Prevalence of diabetes distress and associated factors among patients with diabetes using antihypertensive medications in community health centres in Bandung City, Indonesia

Authors

  • Sofa Dewi Alfian Department of Pharmacology and Clinical Pharmacy, Universitas Padjadjaran, Faculty of Pharmacy; Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran
  • Imam A. Wicaksono Department of Pharmacology and Clinical Pharmacy, Universitas Padjadjaran, Faculty of Pharmacy; Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran
  • Norisca A. Putri Faculty of Pharmacy, Department of Pharmaceutics and Pharmaceutical Technology, Universitas Padjadjaran
  • Rizky Abdulah Department of Pharmacology and Clinical Pharmacy, Universitas Padjadjaran, Faculty of Pharmacy; Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran

DOI:

https://doi.org/10.12928/pharmaciana.v11i2.20094

Keywords:

diabetes distress, blood pressure–lowering medication, associated factors

Abstract

Diabetes distress is common among patients with type 2 diabetes mellitus (T2DM), which remains unrecognized in primary care settings. A higher level of diabetes distress was found among T2DM patients with comorbidities. The objectives of this study are to assess the prevalence rate of diabetes distress and its association with sociodemographic factors among T2DM patients using antihypertensive medication in Bandung City, Indonesia. An observational cross-sectional survey was performed in six community health centres in Bandung City, Indonesia, among T2DM patients aged at least 18 years who were using antihypertensive medications. Diabetes distress subscales (emotional, regimen, interpersonal, and physician-related distress) were evaluated using the validated Diabetes Distress Scale. Pearson χ2 and Mann–Whitney tests were performed to assess the associations of patients’ sociodemographic factors (age, gender, insurance type, education, and duration since diagnosed with diabetes and hypertension) with diabetes distress. Of 105 patients who participated and completed the survey (response rate 93.8%), most of them were female and were aged 60-69 years. A total of 38 patients (36.2%) had moderate-high diabetes distress with emotional (56.2%) and regimen (53.3%) distress as the most commonly reported distress. Moderate-high emotional and regimen diabetes distress were significantly higher among the elderly (p 0.014) and patients who could not afford to pay the health insurance premium (p 0.012). Emotional and regimen distress as dominant forms of diabetes distress was observed among T2DM patients using antihypertensive medications. A routine diabetes distress assessment is needed in T2DM patients with comorbidity in primary care settings.

References

Abdulbari Bener, A. O. A. A. A.-H. and E. E. D. (2011). High prevalence of depression, anxiety and stress symptoms among diabetes mellitus patients. The Open Psychiatry Journal, 5, 5–12

Almeda, J. ., Capistrano, T. ., & Sarte, G. . (2010). Elementary Statistic. University of The Philipines Press.

American Diabetes Association. (2019a). 5. Lifestyle management: Standards of medical care in diabetesd2019. Diabetes Care, 42(January), S46–S60. https://doi.org/10.2337/dc19-S005

American Diabetes Association. (2019b). Standards of Medical Care in. Clinical Diabetes Journal, 42, 1–194

Arifin, B., Perwitasari, D. A., Thobari, J. A., Cao, Q., Krabbe, P. F. M., & Postma, M. J. (2017). Translation, Revision, and Validation of the Diabetes Distress Scale for Indonesian Type 2 Diabetic Outpatients with Various Types of Complications. In Value in Health Regional Issues (Vol. 12, pp. 63–73). https://doi.org/10.1016/j.vhri.2017.03.010

Arifin, B., van Asselt, A. D. I., Setiawan, D., Atthobari, J., Postma, M. J., & Cao, Q. (2019). Diabetes distress in Indonesian patients with type 2 diabetes: a comparison between primary and tertiary care. BMC Health Services Research, 19(1), 773. https://doi.org/10.1186/s12913-019-4515-1

Baek, R. N., Tanenbaum, M. L., & Gonzalez, J. S. (2014). Diabetes Burden and Diabetes Distress: the Buffering Effect of Social Support. Annals of Behavioral Medicine, 48(2), 145–155. https://doi.org/10.1007/s12160-013-9585-4

