THE EFFECT OF ANXIETY LEVELS OF TYPE 2 DIABETES MELLITUS PATIENTS ON THEIR TREATMENT ADHERENCE IN THE COVID-19 PANDEMIC PERIOD

Year 2022, Volume: 7 Issue: 2, 112 - 126, 29.08.2022

Alev Yıldırım Keskin , Sibel Şentürk , Zeynep Büşra Teke

https://doi.org/10.33457/ijhsrp.1115603

Abstract

This study was conducted to investigate the effects of the anxiety levels of Diabetes Mellitus (DM) patients on their treatment adherence in the COVID-19 pandemic period. The sample of this descriptive and cross-sectional study consisted of 313 DM patients who presented to the internal medicine outpatient clinic between 01.01.2021 and 01.02.2021. The data were collected using a Personal Information Form, the Coronavirus Anxiety Scale (CAS), and the Morisky Medication Adherence Scale (MMAS-8). Descriptive statistics, Mann-Whitney U test, Kruskal-Wallis test and Spearman’s correlation test were used to analyze the data. The mean CAS score of the DM patients was 7.89±3.87, while their mean total MMAS-8 score was 4.06±1.56. It was determined that the patients who were using oral antidiabetic medications, those adhering to their medication and diet treatment, and those who were not COVID-19 had higher levels of anxiety. There was a negative significant relationship between the MMAS-8 and CAS scores of the patients (p<0.05). It was determined that as the anxiety levels of the DM patients increased in the pandemic process, their treatment adherence levels decreased. To reduce the anxiety levels and increase the treatment adherence of DM patients in the COVID-19 pandemic period, sufficient information, psychosocial support and a multidisciplinary approach should be provided.

