Prevalence, Treatment, and Associated Factors of Hypertension in Spain: A Comparative Study between Populations

The prevalence and related factors of hypertensive subjects according to the resident area (rural versus urban) were investigated in two population-based studies from Spain. Medical questionnaires were administered and anthropometrics were measured, using standardized protocols. Hypertension was diagnosed in pharmacology treated subjects or those with blood pressure (BP) ≥140/90 mm Hg. Regarding BP control, it was defined as under control if BP was <140/90 or <140/85 mm Hg in type 2 diabetic subjects. Information on educational status, social class, smoking habit, and alcohol intake was obtained. 3,816 subjects (54.38 % women) were included. Prevalence of diagnosed hypertension was higher in women and showed no differences according to the living area (men: urban 21.88 versus rural 21.92 %, p = 0.986; women: urban 28.73 versus rural 30.01 %, p = 0.540). Women living in rural areas and men with secondary or tertiary education levels had a lower probability of being BP uncontrolled (OR (95 % CI): 0.501 (0.258–0.970)/p=0.040, 0.245 (0.092–0.654)/p=0.005, and 0.156 (0.044–0.549)/p=0.004, respectively). Urban young men (31-45 years) and medium aged women (46-60 years) were less BP controlled than their rural counterparts (41.30 versus 65.79 %/p=0.025 and 35.24 versus 53.27 %/p=0.002, respectively).

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Applying decision tree for detection of a low risk population for type 2 diabetes: A population based study

Medical Technologies Journal ◽

10.26415/2572-004x-vol1iss4p132-132 ◽

2017 ◽

Vol 1 (4) ◽

pp. 132-132

Author(s):

Habibollah Esmaeily ◽

Maryam Tayefi ◽

Hassan Doosti ◽

Majid Ghayour-Mobarhan ◽

Ali Reza Amirabadizadeh

Keyword(s):

Type 2 Diabetes ◽

Decision Tree ◽

Prediction Model ◽

Roc Curve ◽

Population Based ◽

Low Risk ◽

Tree Model ◽

Related Factors ◽

Study Program

Introduction: The aim of current study was to create a prediction model using data mining approach, decision tree technique, to identify low risk individuals for incidence of Type 2 diabetes (T2DM), using the Mashhad Stroke and Heart Atherosclerotic Disorders (MASHAD) Study program. Methods: a prediction model was developed using classification by the decision tree method on 9528 subjects recruited from MASHAD database. Moreover, the receiver operating characteristic (ROC) curve was applied. Results: The prevalence rate of T2DM was ~14% in our population. For decision tree model, the accuracy, sensitivity, and specificity value for identifying the related factors with T2DM were 78.7%, 47.8% and 83%, respectively. In addition, the area under the ROC curve (AUC) value for recognizing the risk factors associated with T2DM was 0.64. Moreover, we found that subjects with family history of T2DM, age>=48, SBP>=130, DBP>=81, HDL>=29, LDL>=148 and occupation=other have more than 59% chance of this disorder, while the chance of T2DM in subjects without history with TG>=184, age>=48 and hs-CRP>=2.2, have approximately 51% chance. Conclusion: Our findings demonstrated that decision tree analysis, using routine demographic, clinical, anthropometric and biochemical measurements, which combined with other risk score models, could create a simple strategy to predict individuals at low risk for type 2 diabetes in order to decrease substantially the number of subjects needing for screening and recognition of subject at high risk.

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Sleep Quality and Its Associated Factors among Low-Income Adults in a Rural Area of China: A Population-Based Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph15092055 ◽

2018 ◽

Vol 15 (9) ◽

pp. 2055 ◽

Cited By ~ 6

Author(s):

Wenwen Wu ◽

Wenru Wang ◽

Zhuangzhuang Dong ◽

Yaofei Xie ◽

Yaohua Gu ◽

...

Keyword(s):

