Self-Management Practices Among Type 2 Diabetes Patients Attending Physicians And Pharmacists: An Exploratory Study From Lahore, Pakistan

Background: Globally, Pakistan is among the top 10 countries in terms of the proportion of the population living with diabetes. Type 2 diabetes cannot be cured permanently, but complications and premature deaths can be prevented by adopting healthy lifestyles. Self-management is the key to controlling diabetes. Besides rational therapeutic approaches, patient counseling by physicians and pharmacists is crucial because self-management practices are generally influenced by the patient's knowledge of their disease.Objectives: The objectives of this study were to explore self-management practices among type 2 diabetes patients visiting physicians and pharmacists, and to assess the differences in the self-management practices of patients who visit physicians and those who visit pharmacists concerning type 2 diabetes in the past two years.Methods: This exploratory study recruited 363 established type 2 diabetes patients using a simple random sampling technique. The patients had consulted either a physician or pharmacist (but not both) over the past two years in relation to their type 2 diabetes, and physically visited a branch of a private-chain retail pharmacy in Lahore, Pakistan. Face-to-face interviews and structured questionnaires with a few open-ended questions were adopted as methods of data collection, focusing on socio-demographic and clinical factors, and the standard self-management practices of patients. Data were analyzed using frequencies, percentages, means and standard deviations. The difference between categorical variables, i.e. self-management practices and visits to healthcare professionals, were determined using chi-square tests.Results: The results showed that none of the standard diabetes self-management practices were fully adhered to by the patients. The use of the HbA1C test to monitor diabetes was the least used test among diabetic patients visiting a physician (29.60%) or pharmacist (25.70%). Patients visiting pharmacists adhered to medication use (88.50%, p<0.001), eating a well-balanced diet (75.22%, p=0.050), blood glucose level check (88.50%, p<0.001) and regular blood pressure monitoring (81.42%, p<0.001), whereas patients visiting physicians adhered better to daily feet checking (69.20%, p<0.001) and regular exercise (74.80%, p<0.001).Conclusions: Our study indicates that there is a significant fluctuation in adherence to key self-management practices among type 2 diabetes patients who visit physicians and those who visit pharmacists. Increasing the numbers of pharmacists in the healthcare system who have a special focus on diabetes may improve self-management practices among diabetic patients.