Non-adherence to self-care and associated factors among diabetes adult population in Ethiopian: A systemic review with meta-analysis
Bibliographic record
Abstract
BACKGROUND: Self-care practice among people with diabetes is not well-implemented in Ethiopia. So far, in Ethiopia, several observational studies have been done on self-care practice and its determinants in people with diabetes. However, a comprehensive review that would have a lot of strong evidence for designing intervention is lacking. So, this review with a meta-analysis was conducted to bridge this gap. METHODS: A systematic review of an observational study is conducted following the PRISMA checklist. Three reviewers have been searched and extracted from the World Health Organization's Hinari portal (SCOPUS, African Index Medicus, and African Journals Online databases), PubMed, Google Scholar and EMBASE. Articles' quality was assessed using the Newcastle-Ottawa Scale by two independent reviewers, and only studies with low and moderate risk were included in the final analysis. The review presented the pooled proportion of non-adherence to self-care practice in people with diabetes and the odds ratios of risk factors hindering to self-care practice after checking for heterogeneity and publication bias. The review has been registered in PROSPERO with protocol number CRD 42020149478. RESULTS: We included 21 primary studies (with 7,134 participants) in this meta-analysis. The pooled proportion of non-adherence to self-care in the diabetes population was 49.91 (95% CI: 44.73-55.08, I2 = 89.8%). Male (Pooled Odds Ratio (POR): 1.84 95%CI; 1.04-2.64, I2 = 15.0%), having private glucometer (POR: 2.71; 95%CI: 1.46-3.95, I2 = 0.0%), short-term Diabetes Mellitus (DM) duration (POR: 3.69; 95%CI: 1.86-5.52, I2 = 0.0%), DM complication (POR: 2.22; 95%CI: 1.48-2.95, I2 = 0.0%), treatment satisfaction (POR: 1.8; 95% CI: 1.15-2.44, I2 = 0.0%), received diabetes self-management education (POR: 2.71; 95% CI: 1.46-3.95, I2 = 0.0%) and poor self-efficacy (POR: 3.09; 95% CI: 1.70-4.48, I2 = 0.0%) were statistically significant factors of non-adherence to self-care practice. CONCLUSIONS: The overall pooled proportion of non-adherence to self-care among adult diabetes in Ethiopia was high. Further works would be needed to improve self-care practice in the diabetes population. So, factors that were identified might help to revise the plan set by the country, and further research might be required to health facility fidelity and each domain of self-care practice according to diabetes self-management guideline.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.023 | 0.050 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.021 | 0.047 |
| Bibliometrics | 0.011 | 0.010 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".