Bruno, B. A., Choi, D., Thorpe, K. E., & Yu, C. H. (2019). Relationship among diabetes distress, decisional conflict, quality of life, and patient perception of chronic illness care in a cohort of patients with type 2 diabetes and other comorbidities. Diabetes Care, 42(7), 1170–1177. https://doi.org/10.2337/dc18-1256

Carls, G., Huynh, J., Tuttle, E., Yee, J., & Edelman, S. V. (2017). Achievement of Glycated Hemoglobin Goals in the US Remains Unchanged Through 2014. Diabetes Therapy, 8(4), 863–873. https://doi.org/10.1007/s13300-017-0280-5

Chew, B. H., Mohd-Sidik, S., & Shariff-Ghazali, S. (2015). Negative effects of diabetes-related distress on health-related quality of life: An evaluation among the adult patients with type 2 diabetes mellitus in three primary healthcare clinics in Malaysia. Health and Quality of Life Outcomes, 13(1). https://doi.org/10.1186/s12955-015-0384-4

Chew, B. H., Vos, R., Mohd-Sidik, S., & Rutten, G. E. H. M. (2016). Diabetes-Related distress, depression and Distress-Depression among adults with type 2 diabetes mellitus in Malaysia. PLoS ONE, 11(3), 1–16. https://doi.org/10.1371/journal.pone.0152095

Chipidza, F. E., Wallwork, R. S., & Stern, T. A. (2015). Impact of the doctor-patient relationship. Primary Care Companion to the Journal of Clinical Psychiatry, 17(5), 360. https://doi.org/10.4088/PCC.15f01840

Dennick, K., Sturt, J., Hessler, D., Purssell, E., Hunter, B., Oliver, J., & Fisher, L. (2015). High rates of elevated diabetes distress in research populations: A systematic review and meta-analysis. International Diabetes Nursing, 12(3), 93–107. https://doi.org/10.1080/20573316.2016.1202497

Emre, N., Topal, K., Edirne, T., & Gereklioğlu, Ç. (2018). Factors affecting risk of anxiety and depression among diabetic and hypertensive patients who refer to family health centers. International Journal of Diabetes in Developing Countries, 38(3), 305–311. https://doi.org/10.1007/s13410-017-0592-z

Interntional Diabetes Federation. (2017). IDF Diabetes Atlas. https://www.bing.com/search?q=International+Diabetes+Federation+(IDF).+(2017).+IDF+Diabetes+Atlas.+Retrieved+from+http%3A%2F%2Fwww.diabetesatlas.org%2Fresources%2F2017-atlas.html&cvid=df501fbc7d1249f69cfae68e1c8be7aa&aqs=edge..69i57.1093j0j1&pglt=2083&FOR

Fisher, E. B., Thorpe, C. T., Devellis, B. M. E., & Devellis, R. F. (2007). Healthy coping, negative emotions, and diabetes management: A systematic review and appraisal. Diabetes Educator, 33(6), 1080–1103. https://doi.org/10.1177/0145721707309808

Fisher, L., Hessler, D. M., Polonsky, W. H., & Mullan, J. (2012). When is diabetes distress clinically meaningful? Establishing cut points for the diabetes distress scale. Diabetes Care, 35(2), 259–264. https://doi.org/10.2337/dc11-1572

Fisher, L., Mullan, J. T., Arean, P., Glasgow, R. E., Hessler, D., & Masharani, U. (2010). Diabetes distress but not clinical depression or depressive symptoms is associated with glycemic control in both cross-sectional and longitudinal analyses. Diabetes Care, 33(1), 23–28. https://doi.org/10.2337/dc09-1238

Fisher, L., Mullan, J. T., Skaff, M. M., Glasgow, R. E., Arean, P., & Hessler, D. (2009). Predicting diabetes distress in patients with Type 2 diabetes: A longitudinal study. Diabetic Medicine, 26(6), 622–627. https://doi.org/10.1111/j.1464-5491.2009.02730.x

Abdulbari Bener, A. O. A. A. A.-H. and E. E. D. (2011). High prevalence of depression, anxiety and stress symptoms among diabetes mellitus patients. The Open Psychiatry Journal, 5, 5–12

Almeda, J. ., Capistrano, T. ., & Sarte, G. . (2010). Elementary Statistic. University of The Philipines Press.

