Journal of Preventive Medicine and Public Health

Systematic Reviews

Effective Education Methods to Improve Glycemic Control in Type 2 Diabetes Mellitus Patients: A Systematic Review: Ika Mustikaningtias, Anna Wahyuni Widayanti, Pugud Samodro, Nanang Munif Yasin; J Prev Med Public Health. 2025;58(5):453-464. Published online June 4, 2025; DOI: https://doi.org/10.3961/jpmph.25.025

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Objectives
Education for patients with type 2 diabetes mellitus (T2DM) is essential for reinforcing adherence and engagement to achieve therapeutic objectives, given the chronic nature of the treatment. Appropriate strategies for delivering education effectively are crucial. This study aimed to identify effective educational strategies for improving clinical outcomes in patients with T2DM.
Methods
The literature search included original publications from Science Direct, PubMed, and Scopus, published in English between 2015 and February 2024, for which full-text access was available. This review was performed by a team consisting of pharmacists and internist following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
Results
From the initial search yielding 105 articles, 17 met the inclusion criteria. Of these 17 studies, 9 demonstrated significant improvements in clinical outcomes. Not all studies incorporated control groups for comparative analysis during the implementation of educational interventions. Most interventions were delivered via direct face-to-face methods, although there was considerable variation across studies in terms of program duration, intervention frequency, session length, education providers, and educational content.
Conclusions
Studies demonstrating improvements in clinical outcomes predominantly utilized direct face-to-face education methods, typically in sessions lasting between 30 minutes and 60 minutes, with the majority of programs extending over approximately 6 months. Pharmacists contribute significantly to the success of educational programs by providing tailored instructional information that aligns with established protocols while addressing individual patient needs.

Summary

Key Message
This systematic review identifies appropriate educational delivery patterns for patients with Type 2 Diabetes Mellitus (T2DM). This article explores the educational delivery methods, the frequency and duration of educational delivery, the length of educational programs, the providers of education, and the content of education, all of which are associated with clinical outcomes. Education must be customized to the patient's needs, necessitating a two-way conversation to investigate their difficulties or the information they need. Moreover, standardized guidelines should be established to serve as a reference for educators in patient education.

Citations

Citations to this article as recorded by

Effectiveness of video-based home exercise program on physical activity and glycemic control in patients with type 2 diabetes mellitus
Asnuddin Asnuddin, Adillah Nurfatiyah, Sulaeman, Meriem Meisyaroh Syamson
Jurnal Ilmiah Kesehatan Sandi Husada.2026; 15(1): 60. CrossRef

Theory-Based Interventions to Improve Medication Adherence Among Patients With Hypertension in Primary Healthcare and the Community: A Systematic Review: Tri Yulianti, Anna Wahyuni Widayanti, Susi Ari Kristina, Nanang Munif Yasin; J Prev Med Public Health. 2025;58(4):348-359. Published online February 17, 2025; DOI: https://doi.org/10.3961/jpmph.24.651

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Abstract Summary PDF

Objectives
Numerous interventions have been implemented to enhance adherence to antihypertensive medications, yet only a few have utilized health behavioral theories. The research quality and efficacy of these theory-based studies remain undetermined. This systematic review aimed to provide a thorough description of research that employed health behavior theories to improve medication adherence in patients diagnosed with hypertension, particularly in primary healthcare and community settings.
Methods
PubMed and Scopus were searched for randomized clinical trials that employed health behavioral theories to improve medication adherence in patients with hypertension, published in English between 2013 and 2023. Data were extracted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The Joanna Briggs Institute critical appraisal tool was used to evaluate the risk of bias.
Results
Of the 446 studies initially identified, only 10 met the inclusion criteria and were included in this systematic review. Eight studies employed a single theory, and 2 applied a combination of theories, with Social Cognitive Theory and the Transtheoretical Model being the most predominant. Six trials demonstrated a notable enhancement in medication adherence, while 5 studies were assessed to have a high risk of bias.
Conclusions
Although not all studies employed a complete theoretical framework, the majority indicate that utilizing theory can enhance medication adherence.

