Knowledge of the Therapeutic Goals of Diabetes care among Patients with Type 2 Diabetes at Tikur Anbessa Specialized Hospital: A Hospital-Based Cross-Sectional Study, 2020.
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Date
2020-12
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Addis Abeba University
Abstract
Background
Diabetes is a growing public health challenge worldwide, including Ethiopia. Comprehensive
multifactorial cardiovascular risk reduction is recommended to reduce diabetes-associated
morbidity and mortality but achieving the triplet goals (optimization of blood glucose, blood
pressure and low density lipoprotein levels) remained a global clinical challenge. Patients’
knowledge of these therapeutic goals of diabetes care contributes to improved self-care and
glycemic control. However, the patients’ knowledge of the therapeutic goals in diabetes and its
determinants have not been studied comprehensively in Ethiopia.
Objective
This study was conducted to assess patients’ knowledge of the therapeutic goals of diabetes
management and the factors associated with the knowledge score.
Methods
A cross-sectional survey was conducted from March 3 to June 10, 2020, at the diabetes clinic in
Tikur Anbessa Specialized Hospital. Data were collected using a pretested, structured, intervieweradministered
questionnaire. Then, the open data kit (ODK) completed form was exported and
analyzed using SPSS version 25. To identify determinants of knowledge, bivariable and
multivariable binary logistic regression analyses were done. Statistical significance was
considered at the level of significance of 5%, and adjusted odds ratio (AOR) with 95% confidence
interval (CI) was used to present the estimates of the strength of the association
Results
A total of 419 participants were included. The mean knowledge score was 4.7 ±2.2 points (out of
10). Overall, the percentage of patients with a good understanding of the therapeutic goals of
diabetes management was 59.5%. The percentages of patients who reported knowing their target
goals for blood pressure, fasting blood sugar, hemoglobin A1C, and low-density lipoprotein were
79.5, 77.3, 11.7, and 7.2% respectively. Correct target goals for BP, FBS, A1c, and LDL-C were
reported by 75.7, 73.0, 4.1, and 1.0% respectively. The percentages of patients who reported knowing their recent levels for BP, FBS, A1C, and LDL-C were 72.3, 80.2, 16.7, and 8.1%
respectively. The multivariable binary regression analysis demonstrated that patients with longer
diabetes duration (AOR = 1.04, 95% CI: 1.01-1.07) and an increased household income by 1000
Ethiopian birr (AOR = 1.12, 95% CI: 1.02-1.23) were associated with the odds of having good
knowledge of the therapeutic goals. For each one year increase in the age of participants, the odds
of having good knowledge of diabetes therapeutic goals decreases by 3% [AOR = 0.97; 95% CI:
0.95-0.99]. However, compared to higher education level, having no formal education or primary
education was significantly associated with poor knowledge (AOR = 0.03; 95% CI: 0.006-0.13
and AOR = 0.27; 95% CI: 0.15-0.49, respectively). Besides, the odds of having good knowledge
of the therapeutic goals for divorced patients with diabetes decreases by 63% as compared to
married participants [AOR = 0.37%; 95% CI: 0.18-0.76].
Conclusion: This study demonstrated that the majority of participants knew their BP and FBS
targets and own recent levels while only a minority of patients understood their A1c and LDL-C
targets and recent values. It highlighted the need for the provision of patient-centered diabetic
education and sharing responsibility for patients achieving diabetes treatment goals.
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Keywords
Diabetes mellitus, knowledge of therapeutic goals, Tikur Anbessa Specialized Hospital, cross-sectional study