scholarly journals Beliefs about medicines and non-adherence in patients with stroke, diabetes mellitus and rheumatoid arthritis: a cross-sectional study in China

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e017293 ◽  
Author(s):  
Li Wei ◽  
Sarah Champman ◽  
Xiaomei Li ◽  
Xin Li ◽  
Sumei Li ◽  
...  

ObjectivesTo investigate beliefs about medicines and their association with medicine adherence in patients with chronic diseases in China.DesignA cross-sectional questionnaire-based studySettingTwo large urban hospitals in Hefei and Tianjin, ChinaParticipantsHospital inpatients (313 stroke patients) and outpatients (315 diabetic patients and 339 rheumatoid arthritis (RA) patients) were recruited between January 2014 and September 2014.Outcome measuresThe Beliefs about Medicines Questionnaire (BMQ), assessing patients’ beliefs about the specific medicine (Specific-Necessity and Specific-Concerns) prescribed for their conditions (stroke/diabetes/RA) and more general background beliefs about pharmaceuticals as a class of treatment (BMQ-General Benefit, Harm and Overuse); the Perceived Sensitivity to Medicines scale (PSM) assessed patients’ beliefs about how sensitive they were to the effects of medicines and the Medication Adherence Report Scale. The association between non-adherence and beliefs about medicines was assessed using a logistic regression model.ResultsPatients with diabetes mellitus had a stronger perceived need for treatment (mean (SD) Specific-Necessity score, 3.75 (0.40)) than patients with stroke (3.69 (0.53)) and RA (3.66 (0.44)) (p=0.049). Moderate correlations were observed between Specific-Concerns and General-Overuse, General-Harm and PSM (Pearson correlation coefficients, 0.39, 0.49 and 0.49, respectively, p<0.01). Three hundred and eleven patients were non-adherent to their medicine (159 (51.0%) in the stroke group, 60 (26.7%) in the diabetes mellitus group and 62 (19.8%) in the RA group, p<0.01). Across the whole sample, after adjusting for demographic characteristics, non-adherence was associated with patients who had higher concerns about their medicines (OR, 1.35, 95% CI 1.07 to 1.71) and patients who believed that they were personally sensitive to the effects of medications (OR 1.44, 95% CI 1.16 to 1.85).ConclusionThe BMQ is a useful tool to identify patients at risk of non-adherence. In the future, adherence intervention studies may use the BMQ to screen for patients who are at risk of non-adherence and to map interventional support.

Author(s):  
Singam Sivasankar Reddy ◽  
Syeda Rahath ◽  
Rakshitha H N ◽  
Godson K Lal ◽  
Swathy S ◽  
...  

The objective of the study was to evaluate the risk of diabetes mellitus in elderlywith age above 20 years in a hospital setting using Indian Diabetes risk score and to provide patient counselling regarding their life style modifications and health related quality of life among participants with high risk of developing diabetes.A total of 125 non diabetic patients were interviewed with a pre designed selfstructured questionnaire (IDRS). Participants were chosen voluntarily and a written consent was obtained before the administration of the questionnaire from individual patients. In our study we observed that out of 125 patients,males 26[59%]and 18[41%] females were at high risk, males 39[58.2%] and 28[41.8%] females were at moderate risk, males 5[35.7%] and 9[64.3%] females were at low risk of developing diabetes mellitus.


1969 ◽  
Vol 2 (2) ◽  
pp. 187-191
Author(s):  
Sahibzada Saeed Jan ◽  
Taj Muhammad Khan ◽  
Alamzeb ◽  
Izaz-urrahman ◽  
Amanullah ◽  
...  