Sleep Quality ◽

Low Income ◽

Rural Areas ◽

Population Based ◽

Poor Sleep ◽

Chinese Adults ◽

Poor Sleep Quality ◽

Related Factors ◽

Health Related ◽

The Mean

Background: There is limited population-based research focusing on sleep quality among low-income Chinese adults in rural areas. This study aimed to assess sleep quality among low-income adults in a rural area in China and identify the association between sleep quality and sociodemographic, lifestyle and health-related factors. Methods: The study was conducted from September to November in 2017 using a cross-sectional survey questionnaire. A total of 6905 participants were recruited via multistage, stratified cluster sampling. Data were collected using the Chinese versions of Pittsburgh Sleep Quality Index and Food Frequency Questionnaire, while we also determined the sociodemographic profiles of the participants. Results: The mean age of the sample was 58.71 ± 14.50 years, with 59.7% being male, while the mean duration of daily sleep was 5.95 ± 1.31 h, with 56.7% reportedly experiencing poor sleep quality. Multiple regression analysis revealed that older age, unemployment, lower income, disability and chronic disease comorbidities were significant factors associated with an increased risk of poor sleep quality for both genders. Moreover, married and higher education level were associated with decreased risk of poor sleep quality for females, while a meat-heavy diet and illness during the past two weeks increased the risk of poor sleep quality for males. Conclusions: Sociodemographic, lifestyle and health-related factors had an impact on the frequently poor sleep quality of low-income Chinese adults in rural areas. Thus, comprehensive measures must be developed to address the modifiable predictive factors that can possibly enhance sleep quality.

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Association between socioeconomic and health factors and edentulism in people aged 65 and older – a population-based survey

Scandinavian Journal of Public Health ◽

10.1177/1403494817717406 ◽

2017 ◽

Vol 46 (7) ◽

pp. 690-698 ◽

Cited By ~ 5

Author(s):

Hanna Olofsson ◽

Eva Lena Ulander ◽

Yngve Gustafson ◽

Carl Hörnsten

Keyword(s):

Low Income ◽

Rural Areas ◽

Urban Areas ◽

Oral Care ◽

Total Sample ◽

Population Based ◽

Northern Sweden ◽

Dental Services ◽

Related Factors ◽

Health Related

Aims: To study edentulism and use of dental services in a population-based sample of people aged 65 years and older from northern Sweden and western Finland. Methods: In 2010, people aged 65, 70, 75 and 80 years who were living in one of 32 municipalities in northern Sweden and western Finland were invited to answer a questionnaire as part of the Gerontological Regional Database (GERDA) study ( n = 6099). The questionnaire contained items related to socioeconomic status, general health and edentulism. Results: The prevalence of edentulism was 34.9% in Finland, compared with 20.6% in Sweden ( p < 0.001), 31.9% in rural areas, compared with 20.9% in urban areas ( p < 0.001), and 25% overall. The prevalence of edentulism rose from 17.8% in 65-year-olds, 23.8% in 70-year-olds, 33.5% in 75-year-olds and 37.3% in 80-year-olds ( p < 0.001), and was 23.8% in women, compared with 27% in men ( p < 0.001). In multivariate models, edentulism was associated with lower educational level (odds ratio (OR) 2.87, 95% confidence interval (CI) 2.31–3.58), low income level (OR 1.7, CI 1.09–1.47), residence in a rural area (OR 1.43, CI 1.23–1.66), male sex (OR 1.30, CI 1.12–1.52), dependence in instrumental activities of daily living (OR 1.48, CI 1.25–1.74), social isolation (OR 1.52, CI 1.17–1.98) and poor self-experienced health (OR 1.38, CI 1.17–1.62). Conclusions: One-quarter of the total sample was edentulous, with a higher prevalence of edentulism in Finland than in Sweden and in rural than in urban areas. Edentulism was associated with socioeconomic, psychological and health-related factors. These findings could be used to inform preventive measures and identify people aged 65 years and older who are in need of oral care.

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Exploring the Factors Associated with Infant Mortality in Rural Indonesia

Global Journal of Health Science ◽

10.5539/gjhs.v13n1p17 ◽

2020 ◽

Vol 13 (1) ◽

pp. 17

Author(s):

Dian Kristiani Irawaty ◽

Indra Elfiyan ◽

Edy Purwoko

Keyword(s):

Infant Mortality ◽

Rural Areas ◽

Smoking Habit ◽

Age Groups ◽

Wealth Quintile ◽

Educational Status ◽

Maternal Health Services ◽

Health Condition ◽

Cross Sectional ◽

Infant Deaths

Infant mortality is a sensitive indicator to measure the health condition of a population. Despite large declines in infant mortality rates in Indonesia, the people living in rural areas are the most affected. This study aims to analyze the causes of infant mortality in rural Indonesia and suggested strategies for its reduction. This study is an analytical cross-sectional design based on the 2017 Indonesian Demographic and Health Survey (IDHS) dataset for children. The information on infant deaths collected from those mothers who experienced infant deaths. Series of logistic regression models were used to select the significant factors affecting infant mortality in rural Indonesia. Infant mortality is associated with intermediate social determinants such as birth order, birth weight, and breastfeeding status. Socio-demographic factors such as the educational status of mothers, wealth quintile, the smoking habit of the mother, age of mother at first delivery, and sex of the baby are also related to infant mortality. The most crucial factors in rural Indonesia were the age of first-time mothers. As a strategy for addressing the issue of infant mortality in rural areas, the result of the study highlights the need for decreasing adolescent pregnancies among the youngest age groups. Pregnant mothers in the youngest age group should be supported by quality maternal health services to ensure their pregnancies in healthy condition. The focus of breastfeeding promotion programs should be encouraged, particularly on early initiation and duration of breastfeeding.