Keywords

COVID-19, Diabetes Mellitus, Type 2, Treatment Adherence

Project Number

yok

References

• [1] WHO., COVID-19 weekly surveillance report. https://www.euro.who.int/en/health-topics/ health-emergencies/coronavirus-covid-19/weekly-surveillance-report 2020, Acces Date: 12.02.2021.
• [2] Ministry of Health (HM). https://covid19.saglik.gov.tr/.Access Date: 28.12.2021.
• [3] Mechi, A., Al-Khalidi, R., Al-Darraji, et al., "Long-term persistent symptoms of COVID-19 infection in patients with diabetes mellitus", Internal Journal of Diabetes in Developing Countries, 24, 1-4, 2021. https://doi:10.1007/s13410-021-00994-w.
• [4] Tao, L., Gao, Q., Liu, K., Dong, et al., "Factors contributing to glycemic control in diabetes mellitus patients complying with home quarantine during the coronavirus disease 2019 (COVID-19) epidemic", Diabetes Research and Clinical Practice, 170, 108514, 2020. https://doi.org/10.1016/j.diabres.2020.108514.
• [5] Gupta K.S., Lakshmi, P.V.M., Kaur, M., Rastogi, A., "Role of self care in covid 19 pandemic for people living with comorbidities of diabetes and hypertension", Family Medicine and Primary Care, 30, 9(11), 5495-501, 2020. https://doi.org/ 10.4103/jfmpc.jfmpc_1684_20.
• [6] Ghosh, A., Arora, B., Gupta, R., et al., "Effects of nationwide lockdown during COVID-19 epidemic on lifestyle and other medical issues of patients with type 2 diabetes in north ındia. Diabetes Metabolic Syndrome: Clincal Research & Reviews", 14(5), 917-920, 2020. https://doi.org/10.1016/j.dsx.2020.05.044.
• [7] Dennis, J.M., Mateen, B.A., Sonabend, R., et al., Type 2 diabetes and COVID-19-related mortality in the critical care setting: a national cohort study in england. Diabetes Care, 44(1), 50–7, 2021. https://doi.org/ 10.2337/dc20-1444.
• [8] Corrao, S., Pinelli, K., Vacca, M., et al., "Type 2 diabetes mellitus and COVID-19: a narrative review", Front Endocrinol (Lausanne). 12, 609470, 2021. https://doi.org/10.3389/fendo.2021.609470.
• [9] International diabetes federation (IDF) diabetes atlas –sixth edition, available at. http:/www. diabetesatlas. org. (Access 20 December 2021).
• [10] Çelik, G.S., Diabetes mellitus and care management (chapter: 7.3), internal medicine nursing book with case scenarios (Ed. Özer S), Istanbul Medicine Bookstore, 1st Edition, pp.285-303, 2019.
• [11] Young-Hyman, D., Groot, M. de, Hill-Briggs, F., et al., "Psychosocial care for people with diabetes: a position statement of the American Diabetes Association", Diabetes Care, 39, 2126–2140, 2016. https://doi.org/10.2337/dc16-2053.
• [12] Koç, E.M., "Investigation of quality of life and associated factors in patients follow-up with diabetes: a pilot study for Turkey", Konuralp Medical Journal, 7(2), 76-82, 2015. https://doi.org/10.18521/ktd.05733.
• [13] Kretchy, A.I., Danso, A.M., Kretchy, P.J., "Medication management and adherence during the COVID-19 pandemic: Perspectives and experiences from low-and middle-income countries. Research in Social and Administrative Pharmacy", 17(1), 2023-2026, 2021. https://doi.org/10.1016/j.sapharm.2020.04.007.
• [14] Mukhtar, S., Mukhtar, S., "Letter to the editor: Mental health and psychological distress in people with diabetes during COVID-19", Metabolism Clinical and Experimental, 108, 15448, 2020. https://doi.org/10.1016/j.metabol.2020.154248.
• [15] Şişman, P., Polat, I., Aydemir, E., et al., "How the COVID 19 outbreak afected patients with diabetes mellitus?", International Journal of Diabetes in Developing Countries, 1-9, 2021. https://doi.org/10.1007/s13410-021-00992-y.
• [16] Joensen, L.E., Madsen, K.P., Holm, L., et al., "Research: Educational and psychological aspects diabetes and covıd-19: psychosocial consequences of the COVID-19 pandemic in people with diabetes in denmark—what characterizes people with high levels of COVID-19-related worries?" Diabetic Medicine, 37(7), 1146–1154, 2020. https://doi.org/10.1111/dme.14319.
• [17] Küçük, E., Yapar, K., "Health perception, health-related behaviors, and adherence to medication in patients with type II diabetes: A study in the black sea region of Turkey", TAF Preventive Medicine Bulletin, 15(4), 285-292, 2016. https://doi.org/10.5455/pmb.1-1446795532.
• [18] Gutierrez, J., Long, J.A., "Reliability and validity of diabetes specific Health Beliefs Model scales in patients with diabetes and serious mental illness", Diabetes Research and Clinical Practice, 92(3), 342-7, 201”. https://doi: 10.1016/j.diabres.2011.02.018.
• [19] Fedrick, F., Temu, M.J., "Factors contributing to non-adherence to diabetes treatment among diabetic patients attending clinic in Mwanza city", East African Journal of Public Health, 9(3), 90-5, 2012. https://doi.org/10.4314/EAJPH.V9I3.
• [20] Baykal, A., Kapucu, S., "Evaluation of compliance with treatment of patients with type 2 diabetes mellitus. Hacettepe University Journal of Nursing Faculty", 44-58, 2015.
• [21] Özonuk, E., Yılmaz, M., "The relationship between health literacy and treatment compliance in patients with type 2 diabetes mellitus", "Koç University Nursing Education and Research Journal", 16(2), 96-103, 2019. https://doi.org/10.5222/KAFA.2019.096.
• [22] Sujan, H.S., Tasnim, R., Islam, S., et al., "COVID-19-specific diabetes worries amongst diabetic patients: The role of social support and other co-variates", Primer Care Diabetes, 15, 778-85, 2021. https://doi.org/ 10.1016/j.pcd.2021.06.009.
