This research comprises of data which depicts the prevalence of adherence to medication by diabetic patients and different factors that affect their compliance
Evaluations of and Interventions for Non Adherence to Oral Medications as a P...NiyotiKhilare
The focus of this presentation will be medical non-adherence as a psychosocial issue in diabetes. The presentation will also focus elaborately on empowerment as an intervention amongst other interventions.
Compliance, concordance and empowerment in patients with type two diabetes me...NiyotiKhilare
This presentation compares the traditional model that focuses on compliance of the patient, with the new model which focuses on empowering the patient. The presentation will also focus elaborately on empowerment as an intervention for improved medical adherence in diabetic patients.
Explore and analyse concordance as a concept and empowerment as a strategic intervention to improve patient outcomes in diabetes.
This study analyzed prescription claims data from 238,402 patients with type 2 diabetes to identify predictors of changes in adherence to oral antidiabetes medications between years. The study found that about one third of patients changed adherence status from one year to the next, with about 22% becoming nonadherent after being adherent previously. For those who became nonadherent, the strongest predictors were the number of 90-day prescriptions filled, diabetes medication burden, longest gap in filling prescriptions, number of antidiabetes drug classes used, and copay for last drug. For those who became adherent after being nonadherent, the top predictors were medication burden, prescription gaps, fluctuating adherence, 90-day prescript
This document summarizes a study that assessed the knowledge, attitudes, and practices of 100 patients with type 2 diabetes in Pakistan. The study found:
1) Patients had low overall awareness and knowledge about diabetes, glycemic control, risk factors, and complications. The mean correct answers regarding these topics ranged from 33.5-69%.
2) While 61% checked their blood sugar regularly, few knew the target glucose values. Only 18% understood diabetic diet.
3) Awareness of risk factors like hypertension, smoking, and obesity was higher at 69-92% but target values were unknown.
4) 23% first presented with complications and awareness of eye and renal complications was low at
This document provides guidelines for managing hyperglycemia in type 2 diabetes using a patient-centered approach from the American Diabetes Association and European Association for the Study of Diabetes. It summarizes that intensive glycemic control can reduce microvascular complications but may increase mortality risk. The guidelines emphasize individualizing treatment based on patient preferences, needs, and tolerances. A patient-centered approach engages patients in medical decisions to improve adherence and outcomes for their chronic condition.
This document provides a position statement from the American Diabetes Association and European Association for the Study of Diabetes on the management of hyperglycemia in type 2 diabetes. It recommends a patient-centered approach to treatment that considers individual patient needs, preferences, and tolerances. The statement reviews the evidence on glycemic control and outcomes, discusses the increasing complexity of treatment options, and emphasizes the importance of shared decision making between clinicians and patients.
This document summarizes findings from a survey of 50 primary care physicians on their knowledge and perceptions related to treating type 2 diabetes. The survey found that many physicians were unfamiliar with current guidelines regarding appropriate A1c targets and misunderstood results from the ACCORD trial. Physicians were also more likely to recall claims made in marketing materials compared to evidence from clinical studies. Overall, the survey suggests that disseminating evidence-based practices to physicians remains challenging and that new strategies are needed to accelerate adoption of optimal treatment guidelines.
This document provides guidelines for managing hyperglycemia in type 2 diabetes from the American Diabetes Association and European Association for the Study of Diabetes. It summarizes that glycemic management has become complex with many treatment options and uncertainties about benefits. The guidelines aim to encourage individualized patient-centered care over prescriptive algorithms. Effective management of cardiovascular risk factors is also important given risks of complications. The guidelines stress shared decision making between clinicians and patients based on evidence and patient preferences and needs.
Evaluations of and Interventions for Non Adherence to Oral Medications as a P...NiyotiKhilare
The focus of this presentation will be medical non-adherence as a psychosocial issue in diabetes. The presentation will also focus elaborately on empowerment as an intervention amongst other interventions.
Compliance, concordance and empowerment in patients with type two diabetes me...NiyotiKhilare
This presentation compares the traditional model that focuses on compliance of the patient, with the new model which focuses on empowering the patient. The presentation will also focus elaborately on empowerment as an intervention for improved medical adherence in diabetic patients.
Explore and analyse concordance as a concept and empowerment as a strategic intervention to improve patient outcomes in diabetes.
This study analyzed prescription claims data from 238,402 patients with type 2 diabetes to identify predictors of changes in adherence to oral antidiabetes medications between years. The study found that about one third of patients changed adherence status from one year to the next, with about 22% becoming nonadherent after being adherent previously. For those who became nonadherent, the strongest predictors were the number of 90-day prescriptions filled, diabetes medication burden, longest gap in filling prescriptions, number of antidiabetes drug classes used, and copay for last drug. For those who became adherent after being nonadherent, the top predictors were medication burden, prescription gaps, fluctuating adherence, 90-day prescript
This document summarizes a study that assessed the knowledge, attitudes, and practices of 100 patients with type 2 diabetes in Pakistan. The study found:
1) Patients had low overall awareness and knowledge about diabetes, glycemic control, risk factors, and complications. The mean correct answers regarding these topics ranged from 33.5-69%.
2) While 61% checked their blood sugar regularly, few knew the target glucose values. Only 18% understood diabetic diet.
3) Awareness of risk factors like hypertension, smoking, and obesity was higher at 69-92% but target values were unknown.
4) 23% first presented with complications and awareness of eye and renal complications was low at
This document provides guidelines for managing hyperglycemia in type 2 diabetes using a patient-centered approach from the American Diabetes Association and European Association for the Study of Diabetes. It summarizes that intensive glycemic control can reduce microvascular complications but may increase mortality risk. The guidelines emphasize individualizing treatment based on patient preferences, needs, and tolerances. A patient-centered approach engages patients in medical decisions to improve adherence and outcomes for their chronic condition.
This document provides a position statement from the American Diabetes Association and European Association for the Study of Diabetes on the management of hyperglycemia in type 2 diabetes. It recommends a patient-centered approach to treatment that considers individual patient needs, preferences, and tolerances. The statement reviews the evidence on glycemic control and outcomes, discusses the increasing complexity of treatment options, and emphasizes the importance of shared decision making between clinicians and patients.
