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

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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

Development and Validation of an Instrument to Assess the Safe Use of Antidiabetic Medication to Prevent Hypoglycemia Requiring Hospitalization Among Ambulatory Patients With Type 2 Diabetes Mellitus in Bali, Indonesia: Made Krisna Adi Jaya, Fita Rahmawati, Nanang Munif Yasin, Zullies Ikawati; J Prev Med Public Health. 2025;58(1):52-59. Published online October 24, 2024; DOI: https://doi.org/10.3961/jpmph.24.424

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Abstract Summary PDF

Objectives
Ambulatory patients with type 2 diabetes mellitus (T2DM) require special attention when being discharged from the hospital with anti-diabetes medication. This necessity stems primarily from the risk of adverse drug reactions, particularly hypoglycemia. However, this risk is significantly influenced by the patients’ knowledge and behavior regarding their medication use. This study aimed to develop instrument to assess the risk of medication-related hypoglycemia in ambulatory T2DM patients by clinical pharmacists.
Methods
The study was conducted using an observational design that included multiple stages. These stages involved item development through focus group discussions (FGDs), content validation by clinical pharmacists, and criterion and construct validation by ambulatory T2DM patients using a cross-sectional approach.
Results
A total of 10 question items were developed for assessment by clinical pharmacists following FGDs and content validation. Criterion and construct validation identified 8 valid question items through multivariate analysis (p<0.05). The scoring system developed demonstrated a linear relationship between the score and the number of items at risk in the instrument (p<0.05, R²=0.988). Additionally, the instrument was named “Medication-related Hypoglycemia Risk Score Assessment Tools (HYPOGLYRISK).”
Conclusions
The findings of this study suggest that HYPOGLYRISK may serve as a useful tool for clinical pharmacists to evaluate the risk of medication-related hypoglycemia in ambulatory T2DM patients. Additionally, this instrument could assist clinical pharmacists in identifying priority patients and tailoring educational services to meet their specific goals and needs.

Summary

Key Message
- HYPOGLYRISK is an instrument that can be used to assess the risk of hypoglycemia requiring hospitalization in T2DM patients. This instrument met all the requirements for psychometric properties testing in this study. - Patients discharged on antidiabetic medications can be screened for risk of severe hypoglycemia using HYPOGLYRISK, specifically by pharmacists, during drug dispensing. - Patients with T2DM must be ensured to have knowledge related to the five dimensions of medication safety to avoid the risk of hypoglycemia requiring hospitalization.

Citations

Citations to this article as recorded by

Determination, Validation, and Development of Prediction Scores Related to Hypoglycemia Risk Factors Among Ambulatory Type 2 Diabetes Mellitus Patients in Bali, Indonesia
Made Krisna Adi Jaya, Fita Rahmawati, Nanang Munif Yasin, Zullies Ikawati
Current Diabetes Reviews.2026;[Epub] CrossRef

Scoping Review

The Role of Pharmacists’ Interventions in Increasing Medication Adherence of Patients With Epilepsy: A Scoping Review: Iin Ernawati, Nanang Munif Yasin, Ismail Setyopranoto, Zullies Ikawati; J Prev Med Public Health. 2024;57(3):212-222. Published online April 25, 2024; DOI: https://doi.org/10.3961/jpmph.23.592

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Abstract Summary PDF

Objectives
Epilepsy is a chronic disease that requires long-term treatment and intervention from health workers. Medication adherence is a factor that influences the success of therapy for patients with epilepsy. Therefore, this study aimed to analyze the role of pharmacists in improving the clinical outcomes of epilepsy patients, focusing on medication adherence.
Methods
A scoping literature search was conducted through the ScienceDirect, PubMed, and Google Scholar databases. The literature search included all original articles published in English until August 2023 for which the full text was available. This scoping review was carried out by a team consisting of pharmacists and neurologists following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews and the Joanna Briggs Institute guidelines, including 5 steps: identifying research questions, finding relevant articles, selecting articles, presenting data, and compiling the results.
Results
The literature search yielded 10 studies that discussed pharmacist interventions for patients with epilepsy. Five articles described educational interventions involving drug-related counseling with pharmacists. Two articles focused on similar pharmacist interventions through patient education, both verbal and written. Three articles discussed an epilepsy review service, a multidisciplinary intervention program involving pharmacists and other health workers, and a mixed intervention combining education and training with therapy-based behavioral interventions.
Conclusions
Pharmacist interventions have been shown to be effective in improving medication adherence in patients with epilepsy. Furthermore, these interventions play a crucial role in improving other therapeutic outcomes, including patients’ knowledge of self-management, perceptions of illness, the efficacy of antiepileptic drugs in controlling seizures, and overall quality of life.

