International Journal of Pharma and Bio Sciences
    ISSN 0975-6299

Int J Pharm Bio Sci Volume 14 Issue 2, April-June, Pages:48-56

Role of "Family Centered Health Educational Approach" In Improving Adherence to Diabetic and Hypertensive Medications: A Prospective Study

Dr. A. Pavan Rajesh, Dr. Chaitanya Mavuluri, Dr. Pradeep K. Ch. S. G and Dr. K Lakshmi Narayana

Family is one of the vital units of society and living. It should be treated as an intervening variable, participating, contributing, and predisposing factor in the etiology, care, and treatment of physical and mental illnesses. Family-centered care (FCC) is defined as the "provision of healthcare in a partnership or recognition that family is vital in treating persons with chronic disorders. We aim to know the role of a family-centered health education approach in improving medication adherence. Objectives were assessed by taking details from family members through a questionnaire with pre-test and post-test scores. The novelty of this research was that FCC was implemented previously in certain studies. Still, studies need to use a family-centered health education approach like ours in improving medication adherence. The study was conducted in the field practice area (Kuragallu village), Guntur. As per the sample size, 127 patients were included. Patients aged 18-80 years, males and females, who were diagnosed with type 2 diabetes mellitus (T2DM) or hypertension (HTN) or both, were included in the study. All study patients and family members were given a questionnaire before implementing the "Familycentred Health Education Approach," and again after (8 months) to the same patient. Pre and post-approach scores were compared. The mean age of patients was 57.54 years, and most were females. There was a significant improvement in post approach score compared to the pre-approach score concerning medication adherence (intake of recommended dose and composition, at the right time, during travel, and checking the availability of medications in the past ten days). Using compliance aids, proper motivation &support from family proved to increase medication adherence.