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Patient-assessed quality of care in type 2 diabetes in a German nationwide health survey 2017

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.595 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

J Baumert ◽

G L Schmid ◽

Y Du ◽

R Paprott ◽

S Carmienke ◽

...

Keyword(s):

Type 2 Diabetes ◽

Quality Of Care ◽

Chronic Illness ◽

Information Needs ◽

Population Based ◽

Short Version ◽

Chronic Illness Care ◽

Related Factors

Abstract Background Patient-assessed quality of chronic illness care is important to guide medical care for patients with diabetes and other complex chronic diseases, but information from epidemiological studies is scarce. Thus, we examined self-assessed quality of care among adults with type 2 diabetes (T2D) based on a population-based design. Methods The study population was drawn from a nationwide survey on diabetes-related knowledge and information needs conducted in Germany in 2017 and included participants aged ≥18 years with known type 2 diabetes (T2D) in the last 12 months (n = 1,328). A German short version of the “Patient assessment of chronic illness care (PACIC-DSF)” consisting of 9 items based on 5-point Likert scale was applied to assess self-reported quality of care in diabetes which was operationalized by a standardized PACIC sum score ranging from 1 to 5. Linear regression with different stages of adjustment was applied to assess the association of basic characteristics and diabetes-related factors with the PACIC score. Results Quality of care was assessed less favorably by women than by men (PACIC score: 2.38 vs. 2.47) overall and decreased along with age. The PACIC score significantly increased in participants with insulin use (β = 0.16, p = 0.024), ever participating in a diabetes education program (β = 0.33, p < 0.001), following a diet plan at least once a week (β = 0.33, p < =0.001) as well as performing daily self-examination of feet (β = 0.14, p = 0.023), self-control of blood glucose (β = 0.34, p < 0.001), and being physically active for at least 30 min (β = 0.21, p < 0.001) compared to participants without the respective trait. Conclusions Self-assessed quality of care by adults with known T2D from this population-based study is moderate and seems lower compared to findings from clinical studies. Key messages An active involvement of people with type 2 diabetes into the implementation of care is essential and may contribute to improved self-perceived quality of care. To identify and overcome obstacles in diabetes care based on the patient’s perspective remains a public health challenge.

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Polypharmacy among people living with type 2 diabetes mellitus in rural communes in Vietnam

PLoS ONE ◽

10.1371/journal.pone.0249849 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0249849

Author(s):

Dieu Huyen Thi Bui ◽

Bai Xuan Nguyen ◽

Dat Cong Truong ◽

Dan Wolf Meyrowitsch ◽

Jens Søndergaard ◽

...

Keyword(s):

Type 2 Diabetes ◽

Traditional Medicine ◽

Dietary Supplement ◽

Rural Areas ◽

Prescription Medicine ◽

Medicine Use ◽

Cross Sectional Survey ◽

Related Factors ◽

Increased Risk

Objectives People with diabetes are at high risk of polypharmacy owing to complex treatment of diabetes and comorbidities. Polypharmacy is associated with increased risk of adverse reactions and decreased compliance. Therefore, the objectives of this study were to assess polypharmacy in people with type 2 diabetes (T2D) and associated diabetes-related factors in rural areas in Vietnam. Method People with T2D (n = 806) who had received treatment for diabetes at a district hospital were invited to participate in a questionnaire-based cross-sectional survey. Polypharmacy was defined as ≥5 types of medicine and assessed as a) prescription medicine and non-prescription/over the counter (OTC) medicine and b) prescription medicine and non-prescription/OTC, herbal and traditional medicine, and dietary supplement. Multiple logistic regression was used to investigate the association between polypharmacy and diabetes specific factors: duration, comorbidities and diabetes-related distress. Results Of the people with T2D, 7.8% had a medicine use corresponding to polypharmacy (prescription medicine and non-prescription/OTC), and 40.8% when herbal and traditional medicine, and dietary supplement were included. Mean number of medicine intake (all types of medicines and supplements) were 3.8±1.5. The odd ratios (ORs) of polypharmacy (medicine and supplements) increased with diabetes duration (<1–5 years OR = 1.66; 95%CI: 1.09–2.53 and >5 years OR = 1.74; 95%CI: 1.14–2.64 as compared to ≤1-year duration of diabetes), number of comorbidities (1–2 comorbidities: OR = 2.0; 95%CI: 1.18–3.42; ≥3 comorbidities: OR = 2.63;95%CI: 1.50–4.61 as compared to no comorbidities), and suffering from diabetes-related distress (OR = 1.49; 95%CI: 1.11–2.01) as compared to those without distress. Conclusions In rural northern Vietnam, persons with longer duration of T2D, higher number of comorbidities and diabetes-related stress have higher odds of having a medicine use corresponding to polypharmacy. A high proportion of people with T2D supplement their prescription, non-prescription/OTC medicine with herbal and traditional medicine and dietary supplements.