Background: As hypertension is the most important risk factor for stroke, it is generally considered to beasymptomatic condition and require lifetime therapy which may include chemotherapy and lifestylechanges. Hypertension also clearly contributes to the risk of macrovascular disease in patients with type-IIdiabetes mellitus. Therefore, the present study was conducted to evaluate the prevalence of hypertension indiabetic and non-diabetic stroke patients in community hospital district Swat. Methodology: This was a cross-sectional study, comprised of 100 subjects, 50 were diabetic and 50 werenon-diabetic stroke patients of ages between 28 to 90 years. The blood sugar (random and fasting), bloodpressure (systolic and diastolic) of Diabetic stroke subjects were compared with Non-diabetic strokesubjects. Results: The prevalence of hypertension was significantly high in diabetic stroke subject as compared tonon-diabetic stroke subjects. Conclusion: Diabetic patients with persistently elevated blood pressure are more prone to develop stroke ascompared to non diabetic with hypertension KEYWORDS:Stroke, Diabetes mellitus, hypertension.


Author(s):  
Muhammad Zohaib Siddiq ◽  
Shahid Hussain Memon ◽  
Anwar Ali ◽  
Tabassum Almas ◽  
Atiya Razzaq ◽  
...  

Background: Previous studies have established the fact that diabetic patients are predominantly inclined towards silent myocardial infarction (SMI). The objective of the present study is to determine the incidence of SMI in diabetes mellitus (DM) patients. Methodology: In this cross-sectional study, patient data was gathered on a predesigned proforma regarding the detailed history of dyspnea, DM and its duration, chest pain either present or not. Those patients who had normal ECG labeled negative for SMI, while those who had either ST-segment elevation or ST-segment deviation on resting ECG were positive for SMI. Study was conducted at the National Institute of Cardiovascular Diseases (NICVD) Karachi- Pakistan. Results: The mean age of the enrolled patients was 54.21±8.65 (40-70) years. Out of 210, majority were female (51.90%).Overall, 94(44.76%) patients were obese, 122(58.09%) were hypertensive, 90(42.85%) had dyslipidemia and 98(46.66%) diabetic patients were smokers. There were 93 (44.3%) DM patients who had SMI. Moreover, 109(51.90%) patients had a family history of myocardial ischemia. Conclusion:  The SMI incidence among diabetic patients was found higher in local population. It is proposed that diabetic patients with demonstrated cardiovascular autonomic neuropathy must be screened for the manifestation of SMI.


2021 ◽  
Vol 8 ◽  
Author(s):  
Yunru Liao ◽  
Zhenlan Yang ◽  
Zijing Li ◽  
Rui Zeng ◽  
Jing Wang ◽  
...  

Purpose: Purpose of this study is to evaluate the measuring consistency of central refraction between multispectral refraction topography (MRT) and autorefractometry.Methods: This was a descriptive cross-sectional study including subjects in Sun Yat-sen Memorial Hospital from September 1, 2020, to December 31, 2020, ages 20 to 35 years with a best corrected visual acuity of 20/20 or better. All patients underwent cycloplegia, and the refractive status was estimated with autorefractometer, experienced optometrist and MRT. We analyzed the central refraction of the autorefractometer and MRT. The repeatability and reproducibility of values measured using both devices were evaluated using intraclass correlation coefficients (ICCs).Results: A total of 145 subjects ages 20 to 35 (290 eyes) were enrolled. The mean central refraction of the autorefractometer was −4.69 ± 2.64 diopters (D) (range −9.50 to +4.75 D), while the mean central refraction of MRT was −4.49 ± 2.61 diopters (D) (range −8.79 to +5.02 D). Pearson correlation analysis revealed a high correlation between the two devices. The intraclass correlation coefficient (ICC) also showed high agreement. The intrarater and interrater ICC values of central refraction were more than 0.90 in both devices and conditions. At the same time, the mean central refraction of experienced optometrist was −4.74 ± 2.66 diopters (D) (range −9.50 to +4.75D). The intra-class correlation coefficient of central refraction measured by MRT and subjective refraction was 0.939.Conclusions: Results revealed that autorefractometry, experienced optometrist and MRT show high agreement in measuring central refraction. MRT could provide a potential objective method to assess peripheral refraction.


