Relationship between social determinants of health and clinical outcomes in adults with type 2 diabetes in Lebanon

Awad, Nathalie; Saade, Rita; Bassil, Maya; Sukkarieh-Haraty, Ola; Egede, Leonard E.

doi:10.1016/j.jnma.2022.03.002

Cited by 6 publications

(3 citation statements)

References 31 publications

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“…Despite the spread of COVID-19, researchers were still interested in chronic diseases research such as T2DM. Some of them focused on the assessment of the social determinants of health and their impact on clinical outcomes in adults with T2DM 91 and others tested the effect of culturally tailored education targeting diabetes selfcare on hypoglycemia side-effect. 92 , 93 Other reviews and meta-analyses described T2DM complications, reported mortality rates, 94 and compared surgical versus non-surgical treatment options for the treatment of diabetic foot ulcers.…”

Section: Resultsmentioning

confidence: 99%

Identifying health research in the era of COVID-19: A scoping review

Samah

2023

SAGE Open Medicine

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Background: Health improvements are considered one of the most important fields of research. Since the coronavirus disease 2019 was declared a pandemic, it might have impacted clinical and public health research in various forms. Objectives: The goal of this study is to explore health research approaches in the era of coronavirus disease 2019. Methods: In this scoping review, we reviewed published medical full-text studies and identified potential areas of interest of health research in the era the coronavirus disease 2019 pandemic during the last 3 years within a higher educational setting. A bibliometric analysis was used to compare among published works. Results: Among the 93 studies that met the inclusion criteria, most focused on mental health ( n = 23; 24.7%). Twenty-one publications targeted coronavirus disease 2019 and its consequences on general health. Other studies have described hemato-oncological, cardiovascular, respiratory, and endocrinological diseases. 42 studies were cross-sectional or cohort studies and most of them published in Q1 journals. Almost half of them belonged to the Faculty of Medicine (49.5%) followed by the School of Arts, Sciences, and Psychology (26.9%). Conclusions: Health research has been demonstrated to be important, at all times, especially during crises. Therefore, researchers need to invest more efforts into seeking new medical updates in various health-related fields, regardless of their correlation with coronavirus disease 2019.

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Section: Resultsmentioning

confidence: 99%

Identifying health research in the era of COVID-19: A scoping review

Samah

2023

SAGE Open Medicine

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“…In our study sample, there is a greater representation of Mount Lebanon and the capital, Beirut, compared to other remote regions, which may point to regional differences in socioeconomic conditions, infrastructure, and access to healthcare that may have an impact on health outcomes [ 23 ]. Indeed, the impacts of the economic crisis were shown to be more pronounced in rural areas where people have lower incomes and decreased access to healthcare services [ 24 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

Unveiling the unseen toll: exploring the impact of the Lebanese economic crisis on the health-seeking behaviors in a sample of patients with diabetes and hypertension

Cherfane,

Boueri,

Issa

et al. 2024

BMC Public Health

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Background Against the backdrop of Lebanon’s escalating multifaceted crisis which resulted in medication shortages for chronic diseases and unaffordable healthcare services, the current study endeavors to shed light on a critical yet overlooked facet of the Lebanese economic crisis– its profound impact on the health-seeking behaviors of patients with hypertension and diabetes mellitus. Methods An exploratory cross-sectional study based on an online questionnaire was conducted on 156 adult Lebanese citizens diagnosed medically with either hypertension or diabetes. We gathered sociodemographic characteristics and healthcare-related challenges faced during the economic crisis. We also assessed stress levels using the Depression Anxiety Stress Scale (DASS-21). Descriptive and bivariate analyses were done using SPSS version 26. Results The mean age of the population was 49.8 ± 17.7 years old, 51.6% were females and 48.4% were males, 29.7% had diabetes, 51.3% had hypertension and 19.0% had both diseases. Among all, 84.2% reported dissatisfaction with the current healthcare system, 31.6% reported changing their physician mainly because of unaffordable consultation fees (66%) or immigration of the physician (32%). Of those with hypertension and/or diabetes, less than 20% reported finding all their prescribed medications and 47% either modified or discontinued their treatment without seeking medical advice. In case of drug shortage, patients relied on stocked reserves (26%), alternative/generic medications (10%) and external sources for medication procurement such as relatives living abroad (41.7%), outsourcing suppliers (19.9%), dispensaries (19.6%) and NGOs (20.3%). All participants reported a high stress level (5.03/7) with a mean total DASS-21 score of 38.7 ± 35.8 that were attributed to August 4th Beirut port explosion (81.0%), global pandemic (81%), unstable political conditions (90.5%), economic crisis (96.8%), medication shortage (91.8%) and inability to access healthcare (74.1%). Higher sub-scores for anxiety, depression and total stress were insignificantly noted in participants with both hypertension and diabetes (p > 0.05). Conclusion Our findings explore how the economic crisis has taken its toll on almost all aspects of healthcare in a sample of patients with diabetes and hypertension in Lebanon. The drug shortage as well as disruptions in affordable healthcare access imposed several barriers to adequate adherence to treatment regimens and acted as important mental health stressors.

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“…The strategies previously discussed such as using motivational interviewing, health technology, and telephone interventions could be used to enhance diabetes health interventions and improve accessibility among underserved populations residing in any location. Poverty and poor living conditions and built environment conditions can adversely affect diabetes outcomes [ 56 ]. Further research is needed to explore the impact of social determinants of health on factors related to diabetes self-care, such as fatalism, self-efficacy, and social support in other geographic areas, and brainstorm strategies to improve health among diverse populations living with diabetes.…”

Section: Discussionmentioning

confidence: 99%

A Structural Equation Modeling Analysis to Explore Diabetes Self-Care Factors in a Rural Sample

et al. 2022

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Diabetes is a public health problem that requires management to avoid health sequelae. Little is known about the determinants that influence diabetes self-care activities among rural populations. The purpose of this analysis was to explore the relationships among diabetes self-care activities, diabetes knowledge, perceived diabetes self-management, diabetes fatalism, and social support among an underserved rural group in the southern United States. A diabetes health promotion program was tested during a cluster randomized trial that tested a disease risk reduction program among adults living with prediabetes and diabetes. A structural equation model was fit to test psychosocial factors that influence diabetes self-care activities using the Information–Motivation–Behavioral Skills Model of Diabetes Self-Care (IMB-DSC) to guide the study. Perceived diabetes self-management significantly predicted self-care behaviors, and there was also a correlation between perceived diabetes self-management and diabetes fatalism. Perceived diabetes self-management influenced diabetes self-care activities in this rural sample and had an association with diabetes fatalism. The findings of this study can facilitate clinical care and community programs targeting diabetes and advance health equity among underserved rural groups.

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Relationship between social determinants of health and clinical outcomes in adults with type 2 diabetes in Lebanon

Cited by 6 publications

References 31 publications

Identifying health research in the era of COVID-19: A scoping review

Identifying health research in the era of COVID-19: A scoping review

Unveiling the unseen toll: exploring the impact of the Lebanese economic crisis on the health-seeking behaviors in a sample of patients with diabetes and hypertension

A Structural Equation Modeling Analysis to Explore Diabetes Self-Care Factors in a Rural Sample

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