Access to Anti-Diabetic Medicines among Patients Attending Tertiary Health Facilities in Oyo State, Nigeria

Objective: The management of Diabetes Mellitus (DM) is long-term and can be expensive. This study aimed to describe access to anti-diabetic medicines among patients in tertiary health care facilities in Oyo State, Nigeria. Materials and Methods: This was a hospital-based cross-sectional study. The study sites were the University College Hospital (UCH), Ibadan, and Ladoke Akintola University Teaching Hospital, Ogbomosho. It was conducted among 366 diabetic patients who had been attending the endocrinology clinic of these two tertiary health institutions for at least one year. Data analysis was done with the Statistical Program for Social Sciences. Results: Female participants were 186 (50.8%) and 298 (85.6%) depended on close relatives to purchase their drugs. Those who had difficulties affording their anti-diabetic medications were 142 (38.8%) and 80 (56.3%) preferred buying a cheaper brand of anti-diabetic medication. Also, 136 (37.2%) respondents had missed their required drugs at some point due to insufficient funds. Males who were able to afford their anti-diabetic medication were 96 (53.3%) compared to 128 (68.8%) females (P-value= 0.002). Those with no formal education had the highest proportion of respondents who could not easily afford anti-diabetic drugs (60.9%), those with tertiary education had the highest proportion of respondents who could afford their medication (77.5%), (P-value=< 0.001). Among those in the 61-70 years age group, 78 (66.1%) achieved glycaemic control compared to 34 (42.5%) of those above 70 years (P-value=< 0.001). Conclusion: To improve affordability, subsidizing the cost of anti-diabetic medications and encouraging patients to enrol in the Health Insurance Scheme will be beneficial.

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Patients’ Adherence to Anti-diabetic Medications and Associated Factors in Mizan-Tepi University Teaching Hospital: A Cross-Sectional Study

INQUIRY The Journal of Health Care Organization Provision and Financing ◽

10.1177/00469580211067477 ◽

2021 ◽

Vol 58 ◽

pp. 004695802110674

Author(s):

Jafer Siraj ◽

Turi Abateka ◽

Oliyad Kebede

Keyword(s):

Side Effects ◽

Drug Use ◽

Associated Factors ◽

Cross Sectional Study ◽

University Teaching ◽

P Value ◽

Diabetic Patients ◽

Sectional Study ◽

Monthly Income ◽

Cross Sectional

Introduction: A number of medications have been demonstrated to lower blood glucose. However, current-day management has failed to achieve and maintain the optimal glycemic level for diabetic patients. Patients’ non-adherence is among the most contributing factors. Therefore, the aim of this study was to explore the prevalence of non-adherence to anti-diabetic medications and associated factors. Methods: A hospital based cross-sectional study was conducted from November 2020 to January 2021. A systematic random sampling technique was used. Data were collected by structured questionnaire adapted from different literatures. Then, data were entered into SPSS version 25 and analyzed. To determine the association of dependent and independent variables, multiple logistic regression was done. P-value <.05 was considered statistically significant. Results: A total of 275 study participants were interviewed with a response rate of 100%. From this 53.8% were females, 59.3% were in the age group of 41-60 years, 35.3% were college/university graduates and 79.3% were not using social drugs. One hundred eighty-seven (68%) of them were adherent to their anti-diabetic medication. Factors found to be significantly associated with anti-diabetic medication adherence were age >60 years (AOR = .276, 95% CI = .124-.611) attending higher education (AOR = 6.203, 95% CI = 1.775-21.93), retired (AOR = 7.771, 95% CI = 1.458-41.427), housewife (AOR = 7.023, 95% CI = 1.485-33.215), average monthly income 1001birr-2000 birr (AOR = .246, 95% CI = .067-.911) and social drug use (AOR = 3.695, 95% CI = 1.599-8.542). Forgetfulness, not affording, side effects, misunderstanding of instructions, and poly-pharmacy were identified reasons for non-adherence. Conclusions and Recommendations: Patients’ adherence to anti-diabetic medications in the current study is sub-optimal. Age, monthly income, level of education, occupational status, and social drug use were associated with adherence. Forgetfulness, not affording, and side effects were reasons identified to contribute to non-adherence. Therefore, adherence counseling, use of alarms, and the way to mitigate non-affordability, including anti-diabetic medications into a program drug should be considered.

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Attitude and acceptability of assisted reproductive technology among women in a tertiary hospital in Sokoto, northern Nigeria

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20211488 ◽

2021 ◽

Vol 10 (5) ◽

pp. 1770

Author(s):

Amina G. Umar ◽

Aisha N. Adamu

Keyword(s):