This document summarizes findings from a survey of 50 primary care physicians on their knowledge and perceptions related to treating type 2 diabetes. The survey found that many physicians were unfamiliar with current guidelines regarding appropriate A1c targets and misunderstood results from the ACCORD trial. Physicians were also more likely to recall claims made in marketing materials compared to evidence from clinical studies. Overall, the survey suggests that disseminating evidence-based practices to physicians remains challenging and that new strategies are needed to accelerate adoption of optimal treatment guidelines.
This document provides guidelines for managing hyperglycemia in type 2 diabetes from the American Diabetes Association and European Association for the Study of Diabetes. It summarizes that glycemic management has become complex with many treatment options and uncertainties about benefits. The guidelines aim to encourage individualized patient-centered care over prescriptive algorithms. Effective management of cardiovascular risk factors is also important given risks of complications. The guidelines stress shared decision making between clinicians and patients based on evidence and patient preferences and needs.
1) No studies were found that measured quality of life as an outcome of interventions aimed at improving adherence in type 2 diabetes patients.
2) The interventions studied mainly included diabetes education, nurse-led interventions, and pharmacist-led interventions.
3) Nurse-led interventions were found to increase adherence to medication, diet, and glucose monitoring. Pharmacist-led interventions also increased medication adherence.
4) Patient education interventions were found to improve quality of life, though it was not directly measured as an outcome of improved adherence.
Prevalence of cvd risk factors among qatari patients with type 2 diabetes mel...Dr. Anees Alyafei
This study examined the prevalence of cardiovascular disease (CVD) risk factors among 532 Qatari patients with type 2 diabetes attending primary health care centers in 2014. The majority of patients were found to be at high or very high risk for CVD within 10 years based on their risk factor profiles. Lifestyle risk factors such as poor diet, physical inactivity, and smoking were highly prevalent. Over 90% of patients did not meet recommendations for daily fruit and vegetable intake. Metabolic risk factors like overweight/obesity and uncontrolled diabetes were also common. Three-quarters of patients had a history of hyperlipidemia or hypertension. The study concludes that reducing CVD risk among this population will require a greater focus on modifying lifestyle-related
Assessment of cardiovascular disease risk among qatari patients with type 2 p...Dr. Anees Alyafei
Original Research Paper on the Assessment of Cardiovascular Disease Risk on Qatari Diabetics. The behavior of two risk prediction tools categorized patients differently.
https://www.researchgate.net/publication/340895704_Assessment_of_Cardiovascular_Disease_Risk_among_Qatari_Patients_with_Type_2_Diabetes_Mellitus_Attending_Primary_Health_Care_Centers_2014
Diabetic patients knowledge, attitude and practice toward oral healthAlexander Decker
This study assessed the knowledge, attitudes, and practices of 612 diabetic patients in Abha City, Saudi Arabia regarding their oral health. The results showed that over half of patients were unaware of their increased risk of oral diseases as diabetics. Less than half knew that diabetes can cause dental caries and gingivitis. While patients' oral hygiene practices were generally good, their knowledge about the oral health risks of diabetes was deficient. The study highlights the need for better patient education on maintaining oral health and the link between diabetes and oral diseases.
This document discusses the shift in diabetes management from prescriptive guidelines to individualized care. It outlines several factors that have driven this change, including a lack of evidence supporting one treatment over another and recognition that lasting improvement requires considering patient preferences. The document also describes challenges in implementing individualized care within current healthcare systems. It advocates selecting treatments based on a patient's underlying pathologies and broader cardiovascular risk rather than just their diabetes type.
Approach to Support Diabetes through Data Visualization DivyaBastola
Used Tableau to created a Geo-map by zip codes, Bar chart by sex and race, and another Bar chart by age to display the dense of diabetes prevalence in 17 zip codes of North Texas.
Literature Review is conducted to demonstrate the reduction of hyperglycemia events after the implementation of an inpatient multidisciplinary glucose control management program.
Created Info-graphic to exhibit the ways to manage diabetes through education, counseling, meal/diet, and exercise and potential comorbidities in the diabetic patient that undergoes surgeries.
This study assessed the impact of pharmacist counseling on treatment outcomes, knowledge, attitudes, and quality of life in patients with diabetes and hypertension. Patients receiving counseling showed greater improvements in blood pressure, blood sugar levels, knowledge, and physical quality of life scores compared to the control group. However, counseling had no significant effect on mental quality of life scores. The study demonstrates that pharmacist counseling can positively impact treatment outcomes and aspects of quality of life for patients managing diabetes and hypertension.
The document summarizes recommendations from a task force on interventions to reduce morbidity and mortality from diabetes. It finds:
1) Disease management in clinical settings is strongly recommended based on evidence it improves glycemic control and monitoring.
2) Case management is also strongly recommended based on evidence it improves glycemic control when combined with disease management.
3) Diabetes self-management education in community gathering places is recommended for adults with type 2 diabetes based on evidence of improved glycemic control.
This study assessed the effectiveness of a health education program for type 2 diabetes patients in Egypt. It found that most patients had low baseline knowledge about diabetes. After the education program, patients had significant improvements in their knowledge, attitudes, blood sugar levels, and HbA1c. The program involved 3 sessions over 3 months that provided information on diabetes symptoms, treatment, complications, diet, exercise, and self-management. The study demonstrated that health education can positively impact diabetes outcomes and is an important part of diabetes care.
The study profiles renal failure patients undergoing hemodialysis at B.P. Koirala Institute of Health Sciences in Nepal. It found that the majority of patients were male (74%), Hindu (93%), and from very poor communities (80%). Many patients had little knowledge about their disease, with 30% unaware of what condition they had. The most common complication reported during dialysis was nausea and vomiting (20%), followed by hypotension (9%). The study aims to help improve management and prevention of renal failure in Nepal by providing insight into patients' socio-demographic characteristics and knowledge about their treatment.