American Diabetes Association. (2019a). 5. Lifestyle management: Standards of medical care in diabetesd2019. Diabetes Care, 42(January), S46–S60. https://doi.org/10.2337/dc19-S005

American Diabetes Association. (2019b). Standards of Medical Care in. Clinical Diabetes Journal, 42, 1–194

Arifin, B., Perwitasari, D. A., Thobari, J. A., Cao, Q., Krabbe, P. F. M., & Postma, M. J. (2017). Translation, Revision, and Validation of the Diabetes Distress Scale for Indonesian Type 2 Diabetic Outpatients with Various Types of Complications. In Value in Health Regional Issues (Vol. 12, pp. 63–73). https://doi.org/10.1016/j.vhri.2017.03.010

Arifin, B., van Asselt, A. D. I., Setiawan, D., Atthobari, J., Postma, M. J., & Cao, Q. (2019). Diabetes distress in Indonesian patients with type 2 diabetes: a comparison between primary and tertiary care. BMC Health Services Research, 19(1), 773. https://doi.org/10.1186/s12913-019-4515-1

Baek, R. N., Tanenbaum, M. L., & Gonzalez, J. S. (2014). Diabetes Burden and Diabetes Distress: the Buffering Effect of Social Support. Annals of Behavioral Medicine, 48(2), 145–155. https://doi.org/10.1007/s12160-013-9585-4

Bruno, B. A., Choi, D., Thorpe, K. E., & Yu, C. H. (2019). Relationship among diabetes distress, decisional conflict, quality of life, and patient perception of chronic illness care in a cohort of patients with type 2 diabetes and other comorbidities. Diabetes Care, 42(7), 1170–1177. https://doi.org/10.2337/dc18-1256

Carls, G., Huynh, J., Tuttle, E., Yee, J., & Edelman, S. V. (2017). Achievement of Glycated Hemoglobin Goals in the US Remains Unchanged Through 2014. Diabetes Therapy, 8(4), 863–873. https://doi.org/10.1007/s13300-017-0280-5

Chew, B. H., Mohd-Sidik, S., & Shariff-Ghazali, S. (2015). Negative effects of diabetes-related distress on health-related quality of life: An evaluation among the adult patients with type 2 diabetes mellitus in three primary healthcare clinics in Malaysia. Health and Quality of Life Outcomes, 13(1). https://doi.org/10.1186/s12955-015-0384-4

Chew, B. H., Vos, R., Mohd-Sidik, S., & Rutten, G. E. H. M. (2016). Diabetes-Related distress, depression and Distress-Depression among adults with type 2 diabetes mellitus in Malaysia. PLoS ONE, 11(3), 1–16. https://doi.org/10.1371/journal.pone.0152095

Chipidza, F. E., Wallwork, R. S., & Stern, T. A. (2015). Impact of the doctor-patient relationship. Primary Care Companion to the Journal of Clinical Psychiatry, 17(5), 360. https://doi.org/10.4088/PCC.15f01840

Dennick, K., Sturt, J., Hessler, D., Purssell, E., Hunter, B., Oliver, J., & Fisher, L. (2015). High rates of elevated diabetes distress in research populations: A systematic review and meta-analysis. International Diabetes Nursing, 12(3), 93–107. https://doi.org/10.1080/20573316.2016.1202497

Emre, N., Topal, K., Edirne, T., & Gereklioğlu, Ç. (2018). Factors affecting risk of anxiety and depression among diabetic and hypertensive patients who refer to family health centers. International Journal of Diabetes in Developing Countries, 38(3), 305–311. https://doi.org/10.1007/s13410-017-0592-z

Interntional Diabetes Federation. (2017). IDF Diabetes Atlas. https://www.bing.com/search?q=International+Diabetes+Federation+(IDF).+(2017).+IDF+Diabetes+Atlas.+Retrieved+from+http%3A%2F%2Fwww.diabetesatlas.org%2Fresources%2F2017-atlas.html&cvid=df501fbc7d1249f69cfae68e1c8be7aa&aqs=edge..69i57.1093j0j1&pglt=2083&FOR

Fisher, E. B., Thorpe, C. T., Devellis, B. M. E., & Devellis, R. F. (2007). Healthy coping, negative emotions, and diabetes management: A systematic review and appraisal. Diabetes Educator, 33(6), 1080–1103. https://doi.org/10.1177/0145721707309808