Assisted Reproductive Technology ◽

Tertiary Education ◽

Educational Status ◽

Tertiary Hospital ◽

Cross Sectional Study ◽

Reproductive Technology ◽

University Teaching ◽

P Value ◽

Cross Sectional ◽

Living Children

Background: Infertility couple affects the couple's life, work, health, personality, identity and quality of life. The aim of the study is to determine the attitude and acceptability of assisted reproductive technology among women at the Usmanu Danfodiyo University Teaching Hospital, Sokoto.Methods: This is a cross-sectional study that involved three 350 women attending infertility clinic. They were recruited via convenient sampling method using semi-structured questionnaire. The data obtained was managed using the statistical package for social sciences version 20. A p value of <0.05 was considered statistically significant and the result obtained was presented in charts and tables.Results: Among the 350 women recruited, their ages ranged between 14-58 years with a modal age of 25-35 yeas (58.0%) and a mean of 28.59±6.7. They are mostly (78.6%), of the Hausa/Fulani ethnic group. Almost all (98.9%) of them were married and unto 40.5% of them were in polygamous marriage. Majority, 36.9% had tertiary education, and about same proportion, about half, 51.7%% were gainfully employed. About 60.3% of them were nulliparae with a mean duration of infertility of 5.07±4.8 years. Approximately half, 53.1% had secondary infertility and only about half, 51.4% will accept ART if offered. Unfortunately, among those who declined, majority (40.9%) had no reason for doing so. There was statistically significant association between educational status and acceptance of assisted reproductive technology (ART) at p value 0.02.Conclusions: The acceptance of ART in our environment is influenced by the educational status and number of living children.

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DIETARY PRACTICES AND SELF ADHERENCE TO TYPE 2 DIABETIC MANAGEMENT AMONG URBAN POPULATION OF CHENNAI METROPOLITON CITY-A CROSS SECTIONAL STUDY

10.36106/ijar/0309839 ◽

2020 ◽

pp. 85-86

Author(s):

Aravind Raj ◽

Sankar A

Keyword(s):

Physical Activity ◽

Urban Population ◽

Eating Habits ◽

Cross Sectional Study ◽

P Value ◽

Diabetic Patients ◽

Sectional Study ◽

College Hospital ◽

Cross Sectional ◽

Obesity And Diabetes

Background: The prevalence of Diabetes Mellitus is 2.4% among adults in rural population and 4-11.6 % in urban population. In recent years, the simultaneous acceleration of diabetes and obesity worldwide has led to increasingly sedentary lifestyles and poor eating habits. Even children exposed to "junk" food and without enough exercise have now experienced obesity and diabetes. The term metabolic syndrome (formerly called 'Syndrome X') has been applied to an increasingly common disorder in which abdominal obesity and insulin resistance, such as elevated lipid profiles, are accompanied by a constellation of risk factors for cardiovascular disease. Objectives: To observe the dietary patterns of diabetic patients of urban Chennai population. Methods: A cross sectional study was conducted among diabetic patients attending the general out patient department of Balaji medical college hospital Chennai. Patients with following blood glucose levels were taken as Diabetics, F ≥126 mg/dl, PP≥200 mg/dl. Individuals diagnosed and treated for the above conditions for one year or more will be treated as participants. Purposive sampling was used to achieve the sample size of 164 participants. After obtaining the informed consent, the patients were enrolled for the study. Data was analysed using SPSS ver.24. Descriptive data was given in frequency and percentage. chi-square test was used to compare the data. p-value < 0.05 was considered as statistically significant. Result: Among the diabetic patients, their mean level of fasting sugar was 140 and PP was 236 with SD 44.032 and 62.674. More than 65% of the Urban population follow some other diet restrictions such as low salt, low cholesterol and fat. Physical activity of the population are 57% of going for walking also 39% of them are had no physical activity at all. Conclusion: The dietary change coupled with , the intake of cholesterol rich food and lack of physical activity seem to have contributed to the urban population's high prevalence rate of obesity.

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Satisfaction and Adherence to Biological Treatment in Patients with Rheumatic Diseases

Current Rheumatology Reviews ◽

10.2174/1573397118666211230101451 ◽

2021 ◽

Vol 18 ◽

Author(s):

Marwa Hammad ◽

Huny Bakry

Keyword(s):

Rheumatic Diseases ◽

Biological Treatment ◽

Formal Education ◽

Biological Therapy ◽

Cross Sectional Study ◽

P Value ◽

Inflammatory Rheumatic Diseases ◽

Cross Sectional ◽

New Era ◽

The Mean

Background: Autoimmune inflammatory rheumatic diseases have long been treated by conventional disease-modifying anti-rheumatic drugs. Biological therapy is a new era in the treatment of rheumatic diseases, but satisfaction and adherence to it is still not well tested. Aim: To assess the satisfaction and adherence to biological treatment among patients with autoimmune inflammatory rheumatic diseases. Methods: A cross sectional study was conducted among 56 patients suffering from inflammatory rheumatic diseases using Morisky 8 questionnaire and Treatment Satisfaction Questionnaire for Medication (TSQM) over a period of one month Results: About 76.8% of the patients had medium adherence and the underlying cause of missing doses was the unavailability of the drugs. The mean satisfaction with biological treatment was 62.7±6.9. Patients who did not receive formal education had significantly higher satisfaction with the biological treatment than others 64.94±5.01 at a P value 0.04 (<0.05). Conclusion: Patients with inflammatory rheumatic diseases in our study showed medium adherence and satisfaction. Authorities in the medical field are providing great help to these patients in need of biological therapy, but ensuring the availability of all doses of the biological treatment regimen is still necessary. Patient, family and nurse education programs are also necessary to maximize adherence and satisfaction.

