The Relationship between Education Level and TherapeuticOutcomes of Patients using Metformin alone and in Combinationin Ambon City

Abstract

Diabetes mellitus (DM) is a chronic disease caused by problems with the pancreas to produce sufficient amounts of insulin or the body cannot use the insulin it produces properly. Socio-demographic variables such as education level, age, gender, socioeconomic such as employment and medical costs, and frequency and amount of medication are some of the factors that can affect a patient's adherence to taking medication. By knowing these factors, people at risk of developing diabetes can take preventive measures by controlling other factors related to diabetes.
The purpose of the study was to evaluate the effect of DMT2 patients' education level on adherence in the use of single and combination metformin drugs, analyze differences in therapeutic outcomes, find out what factors affect therapeutic outcomes and analyze the patient's quality of life.
Methods: This study involved 300 DM respondents using a cross-sectional approach that met the inclusion criteria. Data were collected through the MMAS-8 questionnaire (Morisky 8-item drug adherence scale) and EQ-5D Value set Indonesia, and were equipped with medical records. Then the Chi-Square test was used to see the relationship between education level and compliance, the Mann-Whitney non- parametric test to analyze the difference in therapeutic outcomes with the type of therapy and to see the relationship between the patient's quality of life and the type of therapy, and the Cox Regression test to determine the factors that determine the level of education to the therapeutic outcome.
The results showed the relationship between education level and patient compliance (p value = 0.291), the difference in therapy results with the type of therapy in the final GDP group that was treated using single and combination metformin (p=0.013 value) while in the Cholesterol group (p=0.036 value). Determinants of education level on therapeutic outcomes for elementary school (p=0.214), junior high school (p=0.428), high school (p=0.789), high compliance (p=0.665), moderate compliance (p=0.136), type of therapy (p=0.624), Age (p=0.085), Male (p=0.948), Female (p=0.959), Private Worker (p=0.830), Entrepreneur (p=0.330), Civil servants (p= 0.499), as well as the relationship between quality of life and the type of therapy (p=0.300).
Conclusions: There was no significant relationship between education levels and patient compliance. The difference in therapy outcomes with the type of therapy in patients from the final GDP and cholesterol therapy outcomes group was significant. There was no significant relationship between the quality of life and the determinants of the treatment outcome were not significant.