Keywords: Adherence, Diabetes, Family-centred approach, Hypertension, Prospective study
Full HTML:
  1. World Health Organization (WHO). Statistical indices of family health. Geneva: World Health Organization; 1976.
  2. Baig AA, Benitez A, Quinn MT, Burnet DL. Family interventions to improve diabetes outcomes for adults. Ann N Y Acad Sci. 2015 Sep;1353(1):89-112. doi: 10.1111/nyas.12844. PMID 26250784.
  3. Johnson BH. Family-centered care: four decades of progress. Fam Syst Health. 2000;18(2):137-56.
  4. Blaylock BL. Patients and families as teachers: inspiring an empathic connection. Fam Syst Health. 2000;18(2):161-75. doi 10.1037/h0091844.
  5. Cohen JJ. Moving from provider-centered toward family-centered care. Acad Med. 1999 Apr;74(4):425. doi: 10.1097/00001888-199904000-00040, PMID 10219226.
  6. Beardslee W, Knitzer J. Mental health services: A family systems approach. In: Investing in children, youth, families, and communities: strengths-based research and policy. Washington: American Psychological Association; 2004. p. 157-71.
  7. Friesen BJ. Family support in child and adult mental health. Redefining family support: innovations in public–private partnerships [Internet]. Vol. 477. p. 259-90; 1996. Available from: [cited 28/3/2023].
  8. Walker JS, Cook J. Caregiver perspectives on cultural competence. Point: Focal Press; 2002;16(2):35-6.
  9. Anjana RM, Deepa M, Pradeepa R, Mahanta J, Narain K, Das HK, et al. Prevalence of diabetes and prediabetes in 15 states of India: results from the ICMR-INDIAB population-based cross-sectional study. Lancet Diabetes Endocrinol. 2017 Aug;5(8):585-96. doi: 10.1016/S2213-8587(17)30174-2. Erratum in: Lancet Diabetes Endocrinol. 2017 Aug;5(8):585-96. doi: 10.1016/S2213-8587(17)30174-2, PMID 28601585.
  10. Oberoi S, Kansra P. Economic menace of diabetes in India: a systematic review. Int J Diabetes Dev Ctries. 2020 Oct;40(4):464-75. doi: 10.1007/s13410-020-00838-z. PMID 32837090, PMCID PMC7299136.
  11. Home [Internet]. [cited Jan 24, 2023]. Available from:
  12. Hypertension [Internet]. Who. Int [cited Jan 24, 2023]. Available from:
  13. Haynes RB, Sackett DL, Gibson ES, Taylor DW, Hackett BC, Roberts RS, et al.. Improvement of medication compliance in uncontrolled hypertension. Lancet. 1976;1(7972):1265-8. doi: 10.1016/s0140-6736(76)91737-2. PMID 73694.
  14. Alqarni AM, Alrahbeni T, Qarni AA, Qarni HMA. Adherence to diabetes medication among diabetic patients in the Bisha governorate of Saudi Arabia – a cross-sectional survey. Patient Prefer AdherencePatient Prefer Adherence. 2019;13:63-71. doi: 10.2147/PPA.S176355. PMID 30636871.
  15. Gast A, Mathes T. Medication adherence influencing factors-an (updated) overview of systematic reviews. Syst Rev. 2019 May 10;8(1):112. doi: 10.1186/s13643-019-1014-8, PMID 31077247, PMCID PMC6511120.
  16. Shivalli S, Majra JP, Akshaya KM, Qadiri GJ. The family-centered approach in primary health care: experience from an urban area of Mangalore, India. ScientificWorldJournal. 2015;2015:419192. doi 10.1155/2015/419192. PMID 25695098, PMCID PMC4322852.
  17. Kuo DZ, Houtrow AJ, Arango P, Kuhlthau KA, Simmons JM, Neff JM. Family-centered care: current applications and future directions in pediatric health care. Matern Child Health J. 2012 Feb;16(2):297-305. doi: 10.1007/s10995-011-0751-7, PMID 21318293, PMCID PMC3262132.
  18. Cheraghi F, Shamsaei F, Mortazavi SZ, Moghimbeigi A. The effect of family-centered care on management of blood glucose levels in adolescents with diabetes. Int J Community Based Nurs Midwifery. 2015 Jul;3(3):177-86. doi: 10.1530/endoabs.43.OC43, PMID 26171406, PMCID PMC4495325.
  19. Geldsetzer P, Manne-Goehler J, Theilmann M, Davies JI, Awasthi A, Vollmer S et al. Diabetes and hypertension in India: A Nationally Representative Study of 1.3 million Adults. JAMA Intern Med. 2018 Mar 1;178(3):363-72. doi: 10.1001/jamainternmed.2017.8094, PMID 29379964, PMCID PMC5885928.
  20. Sullivan GM, Artino AR Jr. Analyzing and interpreting data from Likert-type scales. J Grad Med Educ. 2013 Dec;5(4):541-2. doi: 10.4300/JGME-5-4-18, PMID 24454995, PMCID PMC3886444.
  21. Jebb AT, Ng V, Tay L. A review of key Likert scale development advances: 1995-2019. Front Psychol. 2021 May 4;12:637547. doi 10.3389/fpsyg.2021.637547, PMID 34017283, PMCID PMC8129175.
  22. Pesantes MA, Del Valle A, Diez-Canseco F, Bernabé-Ortiz A, Portocarrero J, Trujillo A, et al. Family support and diabetes: Patient's experiences from a public hospital in Peru. Qual Health Res. 2018;28(12):1871-82. doi 10.1177/1049732318784906.
