Almomani Basima A, Elayyan Roa'a N, Al-Shatnawi Samah F
Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan.
PLoS One. 2025 May 5;20(5):e0322882. doi: 10.1371/journal.pone.0322882. eCollection 2025.
The global prevalence of type 1 diabetes mellitus (T1DM) is increasing. Poor glycemic control in children and adolescents leads to both acute and chronic problems, reduced Health Related Quality of Life (HRQoL), and higher healthcare utilization. This study aimed to assess patient-reported outcomes related to self-management adherence, QoL, diabetes-related stigma, glycemic control, and other clinical outcomes along with their determinants, in insulin-treated pediatric T1DM patients in Jordan. A cross-sectional study was conducted from April to October 2023 at two health centers in Northern Jordan. Eligible pediatric T1DM patients attending outpatient clinics were enrolled. Trained pharmacists conducted face-to-face interviews with both children and their guardians, using validated tools that were translated into Arabic. Adherence was evaluated using the Diabetes Management Questionnaire, HRQoL was measured using the Pediatric Quality of Life Inventory 3.0 Diabetes Module, stigma was assessed using the Child Attitude Toward Illness Scale and glycemic control was determined by glycated hemoglobin levels. A total of 150 patients participated in the study. The mean adherence score was 57.4 ± 18.13. Factors such as younger age (P-value = 0.01), higher monthly income (P-value = 0.022) and shorter disease duration (P-value = 0.008) were associated with improved adherence. The mean pediatric QoL score was 63.27 ± 11.86, with male gender (P-value = 0.021) and the absence of disease-related factors (P-value = 0.004) linked to lower QoL scores. Additionally, body mass index (P-value = 0.041) and a family history of DM (P-value = 0.047) were linked to stigma. Most patients (76%) had uncontrolled diabetes, with disease duration (P-value = 0.019) and maternal educational level (P-value = 0.013) influencing glycemic control. These findings highlight that, despite widespread poor glycemic control, insulin adherence and QoL among pediatric T1DM patients in Jordan are above average. Targeted interventions are recommended to improve adherence and, in turn, overall patient outcomes.
1型糖尿病(T1DM)的全球患病率正在上升。儿童和青少年血糖控制不佳会导致急性和慢性问题、健康相关生活质量(HRQoL)下降以及更高的医疗利用率。本研究旨在评估约旦接受胰岛素治疗的儿科T1DM患者中与自我管理依从性、生活质量、糖尿病相关耻辱感、血糖控制及其他临床结局相关的患者报告结局及其决定因素。2023年4月至10月在约旦北部的两个健康中心进行了一项横断面研究。纳入了在门诊就诊的符合条件的儿科T1DM患者。经过培训的药剂师使用翻译成阿拉伯语的经过验证的工具,对儿童及其监护人进行面对面访谈。使用糖尿病管理问卷评估依从性,使用儿童生活质量量表3.0糖尿病模块测量HRQoL,使用儿童对疾病的态度量表评估耻辱感,并通过糖化血红蛋白水平确定血糖控制情况。共有150名患者参与了该研究。平均依从性得分为57.4±18.13。年龄较小(P值=0.01)、月收入较高(P值=0.022)和病程较短(P值=0.008)等因素与依从性改善相关。儿童生活质量平均得分为63.27±11.86,男性(P值=0.021)和不存在与疾病相关的因素(P值=0.004)与较低的生活质量得分相关。此外,体重指数(P值=0.041)和糖尿病家族史(P值=0.047)与耻辱感相关。大多数患者(76%)患有未控制的糖尿病,病程(P值=0.019)和母亲教育水平(P值=0.013)影响血糖控制。这些发现突出表明,尽管血糖控制普遍不佳,但约旦儿科T1DM患者的胰岛素依从性和生活质量高于平均水平。建议采取有针对性的干预措施来提高依从性,进而改善患者的总体结局。