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Association of treatment satisfaction and physician trust with glycemic control among primary care patients with type 2 diabetes in Egypt

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Abstract

Objectives

To evaluate the association of diabetes treatment satisfaction and trust in family physicians with glycemic control among primary care patients with type 2 diabetes mellitus.

Methods

A cross-sectional study on 319 patients with type 2 diabetes mellitus from five primary healthcare centers in Egypt. Data were collected from February to August 2021 using a structured questionnaire that contained six parts: sociodemographic data, disease profile, the Diabetes Treatment Satisfaction Questionnaire (DTSQ), 8-item Morisky Medication Adherence Scale (MMAS-8), self-reported medication knowledge questionnaire (MKQ), and revised healthcare relationship trust scale (HCR). Multiple linear regression analysis was used to assess predictors of treatment satisfaction, physician trust, and HbA1c level. P values less than 0.05 were considered significant.

Results

The mean age was 59.66 years (± 7.87 years) and 55.17% were females. Multiple linear regression analysis for predicting HbA1c showed that HbA1c level was lower in patients with higher treatment satisfaction scores (β =  − 0.289, p < 0.001) and higher medication adherence scores (β =  − 0.198, p = 0.001). Treatment satisfaction scores were positively predicted by higher physician trust scores (β = 0.301, p < 0.001), increased medication adherence scores (β = 0.160, p = 0.002), and longer duration of diabetes (β = 0.226, p < 0.001). Positive predictors for physician trust included HbA1c level (β = 0.141, p = 0.012), medication knowledge (β = 0.280, p < 0.001), diabetes treatment satisfaction (β = 0.366, p < 0.001) and medication adherence (β = 0.146, p = 0.011).

Conclusion

Optimizing diabetes treatment satisfaction and physician trust could have favorable associations with medication adherence and medication knowledge with a possible improvement in glycemic control. Family physicians should incorporate patients reported outcomes alongside traditional clinical measures in evaluating diabetes management in primary care.

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Data availability

The datasets used and/or analyzed during the present study are available from the corresponding author on reasonable request.

Change history

  • 27 August 2023

    Underlines were included incorrectly in the table 1 and the values are corrected in this version.

References

  1. WHO. Diabetes [Internet]. World Health Organization. World Health Organization; 2022 [cited 2023 Mar 5]. Available from: https://www.who.int/news-room/fact-sheets/detail/diabetes

  2. Powers MA, Bardsley JK, Cypress M, Funnell MM, Harms D, Hess-Fischl A, et al. Diabetes self-management education and support in adults with type 2 diabetes: a consensus report of the American Diabetes Association, the Association of Diabetes Care & Education Specialists, the Academy of Nutrition and Dietetics, the American Academy of Family Physicians, the American Academy of PAs, the American Association of Nurse Practitioners, and the American Pharmacists Association. Diabetes Care. 2020;43(7):1636–49. https://doi.org/10.2337/dci20-0023.

    Article  PubMed  Google Scholar 

  3. Stellefson M, Dipnarine K, Stopka C. The chronic care model and diabetes management in US primary care settings: a systematic review. Prev Chronic Dis. 2013;10:E26. https://doi.org/10.5888/pcd10.120180.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Kim H, Shah K, Buettner C. Use of patient-reported outcomes for assessing diabetes outcomes. Endocrinol Metab Clin North Am. 2022;51(4):781–93. https://doi.org/10.1016/j.ecl.2022.05.001.

    Article  PubMed  Google Scholar 

  5. Hartman I. Insulin analogs: impact on treatment success, satisfaction, quality of life, and adherence. Clin Med Res. 2008;6(2):54–67. https://doi.org/10.3121/cmr.2008.793.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  6. Rodbard HW, Peters AL, Slee A, Cao A, Traina SB, Alba M. The effect of canagliflozin, a sodium-glucose cotransporter 2 inhibitor, on glycemic end points assessed by continuous glucose monitoring and patient-reported outcomes among people with type 1 diabetes. Diabetes Care. 2017;40(2):171–80. https://doi.org/10.2337/dc16-1353.

    Article  PubMed  CAS  Google Scholar 

  7. Lind M, Jendle J, Torffvit O, Lager I. Glucagon-like peptide 1 (GLP-1) analogue combined with insulin reduces HbA1c and weight with low risk of hypoglycemia and high treatment satisfaction. Prim Care Diabetes. 2012;6(1):41–6. https://doi.org/10.1016/j.pcd.2011.09.002.

    Article  PubMed  Google Scholar 

  8. Marrero DG, Hilliard ME, Maahs DM, McAuliffe-Fogarty AH, Hunter CM. Using patient reported outcomes in diabetes research and practice: recommendations from a national workshop. Diabetes Res Clin Pract. 2019;153:23–9. https://doi.org/10.1016/j.diabres.2019.05.016.