2018 ◽  
Vol 8 (3) ◽  
pp. 210-214
Author(s):  
Rushda Sharmin Binte Rouf ◽  
SM Ashrafuzzaman ◽  
Zafar Ahmed Latif

Background: Diabetic retinopathy (DR) and nephropathy are two major complications of diabetes mellitus carrying significant morbidity and mortality. In this study DR was investigated in different stages of chronic kidney disease (CKD) to find out possible association of these two devastating complications.Methods: This cross-sectional study was conducted in 150 diabetic patients having CKD in BIRDEM. CKD was defined as estimated glomerular filtration rate (eGFR) of <60ml/min/1.73m2and/or urinary albumin excretion rate (UAER) >30 mg/day in at least two occasions in 3 months apart. Retinopathy was assessed by direct fundoscopic examination and confirmed by color fundus photography. Severe DR (SDR) included proliferative diabetic retinopathy, severe non-proliferative DR and maculopathy; whereas microaneurysm regarded as non-severe retinopathy.Results: Majority (68%) of the respondents had some form of retinopathy (38.35% SDR and 29.65% nonsevere). There was strong association between different levels of albuminuria (UAER) and DR (p<0.0001). On the contrary DR did not correspond with stages of CKD (P=0.349). Hypertension (79.5%) and dyslipidaemia (59%) were common co-morbidities.Conclusion: This study concluded that DR prevalence was more in nephropathy along with significant association with UAER. Whereas different stages of CKD was not associated with stages of DR . This finding focused the necessity of regular retinal examination irrespective of the stage of renal involvement.Birdem Med J 2018; 8(3): 210-214


2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Tesfamichael G. Mariam ◽  
Abebaw Alemayehu ◽  
Eleni Tesfaye ◽  
Worku Mequannt ◽  
Kiber Temesgen ◽  
...  

Diabetes mellitus is a metabolic disorder which is characterized by multiple long-term complications that affect almost every system in the body. Foot ulcers are one of the main complications of diabetes mellitus. However, there is limited evidence on the occurrence of foot ulcer and influencing factors in Ethiopia. An institutional-based cross-sectional study was conducted in Gondar University Hospital, Ethiopia, to investigate foot ulcer occurrence in diabetic patients. Systematic random sampling was used to select 279 study participants. Bivariate and multivariable logistic regression model was fitted to identify factors associated with diabetic foot ulcer. Odds ratio with 95% confidence interval was computed to determine the level of significance. Diabetic foot ulcer was found to be 13.6%. Rural residence [AOR = 2.57; 95% CI: 1.42, 5.93], type II diabetes mellitus [AOR = 2.58; 95% CI: 1.22, 6.45], overweight [AOR = 2.12; 95% CI: 1.15, 3.10], obesity [AOR = 2.65; 95% CI: 1.25, 5.83], poor foot self-care practice [AOR = 2.52; 95% CI: 1.21, 6.53], and neuropathy [AOR = 21.76; 95% CI: 8.43, 57.47] were factors associated with diabetic foot ulcer. Diabetic foot ulcer was found to be high. Provision of special emphasis for rural residence, decreasing excessive weight gain, managing neuropathy, and promoting foot self-care practice would decrease diabetic foot ulcer.


2021 ◽  
Author(s):  
Elisangela Gueiber Montes ◽  
Fabiana Postiglioni Mansani ◽  
Alceu de Oliveira Toledo Júnior ◽  
Marcelo Derbli Schafranski ◽  
Bruno Queiroz Zardo ◽  
...  

Abstract Background: Rheumatoid arthritis is an inflammatory disease with joint manifestations. In the presence of extra-articular manifestations, the morbidity and severity of the disease increases. Glucocorticoid is used as a treatment and may result in side effects related to cardiovascular risk. Methods: This was a cross-sectional study including 59 volunteers with rheumatoid arthritis receiving treatment at a Hospital of Campos Gerais, that aimed to establish the relation between cardiovascular risk, glucocorticoid treatment and myeloperoxidase in these patients. Subjects were divided into two groups: using (n = 39) and without glucocorticoids (n = 20). They underwent clinical evaluation, physical examination and blood samples were taken. Statistical analysis was performed using Student's t-test and Mann-Whitney test. Logistic regression was performed to assess cardiovascular risk. The significance level was 5% (α = 0.05). Calculations were performed using the Statistical Package for the Social Science version 21.0. Results: There has been a significant difference between groups in blood glucose values (p = 0.012), that can be explained by the different percentage of diabetic patients in the groups. When assessed cardiovascular risk using the predictors of glucocorticoid dose, time of glucocorticoid use, myeloperoxidase, and C-reactive protein together, these were responsible for significantly predicting cardiovascular risk (p = 0.015). Conclusions: A significant relation between the predictor myeloperoxidase alone was also demonstrated (p = 0.037), may it be an important predictor of cardiovascular risk among individuals with rheumatoid arthritis.