A DIRECT MEDICAL COST ANALYSIS OF PATIENTS WITH T2DM AND ITS MACROVASCULAR CO...Abith Baburaj
A DIRECT MEDICAL COST ANALYSIS OF PATIENTS WITH T2DM AND ITS MACROVASCULAR COMPLICATIONS
-A PHARMACOECONOMIC STUDY
-assessment of cost of treatment of diabetis with its macrovascular complication patients
Anti diabetic drugs in patients with diabetespharmaindexing
This study evaluated 93 diabetic patients with comorbidities to assess rational use of antidiabetic medications. The most common comorbidity was hypertension (48% of patients). Insulin was the most prescribed antidiabetic drug (64.4% of patients). Patient information materials on diabetes management were provided. The study aims to improve treatment of diabetes and comorbidities through rational prescribing and patient education.
The document describes a study protocol for a randomized controlled trial evaluating a "self-selected" lifestyle intervention aimed at improving insulin sensitivity in people at risk of developing type 2 diabetes. 360 subjects at risk will be randomly assigned to a control group receiving general lifestyle/diabetes risk information or an intervention group participating in a 12-week supervised exercise program with dietary advice. The primary outcome is change in insulin sensitivity. Secondary outcomes include other measures of glucose function, fitness, body composition, and quality of life. The intervention group will choose their own exercise classes 4 times per week and receive guidance to modify dietary choices. The study will assess if this self-selected approach improves diabetes risk factors more than the control.
This document discusses inappropriate prescribing in hospitalized elderly patients. It defines inappropriate prescribing as using medications that significantly increase the risk of adverse drug events when safer alternatives exist. Inappropriate prescribing is common in the elderly and associated with increased morbidity, mortality and healthcare costs. Risk factors in hospitals include advanced age, polypharmacy due to multiple comorbidities, and transitions of care involving multiple providers. The document reviews validated tools to evaluate inappropriate prescribing, including Beers Criteria, IPET, STOPP and MAI. It concludes inappropriate prescribing in hospitals is an important public health problem given the aging population.
This study assessed compliance to dietary counseling among 72 patients with type 2 diabetes at a hospital in Pakistan. At their first visit, 66.7% had very inadequate diets and 29.2% had poor diets. After 3 months, 19.4% had very inadequate diets and only 1.4% had poor diets, showing improved diet quality for 94.5% of subjects. Compliance rates were determined to be very good for 19.4%, good for 37.5%, and fair for 33.3%. While compliance varied by recommendation, overall rates were sufficiently high to positively change diets and potentially help control diabetes complications.
Knowledge about hypertension and antihypertensive medication compliance in a ...Alexander Decker
The document discusses a study that investigated the relationship between knowledge about hypertension and compliance with antihypertensive medications in elderly Jordanians. The study found that elders with higher knowledge scores about hypertension were more likely to comply with their medications. The document concludes that providing education to elders about hypertension and medications can help improve compliance.
Study on Role of Clinical Pharmacist in counselling of Diabetic PatientsBRNSSPublicationHubI
This study assessed the impact of clinical pharmacist counseling on knowledge, attitudes, and practices of diabetic patients in India. 120 diabetic inpatients were enrolled and counseled by clinical pharmacists during their hospital stay using oral counseling, pamphlets, and visual aids. Patients completed a questionnaire assessing knowledge, attitudes, and practices regarding diabetes before and after counseling. Results showed counseling significantly improved scores for knowledge (mean increase of 3 points), attitudes (mean increase of 0.5 points), and practices (mean increase of 0.6 points). The study concluded that clinical pharmacist counseling can effectively educate diabetic patients and play a vital role in diabetes management.
1) The study evaluated medication adherence in 100 patients with chronic kidney disease (CKD) using the Morisky Medication Adherence Scale. 36% of patients showed low adherence.
2) Common causes of low adherence were complex dosing schedules (20%), difficulty taking a large number of pills daily (20%), and forgetfulness (18%). 70% of patients were unaware of the importance of each medication.
3) There were statistically significant positive correlations between poor adherence and the number of concurrent illnesses and number of medications taken daily. Improving patient awareness and simplifying dosing regimens can help enhance medication adherence in CKD patients.
Healthcare Perceptions of Injectable Therapies for Diabetes Mellitus Type 2CrimsonPublishersIOD
Diabetes mellitus is considered a global epidemic, with financial impacts beyond the cost of treatment. Multiple treatment options are available;
however, many healthcare providers lack knowledge or face perceived barriers to prescription. While the American Diabetes Association publishes
yearly guideline updates for the management and care of diabetes, many health care providers are unfamiliar with these guidelines. These guidelines
recommend insulin and other inject able therapies early in the disease progression, yet the DAWN study demonstrated that physicians delay the initiation
of insulin therapy. This paper will review the knowledge gaps, health care provider barriers, and perceptions of inject able therapies. From this review,
more knowledge is needed by prescribers in the initiation and management of injectable therapies to help patients successfully reach glycemic targets.
1) No studies were found that measured quality of life as an outcome of interventions aimed at improving adherence in type 2 diabetes patients.
2) The interventions studied mainly included diabetes education, nurse-led interventions, and pharmacist-led interventions.
3) Nurse-led interventions were found to increase adherence to medication, diet, and glucose monitoring. Pharmacist-led interventions also increased medication adherence.
4) Patient education interventions were found to improve quality of life, though it was not directly measured as an outcome of improved adherence.
Prevalence of cvd risk factors among qatari patients with type 2 diabetes mel...Dr. Anees Alyafei
This study examined the prevalence of cardiovascular disease (CVD) risk factors among 532 Qatari patients with type 2 diabetes attending primary health care centers in 2014. The majority of patients were found to be at high or very high risk for CVD within 10 years based on their risk factor profiles. Lifestyle risk factors such as poor diet, physical inactivity, and smoking were highly prevalent. Over 90% of patients did not meet recommendations for daily fruit and vegetable intake. Metabolic risk factors like overweight/obesity and uncontrolled diabetes were also common. Three-quarters of patients had a history of hyperlipidemia or hypertension. The study concludes that reducing CVD risk among this population will require a greater focus on modifying lifestyle-related
Assessment of cardiovascular disease risk among qatari patients with type 2 p...Dr. Anees Alyafei
Original Research Paper on the Assessment of Cardiovascular Disease Risk on Qatari Diabetics. The behavior of two risk prediction tools categorized patients differently.
https://www.researchgate.net/publication/340895704_Assessment_of_Cardiovascular_Disease_Risk_among_Qatari_Patients_with_Type_2_Diabetes_Mellitus_Attending_Primary_Health_Care_Centers_2014
Diabetic patients knowledge, attitude and practice toward oral healthAlexander Decker
This study assessed the knowledge, attitudes, and practices of 612 diabetic patients in Abha City, Saudi Arabia regarding their oral health. The results showed that over half of patients were unaware of their increased risk of oral diseases as diabetics. Less than half knew that diabetes can cause dental caries and gingivitis. While patients' oral hygiene practices were generally good, their knowledge about the oral health risks of diabetes was deficient. The study highlights the need for better patient education on maintaining oral health and the link between diabetes and oral diseases.