    Article  PubMed  Google Scholar 

  9. Saisho Y. Use of diabetes treatment satisfaction questionnaire in diabetes care: importance of patient-reported outcomes. Int J Environ Res Public Health. 2018;15(5):947. https://doi.org/10.3390/ijerph15050947.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Muhammad Haskani NH, Goh HP, Wee DV, Hermansyah A, Goh KW, Ming LC. Medication knowledge and adherence in type 2 diabetes mellitus patients in Brunei Darussalam: a pioneer study in Brunei Darussalam. Int J Environ Res Public Health. 2022;19(12):7470. https://doi.org/10.3390/ijerph19127470.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Cani CG, Lopes LD, Queiroz M, Nery M. Improvement in medication adherence and self-management of diabetes with a clinical pharmacy program: a randomized controlled trial in patients with type 2 diabetes undergoing insulin therapy at a teaching hospital. Clinics. 2015;70(2):102–6. https://doi.org/10.6061/clinics/2015(02)06.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Negarandeh R, Mahmoodi H, Noktehdan H, Heshmat R, Shakibazadeh E. Teach back and pictorial image educational strategies on knowledge about diabetes and medication/dietary adherence among low health literate patients with type 2 diabetes. Prim Care Diabetes. 2013;7(2):111–8. https://doi.org/10.1016/j.pcd.2012.11.001.

    Article  PubMed  Google Scholar 

  13. AlRuthia Y, Almalag H, Sales I, Albassam AA, Alharbi FA, Almutairi AM, et al. The relationship between trust in primary care physicians and medication knowledge among diabetic patients. Res Social Adm Pharm. 2019;15(6):656–61. https://doi.org/10.1016/j.sapharm.2018.08.004.

    Article  PubMed  Google Scholar 

  14. Lee YY, Lin JL. The effects of trust in physician on self-efficacy, adherence and diabetes outcomes. Soc Sci Med. 2009;68(6):1060–8. https://doi.org/10.1016/j.socscimed.2008.12.033.

    Article  PubMed  Google Scholar 

  15. Dawson B, Trapp RG. Basic and clinical biostatistics. 4th ed. Philadelphia: McGraw-Hill Medical; 2004.

    Google Scholar 

  16. American Diabetes Association. Standards of medical care in diabetes—2020 abridged for primary care providers. Clin Diabetes. 2020;38(1):10–38. https://doi.org/10.2337/cd20-as01.

    Article  PubMed Central  Google Scholar 

  17. Bradley CL. The diabetes treatment satisfaction questionnaire: DTSQ. In: Handbook of psychology and diabetes: a guide to psychological measurement in diabetes research and practice. Chur, Switzerland: Harwood Academic Publishers 1994;pp. 111–132.

  18. Wilbur K, Al Hammaq AO. Validation of an Arabic version of the diabetes treatment satisfaction questionnaire in Qatar. Diabetes Res Clin Pract. 2016;113:53–9. https://doi.org/10.1016/j.diabres.2015.12.005.

    Article  PubMed  Google Scholar 

  19. Bova C, Route PS, Fennie K, Ettinger W, Manchester GW, Weinstein B. Measuring patient–provider trust in a primary care population: refinement of the health care relationship trust scale. Res Nurs Health. 2012;35(4):397–408. https://doi.org/10.1002/nur.21484.

    Article  PubMed  Google Scholar 

  20. Morisky DE, Ang A, Krousel-Wood M, Ward HJ. Predictive validity of a medication adherence measure in an outpatient setting. J Clin Hypertens (Greenwich). 2008;10(5):348–54. https://doi.org/10.1111/j.1751-7176.2008.07572.x.

    Article  PubMed  Google Scholar 

  21. Ashur ST, Shamsuddin K, Shah SA, Bosseri S, Morisky DE. Reliability and known-group validity of the Arabic version of the 8-item Morisky Medication Adherence Scale among type 2 diabetes mellitus patients. East Mediterr Health J. 2015;21(10):722–8. https://doi.org/10.26719/2015.21.10.722.

    Article  PubMed  CAS  Google Scholar 

  22. Burge S, White D, Bajorek E, Bazaldua O, Trevino J, Albright T, et al. Correlates of medication knowledge and adherence: findings from the Residency Research Network of South Texas. Fam Med. 2005;37(10):712–8.

    PubMed  Google Scholar 

  23. BMJ Publishing Group. Correlation and regression. http://www.bmj.com/about-bmj/resources-readers/publications/statistics-square-one/11-correlation-and-regression (2022). Accessed 5 Aug 2023.

  24. DePablos-Velasco P, Salguero-Chaves E, Mata-Poyo J, DeRivas-Otero B, García-Sánchez R, Viguera-Ester P. Quality of life and satisfaction with treatment in subjects with type 2 diabetes: results in Spain of the PANORAMA study. Endocrinol Nutr. 2014;61(1):18–26. https://doi.org/10.1016/j.endonu.2013.05.005.

    Article  PubMed  Google Scholar 

  25. Bener A, Al-Hamaq AO, Yousafzai MT, Abdul-Ghani M. Relationship between patient satisfactions with diabetes care and treatment. Niger J Clin Pract. 2014;17(2):218–25. https://doi.org/10.4103/1119-3077.127562.