Fisher, L., Hessler, D. M., Polonsky, W. H., & Mullan, J. (2012). When is diabetes distress clinically meaningful? Establishing cut points for the diabetes distress scale. Diabetes Care, 35(2), 259–264. https://doi.org/10.2337/dc11-1572

Fisher, L., Mullan, J. T., Arean, P., Glasgow, R. E., Hessler, D., & Masharani, U. (2010). Diabetes distress but not clinical depression or depressive symptoms is associated with glycemic control in both cross-sectional and longitudinal analyses. Diabetes Care, 33(1), 23–28. https://doi.org/10.2337/dc09-1238

Fisher, L., Mullan, J. T., Skaff, M. M., Glasgow, R. E., Arean, P., & Hessler, D. (2009). Predicting diabetes distress in patients with Type 2 diabetes: A longitudinal study. Diabetic Medicine, 26(6), 622–627. https://doi.org/10.1111/j.1464-5491.2009.02730.x

Gahlan, D., Rajput, R., Gehlawat, P., & Gupta, R. (2018). Prevalence and determinants of diabetes distress in patients of diabetes mellitus in a tertiary care centre. Diabetes and Metabolic Syndrome: Clinical Research and Reviews, 12(3), 333–336. https://doi.org/10.1016/j.dsx.2017.12.024

Hannonen, R., Eklund, K., Tolvanen, A., Komulainen, J., Riikonen, R., Delamater, A. M., & Ahonen, T. (2015). Psychological distress of children with early-onset type 1 diabetes and their mothers’ well-being. Acta Paediatrica, International Journal of Paediatrics, 104(11), 1144–1149. https://doi.org/10.1111/apa.13144

Naicker, K., Johnson, J. A., Skogen, J. C., Manuel, D., Øverland, S., Sivertsen, B., & Colman, I. (2017). Type 2 diabetes and comorbid symptoms of depression and anxiety: Longitudinal associations with mortality risk. Diabetes Care, 40(3), 352–358. https://doi.org/10.2337/dc16-2018

Ogurtsova, K., da Rocha Fernandes, J. D., Huang, Y., Linnenkamp, U., Guariguata, L., Cho, N. H., Cavan, D., Shaw, J. E., & Makaroff, L. E. (2017). IDF Diabetes Atlas: Global estimates for the prevalence of diabetes for 2015 and 2040. Diabetes Research and Clinical Practice, 128, 40–50. https://doi.org/10.1016/j.diabres.2017.03.024

Polonsky, W. H., Fisher, L., Earles, J., James Dude, R., Lees, J., Mullan, J., & Jackson, R. A. (2005). Assessing Psychosocial Distress in. Diabetes Care, 28(3), 626–631

Rubin, R. R., & Peyrot, M. (1999). Quality of life and diabetes. Diabetes/Metabolism Research and Reviews, 15(3), 205–218. https://doi.org/10.1002/(SICI)1520-7560(199905/06)15:3<205::AID-DMRR29>3.0.CO;2-O

Sturt, J., Dennick, K., Hessler, D., Hunter, B. M., Oliver, J., & Fisher, L. (2015). Effective interventions for reducing diabetes distress: systematic review and meta-analysis. International Diabetes Nursing, 12(2), 40–55. https://doi.org/10.1179/2057332415y.0000000004

Wardian, J., & Sun, F. (2014). Factors Associated With Diabetes-Related Distress: Implications for Diabetes Self-Management. Social Work in Health Care, 53(4), 364–381. https://doi.org/10.1080/00981389.2014.884038

Zanchetta, F. C., Trevisan, D. D., Apolinario, P. P., Silva, J. B. da, & Lima, M. H. de M. (2016). Clinical and sociodemographic variables associated with diabetes-related distress in patients with type 2 diabetes mellitus. Einstein (Sao Paulo, Brazil), 14(3), 346–351. https://doi.org/10.1590/S1679-45082016AO3709

Downloads

Published

2021-07-30

Issue

Vol. 11 No. 2 (2021): Pharmaciana

Section

Clinical and Community Pharmacy

License

Authors who publish with Pharmaciana agree to the following terms:

  1. Authors retain copyright and grant the journal the right of first publication with the work simultaneously licensed under a Creative Commons Attribution License (CC BY-SA 4.0) that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal. 
  2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
  3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.