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Medication Adherence and its Related Factors in Patients with Type 2 Diabetes

Yafteh Lorestan University of Medical Sciences ◽

10.32592/yafteh.2021.23.2.1 ◽

2021 ◽

pp. 1-10

Keyword(s):

Type 2 Diabetes ◽

Medication Adherence ◽

Descriptive Analysis ◽

Educational Status ◽

Easy Access ◽

Adherence To Treatment ◽

Related Factors ◽

Cross Sectional ◽

Significance Level

Background: One of the public health challenges in the worldwide is diabetes, and adherence to treatment is crucial. Adherence to treatment can help reduce the complications of the disease. Therefore, this study was performed to evaluate the status of adherence to treatment among patients with type 2 diabetes in Khorramabad. Materials and Methods: In this cross-sectional study, 392 men and women with type 2 diabetes referred to comprehensive health centers in Khorramabad between May and August 2016 were studied. Demographic questionnaire and Morisky Medication Adherence Scale (MMAS-8) were used to collect data. Version 22 SPSS and descriptive analysis were used to analyze the data. Significance level in the present study was less than 0.05. Descriptive tests, Chi-square, Fisher's exact test, and independent t-test were used. Results: The mean age of study participants was 56.03 ± 10.91. 68.9% (270 people) were women and 31/1% (122 people) were men. According to the score obtained from the Morisky questionnaire, a total of 219 patients (55/9%) followed the desired treatment and 173 (44/1%) followed the unfavorable treatment. There was a significant relationship between patients' adherence to treatment with the variables of gender, marital status, educational status, and their monthly income. No statistically significant between age and employment status with adherence to treatment were observed. Conclusion: Findings of this study showed that adherence to treatment among patients with type 2 diabetes in Khorramabad is in a good level. Health policy makers should strive to ensure that all patients adhere to their treatment process with easy access to services and reduced costs.

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Health App Use and Its Correlates Among Individuals With and Without Type 2 Diabetes: Nationwide Population-Based Survey

JMIR Diabetes ◽

10.2196/14396 ◽

2020 ◽

Vol 5 (2) ◽

pp. e14396

Author(s):

Lena M Stühmann ◽

Rebecca Paprott ◽

Christin Heidemann ◽

Jens Baumert ◽

Sylvia Hansen ◽

...

Keyword(s):