    Article  PubMed  CAS  Google Scholar 

  26. Redekop WK, Koopmanschap MA, Stolk RP, Rutten GE, Wolffenbuttel BH, Niessen LW. Health-related quality of life and treatment satisfaction in Dutch patients with type 2 diabetes. Diabetes Care. 2002;25(3):458–63. https://doi.org/10.2337/diacare.25.3.458.

    Article  PubMed  Google Scholar 

  27. Biderman A, Noff E, Harris SB, Friedman N, Levy A. Treatment satisfaction of diabetic patients: what are the contributing factors? Fam Pract. 2009;26(2):102–8. https://doi.org/10.1093/fampra/cmp007.

    Article  PubMed  Google Scholar 

  28. Saudi RA, Abbas RA, Nour-Eldein H, Sayed Ahmed HA. Illness perception, medication adherence and glycemic control among primary health-care patients with type 2 diabetes mellitus at Port Said City, Egypt. Diabetol Int. 2022;13(3):522–30. https://doi.org/10.1007/s13340-021-00567-6.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Iglay K, Cartier SE, Rosen VM, Zarotsky V, Rajpathak SN, Radican L, et al. Meta-analysis of studies examining medication adherence, persistence, and discontinuation of oral antihyperglycemic agents in type 2 diabetes. Curr Med Res Opin. 2015;31(7):1283–96. https://doi.org/10.1185/03007995.2015.1053048.

    Article  PubMed  CAS  Google Scholar 

  30. Baser O, Tangirala K, Wei W, Xie L. Real-world outcomes of initiating insulin glargine-based treatment versus premixed analog insulins among US patients with type 2 diabetes failing oral antidiabetic drugs. Clinicoecon Outcomes Res. 2013;5:497–505. https://doi.org/10.2147/CEOR.S49279.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Jaam M, Awaisu A, Ibrahim MI, Kheir N. A holistic conceptual framework model to describe medication adherence in and guide interventions in diabetes mellitus. Res Social Adm Pharm. 2018;14(4):391–7. https://doi.org/10.1016/j.sapharm.2017.05.003.

    Article  PubMed  Google Scholar 

  32. Halepian L, Saleh MB, Hallit S, Khabbaz LR. Adherence to insulin, emotional distress, and trust in physician among patients with diabetes: a cross-sectional study. Diabetes Ther. 2018;9(2):713–26. https://doi.org/10.1007/s13300-018-0389-1.

    Article  PubMed  PubMed Central  Google Scholar 

  33. White RO, Osborn CY, Gebretsadik T, Kripalani S, Rothman RL. Health literacy, physician trust, and diabetes-related self-care activities in Hispanics with limited resources. J Health Care Poor Underserved. 2013;24(4):1756–68. https://doi.org/10.1353/hpu.2013.0177.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Hill-Briggs F, Adler NE, Berkowitz SA, Chin MH, Gary-Webb TL, Navas-Acien A, et al. Social determinants of health and diabetes: a scientific review. Diabetes Care. 2021;44(1):258–79. https://doi.org/10.2337/dci20-0053.

    Article  Google Scholar 

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Acknowledgements

Deepest appreciation for the PHC patients with T2DM who participated in this study.

Funding

This research did not receive external funding.

Author information

Author notes

  1. Hazem A. Sayed Ahmed, Nada Emad Abdelsalam, and Anwar I. Joudeh contributed equally to this work and share the first authorship.

Authors and Affiliations

  1. Department of Family Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt

    Hazem A. Sayed Ahmed, Ahmed Gharib Abdelrahman & Nahed Amen Eldahshan

  2. Primary Health Care, Ministry of Health and Population, Port Said, Egypt

    Nada Emad Abdelsalam

  3. Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar

    Anwar I. Joudeh

  4. Department of Internal Medicine, Faculty of Medicine, University of Jordan, Amman, Jordan

    Anwar I. Joudeh

Authors
  1. Hazem A. Sayed Ahmed
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  3. Anwar I. Joudeh
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  4. Ahmed Gharib Abdelrahman
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  5. Nahed Amen Eldahshan
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Contributions

All authors contributed to the study’s conception, and design. NEA collected the data and HASA analyzed these data. The first draft of the manuscript was written by HASA and AIJ. HASA, NEA, and AIJ contributed equally to this work and share the first authorship. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Hazem A. Sayed Ahmed.

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Conflict of interest

The authors declare no conflict of interest.

Ethical approval

The study was approved by the Research Ethics Committee at the Faculty of Medicine, Suez Canal University, Ismailia, Egypt (Reference number 4099/2020, dated 17/2/2020). Informed consent was obtained from the participants before enrollment in the study.

Human rights statement

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and the Helsinki Declaration of 1964 and later versions.

Informed consent

Informed consent was obtained from all patients for being included in the study.

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Sayed Ahmed, H.A., Abdelsalam, N.E., Joudeh, A.I. et al. Association of treatment satisfaction and physician trust with glycemic control among primary care patients with type 2 diabetes in Egypt. Diabetol Int 15, 67–75 (2024). https://doi.org/10.1007/s13340-023-00653-x

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  • DOI: https://doi.org/10.1007/s13340-023-00653-x

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