Economic And Behavioural Assessment Of A Diabetes Self-Management Education Programme Among Type 2 Diabetes Patients At Diabetes Centre In Riyadh, Saudi Arabia
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Date
2016-02
Authors
Al-Aboudi, Ibrahim Suliman
Journal Title
Journal ISSN
Volume Title
Publisher
Universiti Sains Malaysia
Abstract
The prevalence of diabetes mellitus has increased tremendously among the Saudi
population during the last decade. This represent as a major economic burden in health
care system. The objective was to evaluate the effectiveness of the Diabetes Self-
Management Education (DSME) programme in improving clinical outcomes, self-care
behaviours and Health Related Quality of Life and to perform an economic evaluation of
DSME on health status in type 2 diabetes patients at the Diabetic Centre in King Abdulaziz
University Hospital, Riyadh, Saudi Arabia. The study include three phases a cross
sectional, pre and post interventional and economic study. The data were obtained by
using questionnaires completed during face-to-face interviews. The revised summary of
the Diabetes Self-care Activities Scale (SDSCA), the Diabetes Management self-efficacy
Scale (DMSES), the University of Michigan Diabetes Research and Training Centre
(MDRTC) knowledge test and the diabetic care profile of the University of Michigan were
used to measure attitudes towards diabetes. The Health Related Quality of Life was
assessed at baseline using The Quality of Life scale (EQ-5D). In cross sectional descriptive
study, the mean of EQ-5D score in type 2 diabetic patients was 0.71, which is considered
a moderately low score. The mean score of the MDKT was 8.96 ± 2.1, indicating that
overall, the patients had moderate knowledge about diabetes. The average attitude score of all respondents in this study was overall, positive of 6.38 ± 2.11. The mean scores of
total self-efficacy were moderately low, at 6.97 ± 1.49 of 10.00 as the maximum score.
The mean scores of the total self-care behaviours were low, at 3.64 ± 1.06 of 7.00 as the
maximum score. Linear correlations showed that self-efficacy subscales were significant
predictors of their respective self-care behaviours. The self-efficacy for blood sugar
monitoring seemed to be a stronger predictor of glycaemic control. A total of 75 type 2
diabetes patients were enrolled from April 2012 to July 2012 (over four months) as a
baseline study and each patient was followed up for three months with reinforcement and
at six months after intervention. Group sessions were conducted for five consecutive days
with males and females attending separately. The interventional study revealed a
significant improvement in HbA1c levels (p < 0.001) and reduction in BMI, HDL-C, SBP
and DBP from baseline to post-intervention follow-up. There is also a significant increase
in the total self-efficacy (p = 0.004) and the total self-care behaviours scores (p = 0.012).
The present study demonstrated that the total cost incurred by the intervention group was
Saudi Riyal (SAR) 1351.385, which was lower than the cost incurred by the control group
(SAR 1933.596) per participant over the 6-month study period. The ICER per unit
improvement in serum TC and LDL-C levels were 0.14 and 0.17 (<1.0 GDP per capita in
Saudi Arabia), respectively indicating that the DSME programme as a highly costeffective
method of improving TC and LDL-C levels from the perspective of health care
providers that would be cost-effective if implemented in Saudi Arabia.
Description
Keywords
Diabetes Self- Management Education (DSME)