• [23] Alhareef, R., Zahrani Al, A., Alzahran, A., Ghandoura, L., "Impact of the COVID-19 lockdown on diabetes patients in jeddah, Saudi Arabia", Diabetes & Metabolic Syndrom, 14(5), 1583-1587, 2020. https://doi.org/10.1016/j.dsx.2020.07.051.
• [24] Siddiqui, S., "Depression in type 2 diabetes mellitus—a brief review", "Diabetes & Metabolic Syndrome", 8(1), 62-65, 2014. https://doi.org/10.1016/j.dsx.2013.06.010.
• [25] Kara, M.A., Kara, T., "The relationship between treatment method applied in patients with type 2 diabetes and adherence to treatment, quality of life and depression in patients". Medical Bulletion Haseki, 57, 377-385, 2019. https://doi.org/ 10.4274/haseki.galenos.2019.4874.
• [26] Adakan, Y.F., Vural, R., Şahintürk, Y. et al., "The relationship of socio-demographic and clinical factors with depression and anxiety levels in diabetic and non-diabetic persons", Konuralp Medical Journal, 9(2), 19-18, 2017.
• [27] Fadare, J., Olamoyegun, M., Gbadegesin, B.A., "Medication adherence and direct treatment cost among diabetes patients attending a tertiary healthcare facility in Ogbomosho, Nigeria", Malawi Medical Journal, 27, 65-70, 2015. https://doi: 10.4314/mmj.v27i2.7.
• [28] Lee, S.A., "Coronavirus anxiety scale: A brief mental health screener for covid-19 related anxiety", Death Studies, 1-9, 2020. https://doi.org/10.1080/07481187.2020.1748481.
• [29] Biçer, İ., Çakmak, C., Demir, H., Kurt, E.M., "Coronavirus Anxiety Scale Short Form: Turkish Validity and Reliability Study", Anadolu Clinic Journal of Medical Sciences, 25(1), 1-10, 2020.
• [30] Morisky, D.E., Green, L.W., Levine, D.M., "Concurrent and predictive validity of a self- reported measure of medication adherence", Meical Care, 24, 67-74, 1986. https://doi.org/ 10.1097/00005650-98601000-00007.
• [31] Sayiner, Z.A., Turkish validity and reliability study of Morisky treatment adherence scale-8 in diabetes mellitus and determining its relationship with factors indicating treatment compliance in patients, specialty thesis Gaziantep: Gaziantep University, 2014.
• [32] Singhai, K., Swami, K.M., Nebhinani, N., et al., "Psychological adaptive difficulties and their management during COVID-19 pandemic in people with diabetes mellitus", Clinical Research & Reviews, 14(6), 1603-1605, 2020. https://doi.org/10.1016/j.dsx.2020.08.025.
• [33] Peric, S., Stulnig, T.M., "Diabetes and COVID-19. Wien Klin Wochenschr", 132, 13-14, 356–361, 2020. https://doi.org/10.1007/s00508-020-01672-3.
• [34] Bornstein, S.R., Rubino, F., Khunti, K., et al., "Practical recommendations for the management of diabetes in patients with COVID-19", Lancet Diabetes Endocrinol, 8(6), 546-550, 2020. https://doi.org/10.1016/S2213-8587(20)30152-2.
• [35] Guo, W., Li, M., Dong, Y., Tian, C., et al., "Diabetes is a risk factor for the progression and prognosis of covıd-19", Diabetes/Metabolism Research and Reviewa, e3319, 2020. https://doi.org/10.1002/dmrr.3319.
• [36] Ghosal, S., Sinha, B., Majumder, M., Misra, A., "Estimation of effects of nationwide lockdown for containing coronavirus infection on worsening of glycosylated haemoglobin and increase in diabetes-related complications: A simulation model using multivariate regression analysis", Diabetes & Metabolic Syndrome, 14(4), 319-23, 2020. https://doi.org/10.1016/j.dsx.2020.03.014.
• [37] Biswas, A., Bhattacharjee, U., Chakrabarti, A.K. et al., "Emergence of Novel Coronavirus and COVID-19: whether to stay or die out?" Critical Reviews in Microbiology, 46(2), 182- 193, 2020. https://doi.org/10.1080/1040841X.2020.1739001.
• [38] Pah, A.M., Bucuras, P., Buleu, F., et al., "The importance of DS-14 and HADS questionnaires in quantifying psychological stress in type 2 diabetes mellitus", Medicina, 55, 569, 2019. https://doi.org/10.3390/medicina55090569.
• [39] Rastogi, A., Jude, B.E., "COVID-19 pandemic and life style modification for people with diabetes", Journal of Clinical Diabetes, 5 (1), 1-4, 2020.
• [40] Zakaria, M.O., Albshr, A.F., Aljarrash, M.K., et al., "Does COVID-19 Pandemic Affect Medication Compliance Among Chronic Patients?" Sapporo Medical Journal, 54(7), 1-12, 2020. https://doi.org/covidwho-932028.
• [41] Saraçoğlu, E., Avcı, A.İ., "Identifying diabetes patients' concerns and care needs regarding the covid-19 outbreak", Turkish Journal of Diabetes and Obesity, 2, 202-209, 2021. https://doi.org/10.25048/tudod.901442.
• [42] Xue, T., Li., Q., Zhang, Q., et al., "Blood glucose levels in elderly subjects with type 2 diabetes during COVID-19 outbreak: A retrospective study in a single center", MedRxiv, 1-14, 2020. https://doi.org/10.1101/2020.03.31.20048579.
• [43] Asheq, A., Ashames, A., Tabakha, Al M., et al., "Medication adherence in type 2 diabetes mellitus patients during COVID-19 pandemic: a cross-sectional study from the United Arab Emirates", F1000Research, 10, 435, 2021. https://doi.org/10.12688/f1000research.51729.1.
• [44] Taşkaya, S., Bayram, Ş., "Factors Influencing Adherence to Diabetes Medication in Turkey", Scholars Journal of Applied Medical Sciences, 3(2A), 602-607, 2015.
• [45] Parajuli, J., Saleh, F., Thapa, N., Ali, L. "Factors associated with nonadherence to diet and physical activity among Nepalese type 2 diabetes patients; a cross sectional study", BMC Research Notes, 7, 758, 2014. https://doi.org/10.1186/1756-0500-7-758.
• [46] Ruiz-Roso, M.B., Knott-Torcal, C., Matilla-Escalante, D.C., et al., "COVID-19 lockdown and changes of the dietary pattern and physical activity habits in a cohort of patients with type 2 diabetes mellitus", Nutrients, 12(8), 2327, 2020. https://doi.org/10.3390/nu12082327.