The Relationship Between Health Literacy and Rational Drug Use in Individuals with Diabetes

Year 2020, , 214 - 223, 29.12.2020

Türkan Akyol Güner , Ayşe Kuzu , Taner Bayraktaroğlu

https://doi.org/10.25048/tudod.775075

Cited By: 11

Abstract

Aim: Health literacy is very important to manage a chronic disease effectively. This study was conducted to examine the relationship
between health literacy and rational drug use in individuals with diabetes.
Material and Methods: This descriptive and cross-sectional study was conducted on 220 diabetic individuals/patients who met the
criteria and volunteered to participate between January 24 and March 5 2020 in Zonguldak Diabetes Association located in Zonguldak.
The data were collected by face-to-face interview technique through the socio-demographic and health characteristics form, Turkish
Health Literacy Scale (THLS-32) and Rational Drug Use Scale.
Results: The Health Literacy Scale (THLS-32) average score of individuals with diabetes was found 22.89±13.76; The Rational Drug Use
Scale score average was found 31.30±8.85 and it was determined that both health literacy and rational drug use levels were low. When
the health literacy and rational drug use levels of the participants were compared according to their socio-demographic characteristics,
it has been determined that there is a statistically significant difference in health literacy and rational drug use levels according to
gender, age, education, marital status and income (p<0.001). When the health literacy and rational drug use levels of individuals with
diabetes were compared according to their health characteristics; it was observed that there were statistically significant differences
according to the duration of diabetes diagnosis, other chronic disease status, regular physician control, diabetes education or training
requirement, regular drug use and non-prescription drug use (p<0.001). When the relationship between health literacy and rational
drug use in individuals with diabetes was examined, it was determined that there was a positive and highly significant relationship
(r=0.827; p<0.001).
Conclusion: It was determined that the health literacy level and rational drug use level of individuals with diabetes were insufficient.
Since it is known that rational drug use and treatment compliance will be easier with a sufficient level of health literacy, individuals with
diabetes should be supported in improving their health literacy level.

Keywords

Diabetes, Health literacy, Rational drug use

Diyabetli Bireylerde Sağlık Okuryazarlığı ve Akılcı İlaç Kullanımı Arasındaki İlişki

Abstract

Amaç: Sağlık okuryazarlığı, kronik hastalık yönetiminin etkili yapılabilmesi için oldukça önemlidir. Bu çalışma, diyabetli bireylerde
sağlık okuryazarlığı ve akılcı ilaç kullanımı arasındaki ilişkiyi incelemek amacıyla yapılmıştır.
Gereç ve Yöntemler: Tanımlayıcı ve kesitsel tipteki bu çalışma, 24 Ocak - 5 Mart 2020 tarihleri arasında Zonguldak Merkez’de
bulunan Zonguldak Diyabet Derneği’nde dahil edilme kriterlerini karşılayan ve çalışmaya katılmaya gönüllü 220 diyabetli birey ile
tamamlanmıştır. Çalışmanın verileri, sosyo-demografik ve sağlığa ilişkin özellikler formu, Türkiye Sağlık Okuryazarlığı Ölçeği (TSYO-
32) ve Akılcı İlaç Kullanımı Ölçeği ile yüz yüze görüşme yöntemiyle toplanmıştır.
Bulgular: Diyabetli bireylerin Sağlık Okuryazarlığı Ölçeği (TSOY-32) puan ortalaması 22,89±13,76 olarak; Akılcı İlaç Kullanım
Ölçeği puan ortalaması ise 31,30±8,85 olarak bulunmuş ve düşük seviyelerde olduğu belirlenmiştir. Katılımcıların sosyo-demografik
özelliklerine göre sağlık okuryazarlığı ve akılcı ilaç kullanım düzeylerinin karşılaştırılması yapıldığında; cinsiyetine, yaşına, eğitim
durumuna, medeni durumuna ve gelir durumuna göre sağlık okuryazarlığı ve akılcı ilaç kullanım düzeylerinin istatistiksel olarak
anlamlı farklılık gösterdiği belirlenmiştir (p<0,001). Diyabetli bireylerin sağlık ile ilgili özelliklerine göre sağlık okuryazarlığı ve akılcı
ilaç kullanım düzeylerinin karşılaştırılması yapıldığında ise; diyabet tanı süresine, başka kronik hastalık durumuna, düzenli doktor
kontrolüne, diyabet eğitimi alma ve eğitim gereksinimi durumuna, ilaçlarını düzenli alma ve reçete dışı ilaç kullanma durumuna göre
istatistiksel olarak anlamlı farklılıklar gösterdiği görülmüştür (p<0,001). Diyabetli bireylerde sağlık okuryazarlığı ile akılcı ilaç kullanımı
düzeyleri arasındaki ilişki incelendiğinde ise pozitif yönlü ve yüksek düzeyde anlamlı bir ilişki olduğu belirlenmiştir (r=0,827; p<0,001).
Sonuç: Diyabetli bireylerin sağlık okuryazarlık düzeyinin ve akılcı ilaç kullanımın yetersiz düzeyde olduğu belirlenmiştir. Sağlık
okuryazarlık düzeyinin yeterli olması ile akılcı ilaç kullanımı ve tedavi uyumunun sağlanmasının daha kolay olacağı bilindiğinden,
diyabetli bireyler sağlık okuryazarlık düzeylerinin geliştirilmesi konusunda desteklenmelidir.

