Health literacy and self-care among Malaysian with type 2 diabetes: patients’ and pharmacists’ perspectives
- At: PPR 2022 (2022)
- Type: Poster
- Poster code: PM-02
- By: AHMAD AZHARI, Azrina Ely (University of Nottingham Malaysia)
- Co-author(s): Azrina Ely Ahmad Azhari, Phd Student, University of Nottingham Malaysia, Malaysia
Jim Chai, Assistant Professor, University of Nottingham, United Kingdom
Claire Anderson, Professor
Introduction: Diabetes is a chronic metabolic disorder which is associated with high blood glucose. In Malaysia, 1 in 5 adults are diagnosed with diabetes. Limited health literacy among diabetes patients may result in poor self-care management and diabetes outcome. Pharmacists play a major role in patient education especially on medication adherence and diabetes self-care as they are easily accessible to the public. The accessibility of pharmacy services to the public may aid diabetes patients with health literacy challenges getting advice and support they need in empowering self-care.
Objectives: This exploratory qualitative study examined both patients’ and pharmacists’ perceptions of the knowledge of diabetes and management, and what empowers pre-diabetes and newly diagnosed T2D (≤ 5 years) patients to practise self-care and how pharmacists interact and communicate with individual patients to promote self-care in preventing disease progression.
Methods: 22 patients (18 newly diagnosed and 4 pre-diabetes) and 12 pharmacists (2; public clinic, 6; community pharmacy and 4; hospital pharmacy) were recruited through purposive sampling. 9 patients were recruited from two public clinics and 13 from online posting on social media platforms. 7 patients were individually interviewed using semi-structured interview via Microsoft Teams, while the rest were interviewed via telephone calls. All pharmacists were recruited through online posting on Facebook or instant messaging application, WhatsApp. 3 pharmacists attended a virtual focus group, while the rest were interviewed individually on Microsoft Teams. All interviews and focus group were audio-recorded, translated to English language and transcribed verbatim. NVivo software was used for data analysis and data obtained were coded and categorised into themes using reflexive thematic analysis.
Results: Four themes were identified as empowerment to patient self-care: accessibility to reliable resources, mental health, self-awareness and overcoming the barriers to self-care. Having sufficient access to reliable resources, continuous support from family, peer and healthcare professionals (HCPs), a good understanding about their diabetes, and overcoming the barriers to self-care such as lack of support, difficulty finding information and having the thought that self-care is hard are important in empowering self-care. For pharmacists, four themes were identified to promote self-care: pharmacist’s roles in diabetes care, ways to empower self-care, multidisciplinary team approach and continuing pharmacist’s education. The themes identified from patients and pharmacists can be linked to further empower self-care. Pharmacists are easily accessible and thus a reliable source of information and are capable to provide different services like blood glucose monitoring and patient education using literacy-sensitive techniques. Working together with other HCPs is crucial to provide direct care to tackle complex needs of diabetes patients. Continuing pharmacist’s education on health literacy to enhance communication strategies used for patients with different levels of health literacy is also needed.
Conclusion: With sufficient access to health services, information and support, diabetes patients may be empowered to practise self-care. Managing low health literacy is also crucial to increase patient’s knowledge and self-awareness in preventing diabetes complications. With the accessibility of pharmacists especially in the community to the public, they could be the big players in self-care education.