Summary

Key Message
Epilepsy is a chronic neurological disease that requires long-term treatment and support from health workers, including pharmacists. Pharmacists can provide interventions independently or in collaboration with other health workers, including treatment education through counseling (essential information about the condition, insights into epilepsy, seizure triggers, and antiepileptic drugs) and education and training with therapy-based behavioral interventions (reminders and skill-based psychological support). Pharmacist intervention is known to increase medication adherence, which is an important factor in the success of therapy for epilepsy patients and can improve other therapy outcomes such as increasing knowledge of epilepsy, seizure control, and quality of life.

Citations

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Global burden shift from infectious to non-communicable neurological disorders in adolescents and young adults (10–24 years): findings from the global burden of disease study 1990–2021
Tao Gu, Ruiqi Jiang, Yue Tian, Zhigang Zhao, Li Wang, Mingnan Cao
International Journal of Clinical Pharmacy.2026;[Epub] CrossRef
Knowledge of pharmacists about anti-epileptic drugs in Sudan: a cross-sectional analytical study
Fatima O. Abdelsalam, Shahd A. Mohamed, Asgad A. Altrafi, Doha E. Balla, Abdalrahman M. Abdalrahman, Awab K. Atta, Abdalfattah M. Abdelrahim, Salsabil A. SeedAhmed, Alhumaira Wedaa, Yousif B. Hamadalneel
Journal of Pharmaceutical Health Care and Sciences.2025;[Epub] CrossRef
The Impact of Drug Delivery Systems on Pharmacokinetics and Drug-Drug Interactions in Neuropsychiatric Treatment
Mohammad Nammas
Cureus.2025;[Epub] CrossRef
Pharmacist-assessed medication adherence and quality of life in patients with epilepsy
Michael Petrides, Aliki Peletidi, Spyros Polyzois, Evangelia Nena, Theodoros Constantinidis, Christos Kontogiorgis
Journal of Pharmaceutical Policy and Practice.2025;[Epub] CrossRef
Community pharmacy services and patient quality of life in Lebanon's socioeconomic crisis: Findings from the IMPHACT-LB study
Aline Hajj, Marwan Akel, Rony M. Zeenny, Hala Sacre, Chadia Haddad, Jihan Safwan, Fouad Sakr, Pascale Salameh
Exploratory Research in Clinical and Social Pharmacy.2025; 20: 100659. CrossRef
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
Journal of Preventive Medicine and Public Health.2025; 58(5): 453. CrossRef
Practical aspects of antiseizure medication treatment in pediatric patients: A helpful guide for pharmacists counseling young patients with epilepsy and their parents
Uroš Pecikoza, Katarina Nastić
Arhiv za farmaciju.2025; 75(5): 423. CrossRef
Medication self-management in patients with epilepsy: a narrative review of current status, influencing factors, and intervention strategies
Huayuan Wang, Xinmin Liu
Frontiers in Neurology.2025;[Epub] CrossRef
Impact of the Information-Motivation-Behavioral Skills Model Based Medication Literacy Intervention on Medication Self-Management Capacity in Stroke Patients: A Randomized Controlled Trial
Linlin Ma, Zhimin Liu, Xueru Chen, Qian Zhang, Tianyu Chu, Xian Chen, Jiajia Zhang, Renjuan Sun, Yibo Wu
Patient Preference and Adherence.2025; Volume 19: 3785. CrossRef
Implementation, barriers, solving strategies and future perspectives of reimbursed community pharmacy services - a nationwide survey for community pharmacies in Germany
Ann-Christin Kroenert, Thilo Bertsche
BMC Health Services Research.2024;[Epub] CrossRef

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