Keywords

Sağlık okuryazarlığı, Diyabet, Akılcı İlaç Kullanımı

References

• KAYNAKLAR 1. Papadakos JK, Hasan SM, Barnsley J. et al., Health literacy and cancer selfmanagement behaviors: a scoping review, Cancer 2018;124:4202–4210.
• 2. Poureslami I, Nimmon L, Rootman I, Fitzgerald MJ. Priorities for action: recommendations from an international roundtable on health literacy and chronic disease management, Health Promot. Int. 2017;32:743–754.
• 3. Van der Heide I, Poureslami I, Mitic W, Shum J, Rootman I, FitzGerald JM. Health literacy in chronic disease management: a matter of interaction, J. Clin. Epidemiol. 2018;102:134–138.
• 4. Hussein SH, Almajran A, Albatineh AN. Prevalence of health literacy and its correlates among patients with type II diabetes in Kuwait: a population based study, Diabetes Res. Clin. Pract. 2018;141:118–125.
• 5. Luckenbaugh AN, Moses KA. The impact of health literacy on urologic oncology care, Urol. Oncol.2019;19:1078–1439.
• 6. Mackey LM, Doody C, Werner, EL, Fullen B. Self-management skills in chronic disease management: what role does health literacy have? Med. Decis. Making. 2016; 36:741–759.
• 7. Yilmazel G, Cetinkaya F. Health literacy among schoolteachers in Corum, Turkey | East. Mediterr. Health J. 2015;21:598–605.
• 8. Bazm R, Sardari F. Growth of health literacy research activity in three Middle Eastern countries, BMJ Health Care Inform. 2019;26:e000027.
• 9. Deniz SS¸ Özer Ö, Songur C. Effect of health literacy on health perception: an application in ındividuals at age 65 and older, Soc. Work Public Health. 2018;33:85–95.
• 10. Tanrıöver M, Yıldırım H, Ready FND, Cakır B, Akalın E. Turkey Health Literacy Survey 2014; http://www.sagliksen.org.tr. Accessed:13.05.2020.
• 11. Sorensen K, Pelikan JM, Röthlin F. et al. Health literacy in Europe: comparative results ofthe European health literacy survey (HLS-EU), Eur. J. Public Health. 2015; 25:1053–1058.
• 12. International Diabetes Federation (IDF) Diabetes Atlas. 9th ed. 2019; Erişim:https://www.diabetesatlas.org/. Alıntı:10.05.2020.
• 13. International Diabetes Federation (IDF) Diabetes Atlas, 1th ed. 2000; Erişim:http://www.idf.org/webdata/docs/Diabetes%20Atlas%20Executive %20Summary.pdf. Alıntı:10.05.2020.
• 14. Satman I, Omer B, Tutuncu Y, Kalaca S, Gedik S, Dinccag N, Karsidag K, Genc S, Telci A, Canbaz B,Turker F, Yilmaz T, Cakir B, Tuomilehto J. TURDEP-II Study Group. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. European Journal of Epidemiology. 2013;28:169-180.
• 15. American Diabetes Association Standards of medical care in diabetes. Diabetes Care. 2013; 36:11–66.
• 16. American Diabetes Association. Microvascular complications and foot care. Diabetes Care. 2016;39:72-80.
• 17. Singh S, Acharya SD, Kamath A, Ullal SD, Urval RP. Health literacy status and understanding of the prescription ınstructions in diabetic patients, J. Diabetes Res. 2018: 1–5.
• 18. Sorensen K, Van Den Broucke S, Fullam J, Doyle G, Pelikan J, Slonska Z. (HLS EU) Consortium, Health Literacy Project European, Health literacy and public health: a systematic review and integration of definitions and models, BMC Public Health 2012;12:1–13.
