A Thematic Analysis of Non-Pharmacological Intervention Strategies in the Management of Diabetic Patients in Malaysia

Abstract

Pharmacotherapy is one of the most effective treatments for the control of diabetes and the prevention of its complications. Optimal glycaemic control can reduce the healthcare burden. Nonetheless, the efficacy of diabetes management is often limited by poor medication adherence among patients. The level of medication adherence among diabetic patients in Malaysia has been reported to be 36%-87% for oral medication and 54%-81% for insulin injection. In order to increase the proportion of diabetic patients with good glycaemic control and low disease complications, other intervention strategies that are complementary to drug treatment should be considered. These strategies include all the non-pharmacological interventions and patient-mediated strategies that can be implemented either as standalone or adjunct therapy to promote better diabetic control among patients who are already prescribed with conventional pharmacotherapy. This study aimed to provide a synthesis of the themes for all the non-pharmacological intervention strategies applied in the management of diabetic patients in Malaysia. An electronic literature search for English articles in four databases (PubMed, SCOPUS, Web of Science, and OVID) was conducted using relevant search strings. Twenty-two articles were included in the final analysis. Six themes were identified, namely diabetes education programmes, patient empowerment programmes, adherence support programmes, lifestyle adjustment programmes, psychological intervention programmes, and shared decision- making. Further research is warranted to empirically validate these results and to obtain a better understanding of the themes that are most meaningful for patients as well as their practical application in real-life settings.