Author(s):  
Mahmoud Elnil ◽  
Zeinab Swaraldahab ◽  
Sulaf Ibrahim Abdelaziz

Background: Diabetes mellitus is a chronic disease with devastating short and long-term complications that affect productivity. The corner stone for diabetes care is tight glycemic control with regular follow up. To achieve this care, medications and other health care services must be available and affordable. Objective: To estimate the direct cost of diabetes mellitus care among adult patients in Khartoum state. Methods: Cross-sectional study using multi-stage sampling technique to select the facilities proportional to population size. Patients were interviewed using questionnaire. Results: The total annual cost of Diabetes was estimated to be 3820 Sudanese pound (SDG) per person. Hospitalizations fees accounted for the major portion of the cost. Forty-seven percent of the patients were admitted with diabetes related problems during the previous year. One in four of the diabetic patients had no sufficient supply of medications. Conclusion: The total annual cost was significantly lower among those with regular follow up visits than those with irregular visits (P < 0.03). Emphasis should be put on providing affordable and available health services and medication especially at PHC level.


2017 ◽  
Vol 70 (2) ◽  
pp. 265-270 ◽  
Author(s):  
José Cláudio Garcia Lira Neto ◽  
Mayra de Almeida Xavier ◽  
José Wicto Pereira Borges ◽  
Márcio Flávio Moura de Araújo ◽  
Marta Maria Coelho Damasceno ◽  
...  

ABSTRACT Objective: to identify the prevalence of Metabolic Syndrome and its components in a population of patients with type 2 Diabetes Mellitus. Method: a cross-sectional study was conducted with 201 diabetic patients. A descriptive analysis and Chi-square and Fisher's exact tests ( p <0.05) were performed. Results: the majority of participants were females and overweight, with a mean age of 63.1 years and a low level of education, and categorized as physically inactive. Of all individuals investigated, 50.7% were diagnosed with Metabolic Syndrome and 92% had at least one of the syndrome components with values beyond those recommended. Conclusion: it is essential to take preventive actions and develop studies that help to identify the factors associated with this syndrome.


2013 ◽  
Vol 6 ◽  
pp. CMAMD.S11481 ◽  
Author(s):  
J Al-Bishri ◽  
SM Attar ◽  
Nawal Bassuni ◽  
Yasser Al-Nofaiey ◽  
Hamed Qutbuddeen ◽  
...  

Comorbid conditions play a pivotal role in rheumatoid arthritis management and outcomes. We estimated the percentage of comorbid illness among rheumatoid arthritis patients and explored the relationship between this comorbidity and different prescriptions. A cross-sectional study of patients with rheumatoid arthritis in three centers in Saudi Arabia was carried out. Comorbidity and antirheumatoid medication regimens prescribed were recorded on a specially designed Performa. The association between comorbidity and different drugs was analyzed. A total of 340 patients were included. The most comorbidities were hypertension 122 (35.9%), diabetes 105 (30.9%), osteoporosis 88 (25.8%), and dyslipidemia in 66 (19.4). The most common drug prescribed was prednisolone in 275 (80.8%) patients followed by methotrexate in 253 (74.4%) and biological therapy in 142 (41.5%) patients. Glucocorticoids were prescribed considerably more frequently in hypertensive and diabetic patients as well as in patients with osteoporosis and dyslipidemia. Most patients with rheumatoid arthritis suffered from comorbid diseases.


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