This document discusses the shift in diabetes management from prescriptive guidelines to individualized care. It outlines several factors that have driven this change, including a lack of evidence supporting one treatment over another and recognition that lasting improvement requires considering patient preferences. The document also describes challenges in implementing individualized care within current healthcare systems. It advocates selecting treatments based on a patient's underlying pathologies and broader cardiovascular risk rather than just their diabetes type.
Approach to Support Diabetes through Data Visualization DivyaBastola
Used Tableau to created a Geo-map by zip codes, Bar chart by sex and race, and another Bar chart by age to display the dense of diabetes prevalence in 17 zip codes of North Texas.
Literature Review is conducted to demonstrate the reduction of hyperglycemia events after the implementation of an inpatient multidisciplinary glucose control management program.
Created Info-graphic to exhibit the ways to manage diabetes through education, counseling, meal/diet, and exercise and potential comorbidities in the diabetic patient that undergoes surgeries.
This study assessed the impact of pharmacist counseling on treatment outcomes, knowledge, attitudes, and quality of life in patients with diabetes and hypertension. Patients receiving counseling showed greater improvements in blood pressure, blood sugar levels, knowledge, and physical quality of life scores compared to the control group. However, counseling had no significant effect on mental quality of life scores. The study demonstrates that pharmacist counseling can positively impact treatment outcomes and aspects of quality of life for patients managing diabetes and hypertension.
The document summarizes recommendations from a task force on interventions to reduce morbidity and mortality from diabetes. It finds:
1) Disease management in clinical settings is strongly recommended based on evidence it improves glycemic control and monitoring.
2) Case management is also strongly recommended based on evidence it improves glycemic control when combined with disease management.
3) Diabetes self-management education in community gathering places is recommended for adults with type 2 diabetes based on evidence of improved glycemic control.
This study assessed the effectiveness of a health education program for type 2 diabetes patients in Egypt. It found that most patients had low baseline knowledge about diabetes. After the education program, patients had significant improvements in their knowledge, attitudes, blood sugar levels, and HbA1c. The program involved 3 sessions over 3 months that provided information on diabetes symptoms, treatment, complications, diet, exercise, and self-management. The study demonstrated that health education can positively impact diabetes outcomes and is an important part of diabetes care.
The study profiles renal failure patients undergoing hemodialysis at B.P. Koirala Institute of Health Sciences in Nepal. It found that the majority of patients were male (74%), Hindu (93%), and from very poor communities (80%). Many patients had little knowledge about their disease, with 30% unaware of what condition they had. The most common complication reported during dialysis was nausea and vomiting (20%), followed by hypotension (9%). The study aims to help improve management and prevention of renal failure in Nepal by providing insight into patients' socio-demographic characteristics and knowledge about their treatment.
A DIRECT MEDICAL COST ANALYSIS OF PATIENTS WITH T2DM AND ITS MACROVASCULAR CO...Abith Baburaj
A DIRECT MEDICAL COST ANALYSIS OF PATIENTS WITH T2DM AND ITS MACROVASCULAR COMPLICATIONS
-A PHARMACOECONOMIC STUDY
-assessment of cost of treatment of diabetis with its macrovascular complication patients
Anti diabetic drugs in patients with diabetespharmaindexing
This study evaluated 93 diabetic patients with comorbidities to assess rational use of antidiabetic medications. The most common comorbidity was hypertension (48% of patients). Insulin was the most prescribed antidiabetic drug (64.4% of patients). Patient information materials on diabetes management were provided. The study aims to improve treatment of diabetes and comorbidities through rational prescribing and patient education.
The document describes a study protocol for a randomized controlled trial evaluating a "self-selected" lifestyle intervention aimed at improving insulin sensitivity in people at risk of developing type 2 diabetes. 360 subjects at risk will be randomly assigned to a control group receiving general lifestyle/diabetes risk information or an intervention group participating in a 12-week supervised exercise program with dietary advice. The primary outcome is change in insulin sensitivity. Secondary outcomes include other measures of glucose function, fitness, body composition, and quality of life. The intervention group will choose their own exercise classes 4 times per week and receive guidance to modify dietary choices. The study will assess if this self-selected approach improves diabetes risk factors more than the control.
This document discusses inappropriate prescribing in hospitalized elderly patients. It defines inappropriate prescribing as using medications that significantly increase the risk of adverse drug events when safer alternatives exist. Inappropriate prescribing is common in the elderly and associated with increased morbidity, mortality and healthcare costs. Risk factors in hospitals include advanced age, polypharmacy due to multiple comorbidities, and transitions of care involving multiple providers. The document reviews validated tools to evaluate inappropriate prescribing, including Beers Criteria, IPET, STOPP and MAI. It concludes inappropriate prescribing in hospitals is an important public health problem given the aging population.
This study assessed compliance to dietary counseling among 72 patients with type 2 diabetes at a hospital in Pakistan. At their first visit, 66.7% had very inadequate diets and 29.2% had poor diets. After 3 months, 19.4% had very inadequate diets and only 1.4% had poor diets, showing improved diet quality for 94.5% of subjects. Compliance rates were determined to be very good for 19.4%, good for 37.5%, and fair for 33.3%. While compliance varied by recommendation, overall rates were sufficiently high to positively change diets and potentially help control diabetes complications.
Knowledge about hypertension and antihypertensive medication compliance in a ...Alexander Decker
The document discusses a study that investigated the relationship between knowledge about hypertension and compliance with antihypertensive medications in elderly Jordanians. The study found that elders with higher knowledge scores about hypertension were more likely to comply with their medications. The document concludes that providing education to elders about hypertension and medications can help improve compliance.
