scholarly journals Drug utilization pattern in type II diabetes mellitus patients attending non-communicable disease clinic in a tertiary care hospital

Author(s):  
Akash Gadgade ◽  
Shwetha B. ◽  
Basavaraj C. Kotinatiot ◽  
Chetan A. C.

Background: Diabetes mellitus is a metabolic disorder. Early institution of treatment is necessary to prevent complications. Since treatment of diabetes requires lifetime therapy; this study is designed to understand the prescription trends at Non Communicable Disease clinic set up and to provide rationale.Methods: This cross-sectional, observational study was conducted over a period of 2 months (May 2017- June 2017). Details of demographic data, duration and family history of diabetes, antidiabetic medications prescribed, history of comorbid diseases and drugs prescribed by physician for the treatment of comorbid diseases were collected in a structured format. Height and weight were recorded, and body mass index was calculated.Results: Study population included 294 patients and patients in the age groups of 40-59 years formed the bulk. 39% patients were overweight and 19.39% were obese. 93.20% patients were prescribed with metformin. 37 patients received insulin injection. 64.29% received more than one antidiabetic drug. Hypertension (82.05%) was the most common comorbid disease. Amlodipine was the most commonly prescribed antihypertensive drug.Conclusions: Metformin was the most commonly prescribed antidiabetic drug. Utilization of newer antidiabetic drug is inferior. Use of rationale fixed dose combination improves patient compliance.

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
G Sangwan ◽  
A Mehra ◽  
S Grover ◽  
A Avasthi

Abstract Background The presence of psychiatric illness among patients with physical illnesses leads to poor treatment adherence, poor lifestyle, increased cost of treatment, poor quality of life, worsening of physical illness, work absenteeism, increased hospital visits, poor self-care and higher mortality. The study evaluated the prevalence of cognitive impairment and psychiatric morbidity in non-communicable disease patients. The study highlights that NCD patients should be provided information about the development of cognitive impairment in order to prevent it. Methods It was a cross-sectional study conducted among the patients attending the non-communicable disease clinic of a rural community health centre run in collaboration with the Postgraduate Institute Medical Education and Research (PGIMER), Chandigarh. We registered 124 patients after obtaining written informed consent. Instruments: Hindi Mental Status Examination (HMSE), Patient Health Questionnaire-9, Generalized anxiety disorder-7 (GAD-7) scale. Analysis of covariance was applied to see the relationship between the domain of the HMSE and NCDs. Results The mean age of the participants was 55.5 years (SD-11.9, Range-26-90). A little more than one third (N = 48, 38.7%) were diagnosed with hypertension only, one-sixth (N = 22; 17.7%) were diagnosed with diabetes mellitus only, and 54 (43.5%) patients were diagnosed with both hypertension and diabetes mellitus. A slightly more than one-third of the study participants were diagnosed with depressive disorder (N = 44, 35.5%), and 29% (N = 36) of the participants were diagnosed with an anxiety disorder. About one-fourth of patients with NCD have cognitive impairment and 39.51% have psychiatric morbidity. Conclusions The prevalence of cognitive impairment is higher among patients of NCD with psychiatric morbidity. Patients with NCDs should be routinely screened for cognitive functioning and provided information about the development of cognitive impairment. Key messages Because of high prevalence of cognitive impairment and psychiatric morbidity in NCD patients, patients should be provided information to prevent it. There is a need to screen NCD patients routinely for cognitive functioning, and provide them information to prevent cognitive impairment.


Author(s):  
PRUDENCE A. RODRIGUES ◽  
DAWN TESLIN DAMIEN ◽  
MARY CECIL K. T. ◽  
NARESH KUMAR M. ◽  
RESHMA S. S. ◽  
...  

Objective: The objective of this study is to evaluate prescribing pattern, analyze drug-related problems, identify co-morbidities and complications in Type 2 Diabetes Mellitus patients and also to perform cost analysis of Biguanides, Sulfonylureas, Dipeptidyl Peptidase Inhibitors Methods: A Prospective observational study was done in General Medicine and Endocrinology Departments of PSG Hospitals. A total of 200 study subjects, including both inpatients and outpatients, above 18 y of age, prescribed with OHAs (Biguanides, Sulfonylureas and DPP4 inhibitors) were included in the study. Results: Diabetes was more prevalent among males. OHAs were most prescribed in the age group of 51-60 y. Hypertension (71%) was the most common comorbidity and Diabetic neuropathy (23%) was the most common complication found in the patients. Multidrug therapy (72.5%) was most prescribed in diabetic patients, followed by Biguanides. Hypoglycemia was the most prevalent ADR. Cost analysis showed that T. Linagliptin was of high cost and T. Glimepiride being the low cost. Using WHO core indicators prescribing patterns were assessed. Feedback was collected and results were reported to the physicians which showed rational utilization of drugs. Conclusion: The study on drug utilization conducted in a tertiary care hospital helped us to find out that prescribing trends seems to be progressing towards combination therapy, predominantly two-drug therapy