Type 2 Diabetes ◽

Middle Age ◽

Population Based ◽

Determinants Of Health ◽

Diabetes Diagnosis ◽

Related Factors ◽

Health Apps ◽

Health Advice ◽

Health Related

Background Evidence suggests that mobile health app use is beneficial for the prevention and management of type 2 diabetes (T2D) and its associated complications; however, population-based research on specific determinants of health app use in people with and without T2D is scarce. Objective This cross-sectional study aimed to provide population-based evidence on rates and determinants of health app use among adults with and without T2D, thereby covering a prevention perspective and a diabetes management perspective, respectively. Methods The study population included 2327 adults without a known diabetes diagnosis and 1149 adults with known T2D from a nationwide telephone survey in Germany conducted in 2017. Rates of smartphone ownership and health app use were estimated based on weighted sample proportions. Among smartphone owners, determinants of health app use were identified for both groups separately in multivariable logistic regression models. Sociodemographic factors, diabetes-related factors or indicators, psychological and health-related factors, and physician-provided information were selected as potential determinants. Results Among participants without known diabetes, 74.72% (1690/2327) were smartphone owners. Of those, 49.27% (717/1690) used health apps, most often to improve regular physical activity. Among participants with T2D, 42.26% (481/1149) were smartphone owners. Of those, 41.1% (171/481) used health apps, most commonly to target a healthy diet. Among people without known diabetes, determinants significantly (all P values <.05) associated with an increased likelihood of health app use compared with their reference group were as follows: younger and middle age of 18 to 44 or 45 to 64 years (odds ratios [ORs] 3.89; P<.001 and 1.76; P=.004, respectively), overweight or obesity (ORs 1.58; P<.001 and 2.07; P<.001, respectively), hypertension diagnosis (OR 1.31; P=.045), former or current smoking (ORs 1.51; P=.002 and 1.58; P<.001, respectively), perceiving health as very good (OR 2.21; P<.001), other chronic diseases (OR 1.48; P=.002), and having received health advice from a physician (OR 1.48; P<.001). A slight or high perceived diabetes risk (ORs 0.78; P=.04 and 0.23; P<.001, respectively) was significantly associated with a decreased likelihood of health app use. Among people with T2D, younger and middle age (18-64 years; OR 1.84; P=.007), female gender (OR 1.61; P=.02), and using a glucose sensor in addition or instead of a glucose meter (OR 2.74; P=.04) were significantly positively associated with health app use. Conclusions In terms of T2D prevention, age, diabetes-related risk factors, psychological and health-related factors, and medical health advice may inform app development for specific target groups. In addition, health professionals may encourage health app use when giving advice on health behaviors. Concerning T2D management, only a few determinants seem relevant for explaining health app use among people with T2D, indicating a need for more future research on which people with T2D use health apps and why.

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Health App Use and Its Correlates Among Individuals With and Without Type 2 Diabetes: Nationwide Population-Based Survey (Preprint)

10.2196/preprints.14396 ◽

2019 ◽

Author(s):

Lena M Stühmann ◽

Rebecca Paprott ◽

Christin Heidemann ◽

Jens Baumert ◽

Sylvia Hansen ◽

...

Keyword(s):

Type 2 Diabetes ◽

Middle Age ◽

Population Based ◽

Determinants Of Health ◽

Diabetes Diagnosis ◽

Related Factors ◽

Health Apps ◽

Health Advice ◽

Health Related

BACKGROUND Evidence suggests that mobile health app use is beneficial for the prevention and management of type 2 diabetes (T2D) and its associated complications; however, population-based research on specific determinants of health app use in people with and without T2D is scarce. OBJECTIVE This cross-sectional study aimed to provide population-based evidence on rates and determinants of health app use among adults with and without T2D, thereby covering a prevention perspective and a diabetes management perspective, respectively. METHODS The study population included 2327 adults without a known diabetes diagnosis and 1149 adults with known T2D from a nationwide telephone survey in Germany conducted in 2017. Rates of smartphone ownership and health app use were estimated based on weighted sample proportions. Among smartphone owners, determinants of health app use were identified for both groups separately in multivariable logistic regression models. Sociodemographic factors, diabetes-related factors or indicators, psychological and health-related factors, and physician-provided information were selected as potential determinants. RESULTS Among participants without known diabetes, 74.72% (1690/2327) were smartphone owners. Of those, 49.27% (717/1690) used health apps, most often to improve regular physical activity. Among participants with T2D, 42.26% (481/1149) were smartphone owners. Of those, 41.1% (171/481) used health apps, most commonly to target a healthy diet. Among people without known diabetes, determinants significantly (all P values <.05) associated with an increased likelihood of health app use compared with their reference group were as follows: younger and middle age of 18 to 44 or 45 to 64 years (odds ratios [ORs] 3.89; P<.001 and 1.76; P=.004, respectively), overweight or obesity (ORs 1.58; P<.001 and 2.07; P<.001, respectively), hypertension diagnosis (OR 1.31; P=.045), former or current smoking (ORs 1.51; P=.002 and 1.58; P<.001, respectively), perceiving health as very good (OR 2.21; P<.001), other chronic diseases (OR 1.48; P=.002), and having received health advice from a physician (OR 1.48; P<.001). A slight or high perceived diabetes risk (ORs 0.78; P=.04 and 0.23; P<.001, respectively) was significantly associated with a decreased likelihood of health app use. Among people with T2D, younger and middle age (18-64 years; OR 1.84; P=.007), female gender (OR 1.61; P=.02), and using a glucose sensor in addition or instead of a glucose meter (OR 2.74; P=.04) were significantly positively associated with health app use. CONCLUSIONS In terms of T2D prevention, age, diabetes-related risk factors, psychological and health-related factors, and medical health advice may inform app development for specific target groups. In addition, health professionals may encourage health app use when giving advice on health behaviors. Concerning T2D management, only a few determinants seem relevant for explaining health app use among people with T2D, indicating a need for more future research on which people with T2D use health apps and why.

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