Study on Role of Clinical Pharmacist in counselling of Diabetic PatientsBRNSSPublicationHubI
This study assessed the impact of clinical pharmacist counseling on knowledge, attitudes, and practices of diabetic patients in India. 120 diabetic inpatients were enrolled and counseled by clinical pharmacists during their hospital stay using oral counseling, pamphlets, and visual aids. Patients completed a questionnaire assessing knowledge, attitudes, and practices regarding diabetes before and after counseling. Results showed counseling significantly improved scores for knowledge (mean increase of 3 points), attitudes (mean increase of 0.5 points), and practices (mean increase of 0.6 points). The study concluded that clinical pharmacist counseling can effectively educate diabetic patients and play a vital role in diabetes management.
1) The study evaluated medication adherence in 100 patients with chronic kidney disease (CKD) using the Morisky Medication Adherence Scale. 36% of patients showed low adherence.
2) Common causes of low adherence were complex dosing schedules (20%), difficulty taking a large number of pills daily (20%), and forgetfulness (18%). 70% of patients were unaware of the importance of each medication.
3) There were statistically significant positive correlations between poor adherence and the number of concurrent illnesses and number of medications taken daily. Improving patient awareness and simplifying dosing regimens can help enhance medication adherence in CKD patients.
Healthcare Perceptions of Injectable Therapies for Diabetes Mellitus Type 2CrimsonPublishersIOD
Diabetes mellitus is considered a global epidemic, with financial impacts beyond the cost of treatment. Multiple treatment options are available;
however, many healthcare providers lack knowledge or face perceived barriers to prescription. While the American Diabetes Association publishes
yearly guideline updates for the management and care of diabetes, many health care providers are unfamiliar with these guidelines. These guidelines
recommend insulin and other inject able therapies early in the disease progression, yet the DAWN study demonstrated that physicians delay the initiation
of insulin therapy. This paper will review the knowledge gaps, health care provider barriers, and perceptions of inject able therapies. From this review,
more knowledge is needed by prescribers in the initiation and management of injectable therapies to help patients successfully reach glycemic targets.
This document outlines a research protocol to study the psychosocial predictors and mitigation of problems among diabetes clients. The study aims to determine psychosocial factors that influence patients' ability to learn diabetes self-care and aims to improve quality of life by conducting an education program. Psychosocial factors like depression are known to interfere with diabetes management. The study rationale is that knowledge about diabetes is low in Nepal and complications are high, so there is a need for diabetes education. The implications are that psychosocial support from nurses and specialists can improve outcomes for diabetes patients.
THE PREVALENCE AND IMPACT OF DIABETIC RETINOPATHY AMONG TYPE 2 DIABETES POPUL...indexPub
Objective: This study aimed to evaluate the prevalence and visual impact of Diabetic Retinopathy (DR) among individuals with Type 2 Diabetes (T2D) in Hazara, Pakistan. Methods: A cross-sectional study was conducted from May to August 2023. The sample consisted of 1332 patients who attended the Outpatient Department for eye examination, with 133 (10%) identified as diabetics. Parameters such as glycemic control, HbA1C levels, comorbidities, family history, medication, lifestyle factors, and ocular manifestations were analyzed. Results: The study indicated that 73.01% of diabetic patients had uncontrolled glycemic levels. The prevalence of refractive errors was high (84.12%), and the incidence of DR was significant, with 6.34% having proliferative DR. The findings also emphasized lifestyle factors, including screen usage and spectacle usage patterns. In addition, weight-height proportions and a family history of diabetes were associated with the incidence of DR. Conclusion: The high prevalence of uncontrolled diabetes and significant incidence of DR underscores the urgent need for improved diabetes management and regular screenings for early detection of DR. The results advocate for prioritizing regular health checkups, enhancing public health strategies, and improving accessibility to healthcare facilities, particularly in rural regions.
Medication non-adherence is a growing concern, as it is increasingly associated with negative health outcomes and higher cost of care. Tackling the burden of non-adherence requires a collaborative, patient-centric approach that considers individual patient needs and results in intelligent interventions that combine high-tech with high-touch.
Medication non-adherence is a growing concern, as it is increasingly associated with negative health outcomes and higher cost of care. Tackling the burden of non-adherence requires a collaborative, patient-centric approach that considers individual patient needs and results in intelligent interventions that combine high-tech with high-touch.
This document presents a position statement from the American Diabetes Association and European Association for the Study of Diabetes on the management of hyperglycemia in type 2 diabetes. It recommends a patient-centered approach that considers individual patient needs, preferences, and tolerances. Glycemic control is important but must be pursued as part of a multifactorial approach that addresses cardiovascular risk factors. Treatment should be tailored based on disease factors, patient characteristics, and constraints like age and comorbidities. The goal is to encourage shared decision making between clinicians and patients.
Improving Medication Adherence among Type II Home Healthcare DMalikPinckney86
The document discusses a quality improvement project that aims to improve medication adherence among type 2 diabetic patients receiving home healthcare. It will evaluate the effectiveness of implementing resources from the New York City Department of Health and Mental Hygiene Medication Adherence Project (MAP). A quantitative methodology will be used to compare pre-and post-implementation medication adherence rates. Nurses will provide MAP resources to patients over 4 weeks and record adherence data in electronic medical records. The project intends to help patients better manage their condition and reduce healthcare costs.
Pharmacy practice has changed significantly lately. The professionals have the chance to contribute straightforwardly to patient consideration so as to lessen morbimortality identified with medica-tion use, promoting wellbeing and preventing diseases
A study on prescription pattern and rational use of statins in tertiary care ...SriramNagarajan16
Objectives
Our objectives are to evaluate prescription pattern and rational use of statins in a tertiary care corporate hospital.
Methodology
It was a prospective observational study conducted for a period of 6 months and included various departments of 300
bedded multi specialty tertiary care corporate hospital. A total of 200 patients were included and the study criteria
was inpatients and induvial more than 18 years of either gender who are prescribed with HMG-CoA reductase
inhibitors.
Results
In the present study 200 patients belonged to the age group of above 18 years, out of which about 65% were male
and 35% were female. Atorvastatin (67%) was prescribed mostly and Rosuvastatin (29.5%) was also used.