Author(s):  
Manisha R. Gandhewar ◽  
Binti R. Bhatiyani ◽  
Priyanka Singh ◽  
Pradip R. Gaikwad

Background: The aim of this study was to study the prevalence of gestational diabetes mellitus (GDM) using Diabetes in Pregnancy Study group India (DIPSI) criteria to diagnose patients with GDM and to study the maternal and neonatal outcomes.Methods: 500 patients attending the antenatal clinic between January 2013 to September 2014 with singleton pregnancies between 24 and 28 weeks of gestation were evaluated by administering 75g glucose in a nonfasting state and diagnosing GDM if the 2-hour plasma glucose was more than 140 mg/ dl. Women with multiple pregnancies, pre-existing diabetes mellitus, cardiac or renal disease were excluded from the study.Results: 31 women were diagnosed with GDM (prevalence 6.2%). The prevalence of risk factors such as age more than 25, obesity, family history of Diabetes Mellitus, history of GDM or birth weight more than 4.5kg in previous pregnancy and history of perinatal loss were associated with a statistically significant risk of developing GDM. Though the incidence of Gestational hypertension, polyhydramnios and postpartum haemorrhage was higher in the GDM group, it did not reach statistical significance. More women in the GDM group were delivered by LSCS. There was no significant difference in the incidence of SGA or preterm delivery in the groups. The mean birth weight in GDM group was higher than in the non GDM group.Conclusions: Early detection helps in preventing both maternal and fetal complications. This method of screening is convenient to women as it does not require them to be fasting.


Duazary ◽  
2020 ◽  
Vol 17 (1) ◽  
pp. 74-86
Author(s):  
Juan Pablo Álvarez-Najar ◽  
Mery Luz Valderrama-Sanabria ◽  
Amalia Priscila Peña-Pita

Diabetes mellitus is considered a chronic non-communicable disease with high morbidity, presents to its high prevalence, social, family, and economic costs. Interventions aimed at life-style changes are fundamental in managing; due to this, patients must receive education. The aim of the study was to identify the beliefs and practices of the persons with diabetes mellitus, to propose nurse care according to these precepts. This was a descriptive study of systematic literature review, searching for articles in databases, Springer Science, Elsevier, ProQuest, Science Direct, Index, Pubmed, SciELO, Medigraphic, and Medline during 2016 to 2018, published between 2001 and 2018, in Spanish, English, and Portuguese. A total of 49 studies were contributing to fulfilling the objective. Within the beliefs for the management of disease, is the use of herbs, some consider as cause "fright"; Others take into account risk factors such as heredity, obesity, poor eating habits. Various beliefs are presented in relation to insulin treatment. Spirituality is emphasized; seeking refuge in God and prayer. Is important to understand the person, from their values, beliefs, customs and feelings. Education is a fundamental tool to control the disease, but health beliefs must be taken into account in order to achieve favorable results.


Author(s):  
Lukman Fauzi ◽  
R.R. Sri Ratna Rahayu ◽  
Lindra Anggorowati ◽  
Hendri Hariyanto ◽  
Trinita Septi Mentari ◽  
...  

Diabetes Mellitus (DM) is a non-communicable disease that contributes to the cause of death. Based on the analysis of the situation in Kawengen Village, Semarang Regency, there were several problems related to the incidence of DM, including the Non-Communicable Disease Integrated Guidance Post Program (Posbindu PTM), which was not running optimally. Based on these problems, it is necessary to form a movement called the Anti-Diabetes Mellitus Community Alert Movement (SIMANIS). Active case finding and detection of pre-DM cases aim to capture people who already have pre-DM symptoms, but they do not know. Furthermore, if caught, they can be followed up so that they are willing to go to the health service unit before complications occur. The implementation of this community service activity is carried out in four stages, namely the formation of SIMANIS cadres, education on prevention and control of DM to SIMANIS cadres and the community, ToT on how to fill in and use the SIDIA Card (pre-diabetes screening) to SIMANIS cadres, and use of the SIDIA Card for early detection active case finding pre-DM. There was an increase in the pre-post education knowledge score from 7.59 + 1.5 to 8.93 + 0.9 and an increase in the pre-post education attitude score from 7.96 + 1.22 to 9.07 + 0.78. SIMANIS through the use of the SIDIA Card can be used to increase public awareness in prevention, early detection, and case finding of DM.