Summary

Key Message
Developing complex interventions to improve medication adherence in hypertensive patients requires a theoretical framework to increase efficacy. Theoretical frameworks utilized included the predisposing, reinforcing, and enabling constructs in educational diagnosis and evaluation (PRECEDE) model, social cognitive theory (SCT), the transtheoretical model (TTM), motivational interviewing (MI), and information-motivation-behavioral (IMB) skills models as single or combination theories. Research studies applying theoretical frameworks frequently neglect to elucidate the rationale for selecting a specific theory and its underlying mechanisms. Still, most studies that applied theories have successfully enhanced medication adherence. Additional research with a rigorous design and theory is needed to improve medication adherence.

Citations

Citations to this article as recorded by

A Systematic Literature Review: Effectiveness of Social Cognitive Therapy on Hypertension Treatment Adherence
Endang Triyanto, Dian Ramawati
The Journal for Nurse Practitioners.2026; 22(2): 105676. CrossRef
Development and Psychometric Validation of the ASMA Medication Adherence Questionnaire for Adults with Type 2 Diabetes in Saudi Arabia: A Cross-Sectional Study
Nouf Aloudah
Patient Preference and Adherence.2026; Volume 20: 1. CrossRef

Original Article

Medication-related Burden and Experience With Medications in Indonesian Older Adults With Chronic Diseases: A Mixed-method Study: Yeni Farida, Anna Wahyuni Widayanti, Tri Murti Andayani, Probosuseno Probosuseno; J Prev Med Public Health. 2025;58(2):188-198. Published online November 20, 2024; DOI: https://doi.org/10.3961/jpmph.24.374

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Abstract Summary PDF

Objectives
This study explored the specific medication-related burdens experienced by older adults with chronic disease and the contributing factors.
Methods
An exploratory mixed-method study was conducted at a teaching hospital in Surakarta City, Central Java, Indonesia. Combining the Indonesian version of the Living with Medicine Questionnaire (LMQ) and semi-structured interviews allowed for a comprehensive understanding of the medication-related burden. Differences in LMQ scores related to patient characteristics were analyzed using the t-test, F-test, or other alternatives. Quantitative and qualitative data triangulation was used to derive trustworthy and dependable results.
Results
The overall LMQ mean score was 90.4 (n=129), indicating a moderate burden. The average LMQ scores varied significantly based on the number of medications, treatment duration, and the presence of cardiovascular disease (CVD), diabetes mellitus (DM) and stroke. The qualitative study found 3 themes in the chronic medication use of older adults: experiences, challenges, and motivation. Despite their limited understanding of a medication’s name and indication, some patients managed their medications based on the physical look and packaging of the medication. The study also found that patient motivation and familial support could effectively counteract the fatigue and dissatisfaction associated with taking medication.
Conclusions
Older adults with chronic diseases faced medication-related burdens associated with the presence of CVD, DM, stroke, a treatment duration >5 years, and the use of >10 medications. Effective communication with healthcare professionals is required to understand patients’ needs and concerns, thereby helping manage the challenges of medication-related burdens.

Summary

Key Message
Older adults with chronic diseases experienced an increasing burden in taking medication with multimorbidity, number of medicines and duration of illness. Motivation and familial support is crucial to minimize these burdens.

Citations

Citations to this article as recorded by

Medication-related quality of life among individuals utilizing the advanced electronic service for dispensing medications in Saudi Arabia
Ammar Alshamlan, Abdullah Alkattan, Sakinah Alghazal, Manea Almunjem, Ahmed Alkhalifah, Mahdi Almunjem, Eman Alsalameen, Taif Albassri, Asya Alhadad, Amal Alhaqbani
Discover Public Health.2025;[Epub] CrossRef
Latent Profile Analysis and Influencing Factors of Medication-Related Burden in Multidrug-Resistant Tuberculosis Patients in Chengdu, China
Yuanyuan Li, Qiaolin Yu, Rong Yao, Xiaoyi Yang, Bin Wan, Xia Zhao, Yinping Hu, Yan Zhou, Li Dai, Xiaoli Liu, Enchun Xie, Fang Huang, Fanghui Xie, Zhouli Guo
Patient Preference and Adherence.2025; Volume 19: 3387. CrossRef

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