Conclusion
It is finally concluded that Rational and prophylactic use of statins can reduce further complications of Diabetes
Mellitus (DM) and cardiac events.
Statins treatment is favourable in long term treatment of diseases, it is most effectively used in treatment of serious
disease conditions which has shown its immense therapeutic role in treatment
Medication non-adherence is a significant problem for older adults that can lead to worse health outcomes and increased healthcare costs. Many factors contribute to non-adherence in older patients, including complex medication regimens, lack of understanding about their conditions and treatments, side effects, and social determinants. Assessing adherence and addressing the underlying factors through clear communication, education, and simplifying regimens can help improve medication taking in older adults.
Medication adherence is defined as a patient conforming to a healthcare provider's recommendations regarding timing, dosage, and frequency of medication. It involves filling prescriptions and refilling on time. Non-adherence can be caused by patient factors like forgetfulness or cost barriers, physician factors like complex regimens, and health system factors like fragmented care. Pharmacists can improve adherence through education on medication purpose, usage, and side effects. Adherence is especially important for chronic conditions and can be monitored through patient assessments.
BRP Pharmaceuticals is a leader in physician dispensing services that provides instant medication to patients located in Burbank, CA. Visit: http://www.brppharma.com/
Medication adherence is essential for achieving positive therapeutic outcomes, especially in chronic diseases. Non-adherence has many causes like patients not believing treatment is necessary, complex regimens, or poor communication with providers. Pharmacists can play an important role in improving adherence through patient education, simplifying dosing, minimizing side effects, reminder calls/texts, and identifying individual barriers. Proper adherence monitoring is also important, as it allows interventions when non-adherence is detected. Both direct methods like biological fluid testing and indirect methods like pill counting can assess adherence, though indirect methods are less expensive.
DEFINITION
BACKGROUND
METHODS OF ASSESSING COMPLIANCE.
Factors concerned with compliance.
BARRIERS TO COMPLIANCE
IMPROVEMENT OF COMPLIANCE .
NON-COMPLIANCE FACTORS.
Adverse Drug Reactions Risk Factors, Epidemiology, and Management Strategiesijtsrd
Objectives The objective of this article is to review the impact of various factors on the occurrence of Adverse Drug Reactions ADRs . Summary ADRs can be caused by several factors, including patient related, drug related, and social factors. Age is a crucial factor in the occurrence of ADRs, with both very young and very old patients being more vulnerable than other age groups. Alcohol consumption also plays a significant role in ADRs. Other factors that affect ADRs include gender, race, pregnancy, breastfeeding, kidney problems, liver function, drug dose and frequency, and many others. The medical literature has extensively documented the impact of these factors on ADRs. Taking these factors into account during medical evaluation enables healthcare professionals to choose the most appropriate medication regimen for their patients. Conclusion Various factors affect the occurrence of ADRs, some of which can be changed such as smoking or alcohol consumption while others cannot be changed such as age or genetic factors . Understanding the impact of these factors on ADRs can help healthcare professionals to select the best medication for their patients and provide them with appropriate advice. Pharmacogenomics, a new and innovative science, emphasizes the genetic predisposition of ADRs, providing a new perspective in the drug selection decision making process. B. Divya Durga "Adverse Drug Reactions- Risk Factors, Epidemiology, and Management Strategies" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-7 | Issue-2 , April 2023, URL: https://www.ijtsrd.com.com/papers/ijtsrd56216.pdf Paper URL: https://www.ijtsrd.com.com/pharmacy/other/56216/adverse-drug-reactions-risk-factors-epidemiology-and-management-strategies/b-divya-durga
Knowledge, attitude, practice and associated factorsBeka Aberra
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study of compliance of diabetic patients to prescribed mediation
1. International Journal of Scientific and Research Publications, Volume 9, Issue 6, June 2019 911
ISSN 2250-3153
http://dx.doi.org/10.29322/IJSRP.9.06.2019.p90132 www.ijsrp.org
Study of Compliance of Diabetic Patients to
Prescribed Medication
Amber Hameed, Tehreem Rashid, Washma Amin
*
4TH Year MBBS, University Medical and Dental College Faisalabad
DOI: 10.29322/IJSRP.9.06.2019.p90132
http://dx.doi.org/10.29322/IJSRP.9.06.2019.p90132
Abstract- Introduction: The important determinant of treatment
success is adherence to recommended medication and it is one of
the factors which plays a major role between process of disease
and its prognosis. Compliance of patients depends on many factors
such as resource limitations, cost of the treatments, patient’s
beliefs.Diabetes mellitus is a metabolic disorder. There are two
types which are type 1 diabetes and type 2 diabetes.In patients with
diabetes, non-adherence can lead to many serious complications.
Primary goal in management of diabetes is to keep the blood
glucose levels stable. Majority of diabetic patients are ineffectual
in controlling their blood glucose levels with modifications in diet
,exercise and required medication. The aim of this study was to
assess the compliance of diabetic patients to prescribed clinical
regimen and factors affecting it.
Material and methods: Study design Descriptive cross-
sectional study method. Setting: It was conducted in hospitals of
Faisalabad. Duration of study: 6 months; From Jan 2018- June
2018. Sample size: 60 diabetic patients. Sample technique:
random sampling. Sample selection: We included diabetic
patients of all ages and excluded non-diabetic patients. Data
collection procedure: provided well-structured close ended
questionnaire to diabetic patients. Data analysis: SPSS version
20.
Results: According to research, 60% of patients were
compliant to medication while 40% of patients were not adherent.
38% people abstain from medicine when they started feeling
better. People related to lower socio-economic status were more
non-compliant (21.7%). Significant association was found
between knowledge of patient about medicine and compliance to
medication (p-value0.03).
Conclusion: Compliance to medication is an important
factor in managing the diabetes. Several factors affect the medical
adherence including socio-economic status, treatment regimen
complexity and knowledge of patient about disease and
medication.
Index Terms- non-adherence, diabetes mellitus, compliance,
factors of compliance.