Author(s):  
Ayan Roy ◽  
Nayan Kumar Patel

Background: Cardiovascular morbidity plays a villainous role globally as well as countries like India. Additionally, irrational prescription incurs greater damage to health and wellbeing. Drug utilization studies scrutinize the appropriateness of treatment and provide favorable feedbacks to strengthen clinical practices. The objective of the study was to describe treatment practices in cardiology outpatient and drug utilization pattern using core prescribing indicators by World Health Organization (WHO).Methods: A cross-sectional, observational study of 4-month duration was undertaken for cardiology Outdoor patients at a tertiary care hospital. 615 prescriptions were screened and analyzed.Results: Males (59.84%) were more in number than females (40.16%). Average number of the prescribed drugs per patient were 4.32±2.7 and (3.73±1.1 for cardiovascular drugs). Generic prescription was 60.98%. Percentage encounters with antibiotics 4.11, injectables 2.92%, fixed-dose combinations (FDCs) (11.8%) were documented. Drugs from the National List of Essential Medicines were 75.89%. The most common diagnosis was ischemic heart disease (68.29%). Hypolipidemics (78.25%) followed by antiplatelets (71.14%) were toppers in cardiovascular drug. Antiulcer drugs (PPI/Antacids) comprised 58.54% of total prescriptions.Conclusions: Less adherence to EDL, less generic prescriptions, use of FDC are major shortcomings. Areas to further rationalization like optimal use of evidence based medication like beta-blockers, newer anticoagulants/anti-platelet agents and newer anti-anginal agents are identified.


1970 ◽  
pp. 18-21 ◽  
Author(s):  
Md Badiuzzaman ◽  
Fazle Rabbi Mohammed ◽  
Fazle Rabbi Chowdhury ◽  
Md Shafiqul Bari ◽  
Md Billal Alam ◽  
...  

Background: An event of stroke can be ignited by a number of risk factors, some of which are nonmodifiable and some are modifiable. Hypertension, diabetes mellitus, different heart diseases, hyperlipidemia and smoking belong to the latter group and their prevalence shows immense diversity worldwide. In this study we tried to identify the most prevalent risk factor for stroke. Categorization of various types of stroke and history of noncompliance in medication has also been evaluated. Methods: This direct observational study was carried out on 400 patients of stroke admitted in different medicine units of Dhaka Medical College Hospital from July to December, 2007. Only patients having clinical diagnosis of stroke, confirmed by CT scan or MRI, were recruited. Patients were grouped into ischemic or hemorrhagic stroke or sub arachnoid hemorrhage. Results: The male, female ratio was found 1.2:1. In the study cerebral infraction, intra cerebral hemorrhages (ICH) and sub arachnoid hemorrhage (SAH) were found in 56.25%, 38.25% and 5.5% patients respectively. In case of Ischemic stroke and ICH males were predominantly affected but in case of SAH females were predominant. Among patients, hypertension was found in 58.62% followed by smoking (53.79%), lipid disorder (48.01%), heart diseases (25.75%), diabetes mellitus (20.01%), and previous history of stroke (10.61%). 40% patients were on irregular use of antihypertensive drug and it was 17.5% in case of anti diabetic drugs. Major groups (42.44%) of patients have two modifiable risk factors. Conclusion: Stroke is better to prevent than to cure. Identification of risk factors is the only way to achieve this goal. Implementation of screening programme in community to identify risk factors and educate people about primary prevention should be initiated in this regard. This way, we can reduce morbidity and mortality among stroke patients and alleviate the burden of stroke.   doi:10.3329/jom.v10i3.2011   J Medicine 2009; 10 (Supplement 1): 18-21


2020 ◽  
Vol 11 ◽  
Author(s):  
H. David McIntyre ◽  
Anil Kapur ◽  
Hema Divakar ◽  
Moshe Hod

Gestational diabetes mellitus (GDM) is the commonest medical complication of pregnancy. The association of GDM with immediate pregnancy complications including excess fetal growth and adiposity with subsequent risk of birth trauma and with hypertensive disorders of pregnancy is well recognized. However, the associations with wide ranges of longer-term health outcomes for mother and baby, including the lifetime risks of obesity, pre-diabetes, and diabetes and cardiovascular disease have received less attention and few health systems address these important issues in a systematic way. This article reviews historical and recent data regarding prediction of GDM using demographic, clinical, and biochemical parameters. We evaluate current and potential future diagnostic approaches designed to most effectively identify GDM and extend this analysis into a critical evaluation of lifestyle and nutritional/pharmacologic interventions designed to prevent the development of GDM. The general approach to management of GDM during pregnancy is then discussed and the major final focus of the article revolves around the importance of a GDM diagnosis as a future marker of the risk of non-communicable disease (NCD), in particular pre-diabetes, diabetes, and cardiovascular disease, both in mother and offspring.


Sign in / Sign up

Export Citation Format

Share Document