• 19. Nutbeam D. Health Promotion Glossary. Health Promotion International 1998;13:349-364.
• 20. Centers for Disease Control and Prevention (CDC). Learn about health literacy. Erişim: http://www.cdc.gov/healthliteracy/learn/index. html. Alıntı:18.05.2020.
• 21. Ilhan N. et al. Health literacy and diabetes self-care in individuals with type 2 diabetes in Turkey, Prim. Care Diab. 2020.
• 22. Fernández-Silva MJ, Alonso-González A, González-Pérez E, Gestal-Otero JJ, Díaz-Grávalos GJ. Health literacy in patients with type 2 diabetes: a crosssectional study using the HLS-EU-Q47 questionnaire, Semergen. 2019;45:30–36.
• 23. Niknami M, Mirbalouchzehi A, Zareban I, Kalkalinia E, Rikhtgarha G, Hosseinzadeh H. Association of health literacy with type 2 diabetes mellitus selfmanagement and clinical outcomes within the primary care setting of Iran, Aust.J. Prim.Health. 2018;24:162–170.
• 24. Bohanny W, Wu SF, Liu CY, Yeh SH, Tsay SL, Wang TJ. Health literacy, self‐efficacy, and self‐care behaviors in patients with type 2 diabetes mellitus. J Am Assoc Nurse Pract. 2013;25:495-502.
• 25. Bailey SC, Brega AG, Crutchfield TM, Elasy T, Herr H, Kaphingst K, et al. Update on health literacy and diabetes. Diabetes Educ. 2014;40:581-604.
• 26. Al Sayah F, Majumdar SR, Williams B, Robertson S, Johnson JA. Health literacy and health outcomes in diabetes: A systematic review. J Gen Intern Med. 2013;28:444-452.
• 27. Dahal PK, Hosseinzadeh H. Association of health literacy and diabetes selfmanagement: a systematic review, Aust. J. Prim. Health. 2019; 25:526–533.
• 28. Türkoglu C. Analyzing the Relationship between Health Literacy and Self-care Ability Level: the Case of Isparta, Master Thesis, Süleyman Demirel University Institute of Social Sciences, 2016.
• 29. Hussain N , Said Amira SA, Khan Z. Influence of Health Literacy on Medication Adherence Among Elderly Females With Type 2 Diabetes in Pakistan. 2019. https://doi.org/10.1177/0272684X19896724
• 30. Özonuk E, Yılmaz M, Relationship between health literacy and compliance with the treatment among ındividuals with type 2 diabetes mellitus, J. Educ. Res. Nurs. 2019;16:96–103.
• 31. Ho PM, Bryson CL, Rumsfeld JS. Medication Adherence: İts İmportance İn Cardiovascular Outcomes. Circulation, 2009;119:3028-3035.
• 32. World Health Organization (WHO), Promoting rational use of medicines: core components. WHO Policy Perspectives on Medicines no5. WHO, 2002; WHO/EDM/2002.3.Geneva, Alıntı: 10.05.2020.
• 33. World Health Organization WHO 2016; Erişim:http://www.who.int/medicines/areas/rational_ use/en/. Alıntı: 10.06.2020.
• 34. İlhan MN, Aydemir Ö, Çakır M, Aycan S. Akılcı olmayan ilaç kullanım davranışları: Ankara’da üç ilçe örneği. Türkiye Halk Sağlığı Dergisi 2014;12:188-200.
• 35. Uchenna O, Ijeoma E, Pauline E and Sylvester O. Contributory Factors to Diabetes Dietary Regimen NonAdherence in Adults with Diabetes. World Academy of Science, Engineering and Technology. 2010;45:735-742.
• 36. Jin J, Sklar GE, Oh VMS and Li SC. Factors Affecting Therapeutic Compliance: A Review From The Patient’s Perspective, Therapeutics and Clinical Risk Management, 2008;4:269–286.