I. INTRODUCTION
he important determinant of treatment success is adherence to
recommended medication. According to WHO, medical
adherence is defined as “the degree to which the person’s
behaviour corresponds with the agreed recommendations from a
health care provider”. Compliance to treatment is one of the
factors which plays a major role between process of disease and
its prognosis 1
. Poor compliance to prescribed medication can
result in further deterioration of health. Compliance of patients
depends on many factors such as resource limitations, cost of the
treatments, patients beliefs and expectations that prevent person to
follow prescribed medication 2
.
Compliance can be divided into two types; When the
medication is not available to patient then it is called primary non-
compliance and when the medication is not taken as prescribed,
by the patients then it is called secondary non-compliance. It can
be further divided as intentional and unintentional non-
compliance. If diagnosis and treatment of a doctor is rejected by
patient then it is called intentional non-compliance and factors like
social, demographic, psychological and unawareness to
medication can lead to unintentional non-compliance 3
.
Diabetes mellitus is a chronic disorder which is metabolic
in nature and can result either from decrease in insulin production
in body which is Type 1 diabetes or due to increase in insulin
resistance which is called Type 2 diabetes. It is a condition which
adversely affects quality of life and managing this condition is a
complicated task. Diabetes mellitus occurs throughout the world
but greatest increase in prevalence occurs in third world countries.
According to recent research , 451 million adults have diabetes
mellitus 4
. The prevalence of diabetes mellitus type 2 in Pakistan
in 2016 was 11.77% 5
. Moreover, in Pakistan the prevalence of
diabetes mellitus is very high and estimated to reach 15% (14
million) by 20306
.
Non-adherence to treatment is a serious problem in
patients with chronic diseases like diabetes and adherence to
medication is poor in such patients regardless of how much
information was given to them about importance of treatment 7.
Prevalence of adherence to diabetes treatment is reported to range
from 23% to 77%8
. According to one research conducted in
Pakistan, 35% of patients were found to be non-compliant and
20% were compliant 9
. It is also found in another research that rate
of non-adherence in patients with poor knowledge of diabetes is
47% while it is much less (7.8%) in patients who have good
knowledge about diabetes 10
. Such minimum adherence in patients
can result in poor health outcomes and it also has a notable effect
on health care costs11
like increase costs of outpatient care , ER
visits, hospitalization and managing the diabetic complications.
One of the pitfalls of non-adherence in a diabetic patient is
that it doubles the risk of hospitalization. Despite the fact that
diabetes is manageable and reversible with appropriate
management, patients frequently do not comply with
recommended treatment. To keep the blood glucose levels stable
T
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and at normal levels is the primary and main goal in management
of diabetes, in-order to can prevent or delay other medical hazards
that can happen secondary to diabetes. Chances of occurrence of
grave complications of diabetes are much less in people who keep
their blood sugar levels well-controlled. Poor medication
compliance is considerably associated with poor glycemic control.
Majority of diabetic patients are ineffectual in controlling blood
sugar levels with modifications in diet, exercise and required
medication. Pharmacotherapy includes oral hypoglycaemic
agents, injectable insulin formulations and combination therapy.
Chronic poor glycemic control can lead to high rates of morbidity,
mortality and compliance is a key factor regarding this 12
.
Complications of diabetes are retinopathy, neuropathy,
heart diseases, diabetic foot, kidney failure etc. These
complications can prove fatal in non treated person making
diabetes the 8th
leading cause of death in the world 12
.
Objectives:
1) To assess the compliance of diabetic patients to clinical
regimen
2) To scrutinise the factors resulting in non-compliance in
diabetic patients.
Operational definition:
Compliance is defined as engaging in a response that
matches the delivered instructions within ‘x’ seconds from the
time instruction was given and completing request.
II. MATERIAL AND METHODS
i) Study design:
Descriptive cross-sectional study method.
ii) Setting:
It was conducted in hospitals of Faisalabad.
iii) Duration of study:
Duration of this study was 6 months; From Jan 2018- June 2018.
iv) Sample size:
60 diabetic patients.
v) Sample technique:
It was a random sampling
vi) Sample selection:
We included diabetic patients of all ages.
We excluded non-diabetic patients.
Data collection procedure:
We provided well-structured close ended questionnaire to
diabetic patients and data was collected.
Data analysis:
We analysed our results through SPSS version 20.
III. RESULTS
Different factors including age, sex, education , socio-
economic status, duration of diabetes, disease and medicine
related knowledge were associated with medication adherence.
According to research, 60% of patients were compliant to
medication while 40% of patients were non-compliant, out of
which 25% skip their medicine 1-2 times a week. Modifications in
dosage of drug were done by 33% patients. It is found that 38%
people abstain from medicine when they started feeling better.
Some patients stop taking medicines because they felt that
medicine was not effective or it was expensive. Patients who take
medicine more than 3 times a day or take both oral and injectable
forms are found to be non-compliant because of complexity of
regimen. People belonging to lower socio-economic status were
found to be more non-compliant (21.7%) as compared to higher
socio-economic status(1.7%). Another factor associated with non-
adherence is knowledge about diabetes and medicine which 68%
of patients do not have and it is based on information given by
physicians to patients about disease and medicine(66% of patients
were not given any information). Non-compliance was found in
old, uneducated, poor people who were ignorant of benefit of
medication and complications of diabetes.
Figure1:
60%
40%
Compliance of medication in surveyed
population
Patients are compliant
Patients are non-compliant
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This illustrates that 40% of people do not take medicine at recommended time while 60% of patients are compliant to medication.
Figure2:
This shows that one of main reason for noncompliance in patients is when they start feeling better(47%) Other reasons are complexity
of regimen(5.8%)medicine is expensive(9.8%), feeling that drug is not effective(11.7%) or they are taking them for a long time(7.8%).
Figure 3: Relation between compliance of medication and knowledge about
Medicine among surveyed population
This illustrates that people with good knowledge about importance of treatment take their medicine at appropriate time while people
with no knowledge about importance of medication do not comply to treatment.
Figure 4: Relation between information given by physician and knowledge about medicine among surveyed population
47.06%
17.65%
9.80%
11.76%
5.88%
7.84%
Factors affecting the rate of compliance among
surveyed population When feeling better
When feeling worse
Medicine is expensive
feeling that drug is not
effective
Compexity of drug regimen
Taking them for many years
0
5
10
15
20
25
YES NO
knowledge about medicine-
yes
knowledge about medicine-no
Always take medicine at appropriate
ti ti
count
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This figure shows that patient’s knowledge of their disease and medication depends on information given to them by
physicians. If information is given by physicians then patients have knowledge about medication and they show compliance while on
the other hand people have no knowledge if they are not provided any information and guidance.