  23. Black S, Maitland C, Hilbers J, Orinuela K. Diabetes literacy and informal social support: a qualitative study of patients at a diabetes center. J Clin Nurs. 2017 Jan;26(1-2):248-57. doi 10.1111/jocn.13383, PMID 27191540.
  24. Beanlands H, Horsburgh ME, Fox S, Howe A, Locking-Cusolito H, Pare K et al. Caregiving by family and friends of adults receiving dialysis. Nephrol Nurs J. 2005 Nov-Dec;32(6):621-31. PMID 16425810.
  25. Jennings L, Skovholt TM. The cognitive, emotional, and relational characteristics of master therapists. J Couns Psychol. 1999 Jan;46(1):3.
  26. Mayberry LS, Osborn CY. Family support, medication adherence, and glycemic control among adults with type 2 diabetes. Diabetes Care. 2012 Jun;35(6):1239-45. doi 10.2337/dc11-2103. PMID 22538012, PMCID PMC3357235.
  27. Pamungkas RA, Chamroonsawasdi K, Vatanasomboon P. A systematic review: family support integrated with diabetes self-management among uncontrolled type II diabetes mellitus patients. Behav Sci (Basel). 2017 Sep 15;7(3):62. doi: 10.3390/bs7030062, PMID 28914815, PMCID PMC5618070.
  28. Saju MD, Varghese BM, Scaria L et al. Sw?sthya, an integrated chronic condition management program for families of patients with hypertension and diabetes mellitus: a study protocol for a randomized controlled trial. BMC Fam Pract. 2021;22:15. doi: 10.1186/s12875-020-01357-w.
  29. Thakkar J, Kurup R, Laba TL, Santo K, Thiagalingam A, Rodgers A, et al. Mobile telephone text messaging for medication adherence in chronic disease: A meta-analysis. JAMA Intern Med. 2016 Mar;176(3):340-9. doi: 10.1001/jamainternmed.2015.7667, PMID 26831740.
  30. Choudhry NK, Fischer MA, Avorn J, Liberman JN, Schneeweiss S, Pakes J et al. The implications of therapeutic complexity on adherence to cardiovascular medications. Arch Intern Med. 2011 May 9;171(9):814-22. doi 10.1001/arch intern med.2010.495, PMID 21555659.
  31. Rosland AM, Kieffer E, Israel B, Cofield M, Palmisano G, Sinco B et al. When is social support important? The association of family support and professional support with specific diabetes self-management behaviors. J Gen Intern Med. 2008 Dec;23(12):1992-9. doi 10.1007/s11606-008-0814-7. PMID 18855075, PMCID PMC2596525.
  32. DiMatteo MR. Social support and patient adherence to medical treatment: a meta-analysis. Health Psychol. 2004;23(2):207-18. doi: 10.1037/0278-6133.23.2.207.
  33. Pereira MG, Berg-Cross L, Almeida P, Machado JC. Impact of family environment and support on adherence, metabolic control, and quality of life in adolescents with diabetes. Int J Behav Med. 2008;15(3):187-93. doi: 10.1080/10705500802222436, PMID 18696312.
  34. Cox DJ, Gonder-Frederick L. Major developments in behavioral diabetes research. J Consult Clin Psychol. 1992 Aug;60(4):628-38. doi: 10.1037/0022-006x.60.4.628, PMID 1506511.
  35. Kang CM, Chang SC, Chen PL, Liu PF, Liu WC, Chang CC, et al. Comparison of family partnership intervention care vs. conventional care in adult patients with poorly controlled type 2 diabetes in a community hospital: a randomized controlled trial. Int J Nurs Stud. 2010 Nov;47(11):1363-73. doi: 10.1016/j.ijnurstu.2010.03.009. PMID 20371056.
  36. Sado DM. Oxford textbook of Clinical Pharmacology and drug therapy. J R Soc Med. 2002 Sep;95(9):472. doi 10.1177/014107680209500918, PMCID PMC1280003.
  37. World Health Organization. Adherence to long-term therapies: evidence for action. Genève, Switzerland: World Health Organization; 2003.
  38. Mansour M, Parizad N. Hemmati Maslakpak M. Does family-centered education improve treatment adherence, glycosylated hemoglobin, and blood glucose level in patients with type 1 diabetes? A randomized clinical trial. Nurs Open. 2022. doi: 10.1002/nop2.1522.
[Download PDF]
Welcome to IJPBS,Pharmaceutics, Novel, drug, delivery, system, Nanotechnology, Pharmacology, Pharmacognosy
Pharmaceutical Fields
Welcome to IJPBS,Pharmaceutics, Novel, drug, delivery, system, Nanotechnology, Pharmacology, Pharmacognosy Pharmaceutics
Welcome to IJPBS,Pharmaceutics, Novel, drug, delivery, system, Nanotechnology, Pharmacology, Pharmacognosy Novel drug delivery system
Welcome to IJPBS,Pharmaceutics, Novel, drug, delivery, system, Nanotechnology, Pharmacology, Pharmacognosy Nanotechnology
Welcome to IJPBS,Pharmaceutics, Novel, drug, delivery, system, Nanotechnology, Pharmacology, Pharmacognosy Pharmacology
Welcome to IJPBS,Pharmaceutics, Novel, drug, delivery, system, Nanotechnology, Pharmacology, Pharmacognosy Pharmacognosy
© Copyright 2009-2015 IJPBS, India. All rights reserved. Specialized online journals by ubijournal. Website by Ubitech Solutions
         Home I Contact I Terms & Conditions