• 37. Türkiye Diyabet Vakfı. 2010-2020 Ulusal Diyabet Stratejisi Sonuç Dokümanı. Erişim:http://www.tsn.org.tr/folders/file/Diyabet_2020_Sonuc_Dokumani.pdf. Alıntı: 05.05.2020.
• 38. Okyay P, Abacıgil, F. Türkiye Sağlık Okuryazarlığı Ölçekleri, Güvenilirlik ve Geçerlilik Çalışması. (1. Baskı). Ankara: Sağlık Bakanlığı Yayın No:1025, 2016;77-80.
• 39. Demirtaş Z, Dağtekin G, Sağlan R, Alaiye M, Önsüz MF, Işıklı B, et al. Akılcı İlaç Kullanımı Ölçeği Geçerlilik ve Güvenilirliği. ESTÜDAM Halk Sağlığı Dergisi. 2018;3:37-46.
• 40. Cavanaugh KL..Health literacy in diabetes care: explanation, evidence and equipment. Diabetes Manag (Lond). 2011;1:191–199.
• 41. Souza JG, Apolinario D, Magaldi RM, Busse AL, Campora F, Jacob-Filho W. Functional health literacy and glycaemic control in older adults with type 2 diabetes: A cross-sectional study. BMJ Open. 2014;4:e004180.
• 42. Cho YI, Lee SYD, Arozullah AM, Crittenden KS. Effects of health literacy on health status and health service utilization amongst the elderly. Soc Sci Med. 2008;66:1809-1816.
• 43. Morris NS, MacLean CD, Littenberg B. Change in Health literacy over 2 years in older adults with diabetes. Diabetes Educ. 2013;39:63846.
• 44. Ussher M, Ibrahim RS, Reid F, Swah A, Rowlands G. Psychosocial correlates of health literacy among older patients with coronary heart disease. J Health Commun. 2010;15:788-804.
• 45. Inoue M, Takahashi M, Kai I. Impact of communicative and critical health literacy on understanding of diabetes care and self-efficacy in diabetes management: Across-sectional study of primary care in Japan. BMC Fam Pract. 2013;14:1-9.
• 46. Watts SA, Stevenson C, Adams M. Improving health literacy in patients with diabetes. Nursing. 2017;47:24-31.
• 47. Abacıgil F, Gürsoy Turan S, Adana F, Okyay P, Demirci B. Rational Use of Drugs Among Inpatients and Its Association with Health Literacy. Meandros Med Dent J. 2019;20:64-73.
• 48. Singh D, Sawlani K K, Chaudhary S C, Kumar N, Sachan AK. Drug utilization study of drugs used in treatment of diabetes mellitus in medicine OPD of a tertiary care hospital in northern India. IP Int J Compr Adv Pharmacol. 2019;4:120-125.
• 49. Pereira Mendes LV , Luiza VL, Campos Rodrigues M. Rational Use of Medicines by Individuals With Diabetes Mellitus and Arterial Hypertension in the Municipality of Rio De Janeiro, Brazil. Cien Saude Colet. 2014;19:1673-1684.
• 50. Bian C, Xu S, Wang H, Li N, Wu J, Zhao Y et al. A study on the application of the information-motivation-behavioral skills (IMB) model on rational drug use behavior among second-level hospital outpatients in Anhui, China. Plos One. 2015;10:e0135782.
• 51. Shiyanbola OO, Unni E, Huang YM, Lanier C. The association of health literacy with illness perceptions, medication beliefs, and medication adherence among individuals with type 2 diabetes. Res Social Adm Pharm. 2018;14:824-830.
• 52. Fan JH, Lyons SA, Goodman MS, Blanchard MS, Kaphingst KA. Relationship Between Health Literacy and Unintentional and Intentional Medication Nonadherence in Medically Underserved Patients With Type 2 Diabetes. Diabetes Educ. 2016;42:199-208.
• 53. Lee YM, Yu HY, You, Son YJ. Impact of health literacy on medication adherence in older people with chronic diseases. Collegian. 2017;24:11-18.