Patient Activation and Diabetes Outcomes Among Jordanian Patients With Type 2 Diabetes: Longitudinal Evidence on Adherence and Glycemic Control With Linear Mixed Model Analysis

Management of chronic diseases like diabetes mellitus (DM) requires patient activation. Although many studies have associated patient activation with outcomes like increased medication adherence and better blood glucose control, evidence for these outcomes is scarce in the Middle East, particularly in the Jordanian population. To address this issue, the current study examined the association between patient activation and both medication adherence and glycemic control among patients with diabetes in Jordan. A descriptive longitudinal method was used, and convenience sampling was adopted. Newly diagnosed adult patients with diabetes were assessed utilizing the Patient Activation Measure (PAM-13), Adherence to Refills and Medications Scale (ARMS), and glycemic control was evaluated by HbA1c levels. Data were collected from 140 patients at baseline, 3 months, and 6 months from hospital inpatient departments and outpatient clinics. PAM scores increased from 44.7 at baseline to 54.5 at 3 months and 60.0 at 6 months. ARMS scores dropped from 34.4 to 29.7 and 25.3, indicating progressive improvement in medication adherence, and HbA1c from 10.6% to 9.6% and 8.7%. Better activation was significantly associated with higher adherence (F(1, 335.1) = 315.43, p < 0.001) and lower HbA1c (F(1, 362.2) = 414.38, p < 0.001). Time and activation interplay were prominent for adherence (F(2, 177.1) = 3.15, p = 0.045) and HbA1c (F(2, 165.2) = 6.04, p = 0.002). These findings suggest that patient activation is associated with improved health outcomes at 6 months. This finding thus supports prioritizing structured education and support in diabetes care to enhance and maintain patient activation.