Evaluation of a diabetes care center in the city of São Paulo, Brazil. Diabetol. Metab. Syndr., 2014, 6(1), 122.
[http://dx.doi.org/10.1186/1758-5996-6-122] [PMID: 25400703]
[20]
Hu, H.; Sawhney, M.; Shi, L.; Duan, S.; Yu, Y.; Wu, Z.; Qiu, G.; Dong, H. A systematic review of the direct economic burden of type 2 diabetes in China. Diabetes Ther., 2015, 6(1), 7-16.
[http://dx.doi.org/10.1007/s13300-015-0096-0] [PMID: 25652613]
[21]
Hernan, W.H.; Brandle, M.; Zhang, P.; Williamson, D.F.; Matulik, M.J.; Ratner, R.E.; Lachin, J.M.; Engelgau, M.M. Costs associated with the primary prevention of type 2 diabetes mellitus in the diabetes prevention program. Diabetes Care, 2003, 26(1), 36-47.
[http://dx.doi.org/10.2337/diacare.26.1.36] [PMID: 12502656]
[22]
Morisky, D.E.; Ang, A.; Krousel-Wood, M.; Ward, H.J. Predictive validity of a medication adherence measure in an outpatient setting. J. Clin. Hypertens. (Greenwich), 2008, 10(5), 348-354.
[http://dx.doi.org/10.1111/j.1751-7176.2008.07572.x] [PMID: 18453793]
[23]
Morisky, D.E.; Green, L.W.; Levine, D.M. Concurrent and predictive validity of a self-reported measure of medication adherence. Med. Care, 1986, 24(1), 67-74.
[http://dx.doi.org/10.1097/00005650-198601000-00007] [PMID: 3945130]
[24]
Chobot, A. Góَrowska-Kowolik, K.; Sokołowska, M.; Jarosz-Chobot, P. Obesity and diabetes-Not only a simple link between two epidemics. Diabetes Metab. Res. Rev., 2018, 34(7), e3042-e3042.
[http://dx.doi.org/10.1002/dmrr.3042] [PMID: 29931823]
[25]
Pulgaron, E.R.; Delamater, A.M. Obesity and type 2 diabetes in children: Epidemiology and treatment. Curr. Diab. Rep., 2014, 14(8), 508-508.
[http://dx.doi.org/10.1007/s11892-014-0508-y] [PMID: 24919749]
[26]
Purnell, J.Q.; Zinman, B.; Brunzell, J.D. The effect of excess weight gain with intensive diabetes mellitus treatment on cardiovascular disease risk factors and atherosclerosis in type 1 diabetes mellitus: Results from the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study (DCCT/EDIC) study. Circulation, 2013, 127(2), 180-187.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.111.077487] [PMID: 23212717]
[27]
Reinehr, T. Type 2 diabetes mellitus in children and adolescents. World J. Diabetes, 2013, 4(6), 270-281.
[http://dx.doi.org/10.4239/wjd.v4.i6.270] [PMID: 24379917]
[28]
Barlow, GM; Yu, A; Mathur, R Role of the gut microbiome in obesity and diabetes mellitus. Nutr. Clin. Prac.: Off. Pub. Am. Soc. Parent. Ent. Nut., 2015, 30(6), 787-797.
[29]
Paun, A.; Danska, J.S. Modulation of type 1 and type 2 diabetes risk by the intestinal microbiome. Pediatr. Diabetes, 2016, 17(7), 469-477.
[http://dx.doi.org/10.1111/pedi.12424] [PMID: 27484959]
[30]
Fekadu, G.; Bula, K.; Bayisa, G.; Turi, E.; Tolossa, T.; Kasaye, H.K. Challenges and factors associated with poor glycemic control among type 2 diabetes mellitus patients at nekemte referral hospital, Western Ethiopia. J. Multidiscip. Healthc., 2019, 12, 963-974.
[http://dx.doi.org/10.2147/JMDH.S232691] [PMID: 31819470]
[31]
Mosleh, R.; Hawash, M.; Jarrar, Y. The relationships among the organizational factors of a tertiary healthcare center for type 2 diabetic patients in Palestine. Endocr. Metab. Immune Disord. Drug Targets, 2021, 21(3), 464-471.
[http://dx.doi.org/10.2174/1871530320666200513083802] [PMID: 32400340]
[32]
Radwan, H.; Hasan, H.; Hamadeh, R.; Hashim, M. AbdulWahid, Z.; Hassanzadeh Gerashi, M.; Al Hilali, M.; Naja, F. Complementary and alternative medicine use among patients with type 2 diabetes living in the United Arab Emirates. BMC Complement. Med. Ther., 2020, 20(1), 216.
[http://dx.doi.org/10.1186/s12906-020-03011-5] [PMID: 32650773]
[33]
Marín-Peñalver, J.J.; Martín-Timón, I.; Sevillano-Collantes, C.; Del Cañizo-Gómez, F.J. Update on the treatment of type 2 diabetes mellitus. World J. Diabetes, 2016, 7(17), 354-395.
[http://dx.doi.org/10.4239/wjd.v7.i17.354] [PMID: 27660695]
[34]
Atta, M.; Jafari, S.; Moore, K. Complementary and alternative medicine: A review on the effects of ginger, cinnamon and camellia sinensis leaf tea in diabetes. J. Diabetes Mellitus, 2019, 09(3), 126-136.
[http://dx.doi.org/10.4236/jdm.2019.93012]
[35]
Carlson, C.J.; Santamarina, M.L. Update review of the safety of sodium-glucose cotransporter 2 inhibitors for the treatment of patients with type 2 diabetes mellitus. Expert Opin. Drug Saf., 2016, 15(10), 1401-1412.
[http://dx.doi.org/10.1080/14740338.2016.1216100] [PMID: 27449721]

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