Introduction
This educational program is dedicated to the improvement of medication adherence and illness perception among Saudi Arabian adult patients with type 2 diabetes mellitus. Its significance is determined by the fact that in this country, almost 20.5% of adults between the ages of 20–79 are diagnosed with type 2 diabetes mellitus (Alatawi et al., 2016). This disease may be regarded as a considerable risk factor for microvascular complications and cardiovascular disease. At the same time, no more than 40% of patients demonstrate high adherence to antidiabetic medications (Aloudah et al., 2018). Even if the prescribed dose is taken every time, in 50% of cases, right intervals are not observed, and in 60% of cases, the dose is not taken an appropriate number of times per day (Alatawi et al., 2016). These figures indicate the absence of adequate illness perception among adults that determines medication adherence and positive health outcomes, respectively. Thus, patient education is essential to spread awareness concerning the disease, improve self-management skills, and prevent both primary and secondary medication non-adherence.
Goals
The education program has the following goals:
- Improvement of patient’s illness perceptions through the dissemination of information about type 2 diabetes mellitus;
- Breadth and depth of knowledge related to the disease potential risks and the consequences of medication non-adherence;
- The improvement of patients’ self-are and self-management skills for medication adherence and lifestyle changes;
- Reduction of wastage of medication due to patients’ non-adherence in clinical settings.
Objectives
By the end of the course, patients would have achieved the following program objectives:
- Examine the concepts of illness perception and medication adherence;
- Receive information about type 2 diabetes mellitus, its treatment, comorbidities, and the impact of medication non-adherence on their development;
- Receive general information concerning factors that influence illness perception and medication adherence for self-evaluation;
- Obtain skills of self-care and self-management for the empowerment of medication adherence and lifestyle changes.
Learning Materials
Learning materials will include lecture slides in the PowerPoint presentation, YouTube videos, brochures, leaflets, posters, charts, mobile software, the Internet resources, and digital devices (a notebook and projector).
Teaching Method
Teaching will include lectures, the demonstration of video materials, the dissemination of printed materials, group discussions, and consulting. Lectures will be delivered by a competent health care educator with supporting materials, including the slides of the PowerPoint presentation, posters, and charts. In addition, brochures and leaflets with information concerning the importance of medication adherence will be distributed among patients on a permanent basis to ensure that information will not be lost or forgot. The understanding of every lecture may be evaluated during a meeting through group discussions together with an educator. Finally, patients will be able to ask any question concerning the subject matter to ensure understanding.
Instructional Method
First of all, all instruction will be provided by a health care educator through lectures and videos in a visually appealing and highly comprehensive way. Using slides, patients will receive an opportunity to make notes. In addition, they will be able to pose any questions or ask the teacher to clarify provided material. In turn, an educator may ask questions or initiate group discussion to evaluate understanding and fill patients’ gaps in knowledge. Instructions for group activities and questions for class discussions will be provided on a slide after every lecture or expressed orally by an educator.
Learner Assessment Method
In order to assess patients’ learning, an educator may pose questions concerning the subject matter, ask to restate given instruction in their own words, or give simple questionnaires or tests to evaluate their understanding. Later, the evaluation of learner assessment may be conducted through the observation of patients’ physiological measurement and the accuracy and consistency of their self-monitoring. Further assessment will be based on the results of clinical observations. In other words, the improvement of medication adherence by a patent who follow all instructions and a general decrease of medication wastage will indicate the program’s success. In addition, family members and other relatives may be asked about a patient’s adherence to treatment.
Program and Teacher Evaluation Method
The efficiency of the program and a teacher’s competency will be evaluated on the basis of patients’ clinical observations, the accuracy and consistency of their self-measurement, their health care outcomes, medication adherence after the program, and the level of medication wastage in a clinical setting. In addition, after the course, patients will be provided with an opportunity to evaluate the usefulness of the program’s material and the competence of an educator.
Environmental Preparations
The program will be organized for a group of patients with type 2 diabetes mellitus in a hospital in Saudi Arabia. First of all, preparations will include the choice of patients on the basis of their medical adherence. Both direct and indirect methods of adherence measurement should be applied. The direct method includes the measurement of drugs in blood and direct observed therapy. In turn, the indirect method focuses on patient self-reports, patient questionnaires, prescription refill rates, pill counts, and electronic medication monitors. In addition, an educator should initially reflect on the goals and objectives of the program to provide the most appropriate results. Preparations should include literature review and the analysis of available data dedicated to medication adherence, its connection with illness perception, and methods of its improvement. Moreover, patient’s learning, physical, and social peculiarities should be assessed to prepare the most suitable material in the most comprehensive way.
All Supplies and Tools Needed
All supplies and tools include computer software (PowerPoint), access to the Internet, printed materials, and electronic devices (a notebook with a projector). In general, the program will require a room, desks and chairs or only chairs for patients, printing of all handouts, including, leaflets, brochures, charts, and posters, and electronic devices, including a notebook and a projector with the necessary software and stable access to the Internet. The education space will be fully accessible for patients with physical disabilities.
Consideration of Learners
First of all, only patients who demonstrate the lowest medication adherence on the basis of clinical observations will be chosen for the program. The characteristics of learners in relation to the educational process and how they perceive information better will be considered within the program. For this, an educator will document a patient’s form before and after the program to determine and evaluate learning and teaching. This program will include the patient’s learning needs, learning goals and objectives, readiness to learn, preferred learning style, and the results of learning.
In addition, program is suitable for patients with disabilities, chronic diseases, and at different social and developmental stages. First of all, the program’s material and its presentation will be elaborated on in the way to be understandable for an ordinary person who does not have a specific education. In addition, the variety of tools help educate patients who cannot perceive information in particular ways. Thus, individual learning differences will be reflected in the following way:
- For visual and patients with hearing impairment – Slides of the PowerPoint presentation with bullet points for structural perception, videos, leaflets, charts, posters
- For reading/writing learners – Brochures, individually written notes
- For audio learners and patients with poor vision – Group discussions, lectures, asking questions
- Kinesthetic and patients with comorbidities that require treatment – small breaks during lectures
At the same time, for patients with movement restriction and chronic diseases the education program will be available individually, in a full or a shortened format.