Figure 5: Relation between socio-economic status of surveyed population and ability to regularly monitor blood glucose levels
This illustrates that people belonging to lower socio-economic status do not regularly monitor their blood glucose levels while people
with higher socio-economic status do monitor their blood glucose level
0
10
20
30
40
YES NO
Good knowledge about
medicine-yes
Good knowledge about
medicine-no
0
5
10
15
20
25
lower class middle class upper class
regularly monitor blood glucose
levels-yes
regularly monitor blood glucose
levels
Information given by physician about medicine
Socio-economic status
countcount
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Figure 6:
Factors p-value
Good knowledge about medicine* always take medicine at
appropriate time
0.03
Information given by physician about medicine* good knowledge
about medicine
0.00
Socio-economic status* information given by physician about
medicine
0.04
Socio-economic status* regularly monitoring of blood glucose 0.001
This figure shows that there is significant association between compliance of patients to treatment and patient’s knowledge about
medicine.. Good knowledge of patients about medicine is also associated with the information given by physician. Socio-economic
status is also found to be significantly associated with information given by physician and ability of patients to regularly monitor their
blood glucose levels.
Figure 7: Interrelationship between factors affecting compliance to medication
This figure shows the interrelationship between different factors and adherence to medication
IV. DISCUSSION
In this study, ,the adherence to the diabetic medication was
60% which was associated with socioeconomic status, information
given by the physician about medication, patient’s knowledge
about medication and monitoring of blood glucose regularly by
patients.
Socio-Economic status was associated with adherence to
medication. In this study people belonging to poor socio-economic
status were found to be more non compliant (21.7%). Socio-
Economic status is a person’s economic and social position that
they occupy within a given social structure and it is one of the
Compliance
to treatment
socio-
economic
status
regularly
monitoring
of blood
glucose
levels
complexity of
drug regimen
good
knowledge
about
medicine
Information
given by
physician to
patient
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major factor which contributes to many cases of diseases and
disability, including diabetes13,14
. Above 80% of deaths due to
diabetes occurs in middle and low income countries15
.According
to this study, socio-economic status was related to medical
compliance as non-compliance was found to be 21.7% in people
belonging to lower socio-economic status while non-compliance
found in people with higher socio-economic status was 1.7%
similar to a study which shows that in people with high income
and good socio-economic status adherence increases to 90% 16
.
Different studies shows socio-economic status as major
determinant of adherence to anti-diabetic and thus low income
have been associated with high rates of non-adherence. 17,18,19
Knowledge of patient about diabetic medication was also
an important factor contributing to the compliance to medication.
Out of total 40% patients who had poor adherence to medication
68.3% didn’t have good knowledge about their medication. In
other studies common cause of non-adherence was due to limited
knowledge of disease and medication20.
In another study, the
patients who had adequate knowledge about diabetes were found
to be 45% and out of which 93.33% of patients were adherent to
therapy21
. In our study patients with better knowledge about
medication had better adherence to medication (p-value0.03).
The education status of the patient had no significant
relationship with adherence to medication (p-value 0.4) as
compared to the study where patients with good education level
and knowledge had better treatment adherence (P=0.001)21
.
Information given by physician about diabetic medication
to patients had very significant role in medication adherence.
Compliance to treatment improves the outcome of a disease,
prevents complications of unnecessary interventions22
. Among
total 40% of patients were non-adherent to medication, 66.7%
patients didn’t get information about medication from their
physician. Physician communication is significantly related with
patients adherence23
. Risk of non-adherence is 19% among
patients whose physician communicate poorly. This study result
shows that information given by physician about medication had
a very important role in adherence to medication. Adherence to
medication is about 70% in patients who were given information
by physician similar to a study which shows that patient’s
medication adherence becomes 2.16 times better if his physician
communicates well with them and there is a significant role
between patients adherence to medication and their physician
communication and knowledge given by him (P=0.001)23
.
Complexity of drug regimen and cost effective treatment
were also important factors which play part in compliance among
surveyed group. According to our study, there is significant
association between complexity of drug regimen and patient
adherence to medication (p-value0.009). Similar results were
obtained in another research which shows that adherence
decreases with increasing frequency of medication (79% to 94%
for once-daily while 38% to 67% for thrice-daily; p-value<0.05)
24
.
In our study, Regular checking blood glucose levels was
strongly associated with socio-economic status (p-value0.001) but
with adherence to medication, it was not found to be significantly
associated as compared to the results obtained in other studies
which shows that self -monitoring of blood glucose levels lead to
better adherence & low glucose levels (P < 0.0001)25
.
Limitations: some factors limit the scope of our study
such as small sample size and restricted areas for study. Patient
factors were also included like their coordination and willingness
to participate in research.
Recommendations: Physicians should provide adequate
knowledge about disease and its complications especially to
uneducated and to those who belong to lower socio-economic
status so that they can show adherence to medication. Also
Government should lower down the prices of medicines so that
people can afford them.
V. CONCLUSION
It is apparent that diabetes is a progressive disease and to
maintain normal blood glucose levels and to reduce adverse
outcomes, compliance to medication has an important role.
Despite of beneficial outcomes the compliance to medication is
suboptimal among diabetic patients. There are several reasons for
poor adherence including knowledge of a patient about medicine
and disease, complexity of clinical regimen, socio-economic
status (poor, uneducated) have key roles in non-adherence to
diabetic medication.
Moreover, stoppage of taking medicine when patient start
feeling better has also an important role in poor adherence.
Certainly, adherence to medication needs to be improved.
Measures to improve compliance in diabetic patients should
include doctor-patient communication, reduction in complexity of
treatment regimen and reduction in cost of medicines.
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AUTHORS
First Author – Amber Hameed, 4TH Year MBBS
University Medical and Dental College Faisalabad
Second Author – Tehreem Rashid, 4TH Year MBBS
University Medical and Dental College Faisalabad
Third Author – Washma Amin, 4TH Year MBBS
University Medical and Dental College Faisalabad