Inadequate Self-Care Behaviors among Malaysian Diabetic Patients: The Need for Action by Hospital Pharmacists

Abstract

<p style="text-align: justify;"><strong>Background:</strong> Self-care behaviors have been confirmed to be strongly associated with clinical outcomes of diabetes management. <strong>Objective:</strong> To determine the prevalence and risk factors of inadequate self-care behaviors among the Malaysian patients with type two diabetes mellitus (T2DM) through screening by hospital pharmacists. <strong>Methods:</strong> A cross-sectional study was undertaken over a nine-month period at a public tertiary care center in Northern Malaysia. Self-care behaviors of 103 patients with T2DM were evaluated using the 16-item Diabetes Self-Management Questionnaire (DSMQ), and the scores were dichotomized to represent &ldquo;adequate&rdquo; (&ge;6 out of 10) and &ldquo;inadequate&rdquo; (&lt;6 out of 10) self-care behaviors. The risk factors for inadequate self-care behaviors were identified using logistic regression analysis. <strong>Results:</strong> The participants recorded a mean DSMQ score of 7.48&plusmn;1.32, and 16 (15.5%) of them were found to have inadequate self-care behaviors. Among the four subscales assessed, the &ldquo;Health-Care Use&rdquo; had the highest score (8.36&plusmn;1.99), while the &ldquo;Physical Activity&rdquo; had the lowest score (6.82&plusmn;2.56). Patients with a duration of T2DM less than one year (OR: 12.00; 95%CI: 1.80, 80.05; p=0.010) and between six to ten years (OR: 7.11; 95% CI: 1.36, 37.31; p=0.020) were found more likely to have inadequate self-care behaviors, as compared with those with a disease duration greater than 10 years. <strong>Conclusion:</strong> A noticeable proportion of patients with T2DM in Malaysia had inadequate self-care behaviors, and were found to be associated with the disease duration. This study suggests a more active role for hospital pharmacists in monitoring and improving the diabetes management of patients. <p style="text-align: justify;"><strong>Key words:</strong> Malaysia, Tertiary care centers, Pharmaceutical services, Pharmacists, Self-care, Type 2 diabetes mellitus.