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THE IMPACT OF MEDICATION ADHERENCE ON HEALTH-RELATED QUALITY OF LIFE OF DIABETIC PATIENTS IN THE KINGDOM OF SAUDI ARABIA: FINDINGS FROM A CROSS-SECTIONAL STUDY

Periódico Tchê Química ◽

10.52571/ptq.v17.n34.2020.891_p34_pgs_867_873.pdf ◽

2020 ◽

Vol 17 (34) ◽

pp. 867-873

Author(s):

Dhfer ALSHAYBAN ◽

Royes JOSEPH

Keyword(s):

Quality Of Life ◽

Medication Adherence ◽

Cross Sectional Study ◽

P Value ◽

Diabetic Patients ◽

Health State ◽

Cross Sectional ◽

Related Quality ◽

The Impact

Diabetes is a common chronic disease that is considered as one of the fastest-growing health problems in the world. Adherence to medications could be an important factor in reducing these complications and improving the quality of life. The purpose of this research was to assess the impact of treatment adherence on health-related quality of life in patients with type 2 diabetes. A multicenter cross-sectional study was carried out among 368 diabetes patients. General Medication Adherence Scale was used to assess the adherence level and EuroQol-5D to assess the quality of life. The results show that 19%, 21%, and 23% of patients had maintained low medication adherence due to patient’s intentional or unintentional behavior due to additional diseases or pills burden and due to financial constraints, respectively. Overall, 43% (n=162) participants had maintained high medication adherence, and 37% (n=138) had maintained low medication adherence to antidiabetic drugs. Nearly one-third (31%) of patients with high overall adherence had perfect health state in comparison with 4% among patients with low adherence. Further, the lower proportion (21%) of patients with high overall adherence had perfect health state in comparison with that among patients with low adherence (34%). In addition to the overall adherence, the association was statistically significant for the domains related to non-adherence due to the patient’s intentional or unintentional behavior (p-value 0.001) and non-adherence due to additional diseases or pills burden (p-value 0.001) after taking into account of socio-demographic and clinical characteristics. In conclusion, the findings suggest that the policymakers should establish an intervention to improve adherence to diabetic treatment, and thus improve the quality of life for the type 2 diabetic patients.

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Barriers to the early initiation of Insulin therapy among diabetic patients coming to diabetic clinics of tertiary care hospitals

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.35.1.237 ◽

2018 ◽

Vol 35 (1) ◽

Author(s):

Iqra Arshad ◽

Sara Mohsin ◽

Sana Iftikhar ◽

Tahseen Kazmi ◽

Luqman F. Nagi

Keyword(s):

Insulin Therapy ◽

Tertiary Care ◽

Cross Sectional Study ◽

Early Initiation ◽

P Value ◽

Diabetic Patients ◽

Cross Sectional ◽

Creative Commons ◽

Oral Medications ◽

Tertiary Care Hospitals

Background and Objective: Initiation of Insulin therapy during earlier stages has proved to significantly improve health outcomes among diabetics in comparison to oral medications. Not only patients but physicians are also often resistant to early initiation of insulin therapy. The objective was to assess misconceptions and barriers to early initiation of insulin therapy among diabetic patients coming to a diabetic clinic. Methods: This cross sectional study was conducted on 300 patients selected by convenience sampling arriving in Diabetes Outdoor Clinics of Mayo and Services Hospitals, Lahore during August 2017 to May 2018. The data was entered and analyzed by using SPSS version 17. Results: Out of 300 patients included in study, 39% (n= 117) were males and 61% (n=183) were females. The mean age of the participants at presentation was 48.46±13.15 years with a range of 13 to 80 years. Study participants considered it embarrassing to inject insulin in public place (p-value 0.01). The fear associated with lifelong commitment to insulin therapy once it is started, was also found statistically significant (p-value 0.001)particularly in subjects who have long duration of DM (>5 years). Conclusion: Perceptions of diabetic patients about insulin therapy are still barriers to early initiation of therapy and tend to prevail in Pakistan and around the globe. How to cite this:Arshad I, Mohsin S, Iftikhar S, Kazmi T, Nagi LF. Barriers to the early initiation of Insulin therapy among diabetic patients coming to diabetic clinics of tertiary care hospitals. Pak J Med Sci. 2019;35(1):---------. doi: https://doi.org/10.12669/pjms.35.1.237 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Detecting chronic kidney disease in diabetic adults by estimating glomerular filtration rate and Serum Creatinine

Journal of Contemporary Medical Sciences ◽

10.22317/jcms.v7i1.926 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Ahmed Kh. Mohammed Almaawi

Keyword(s):

Risk Factors ◽

Serum Creatinine ◽

Cross Sectional Study ◽

P Value ◽

Diabetic Patients ◽

Kappa Index ◽

Chi Square ◽

Cross Sectional ◽

Female Ratio ◽

Qualitative Variables

Objective: To assess CKD prevalence and risk factors including socio-demography among diabetics by estimating GFR rather than serum creatinine (sCr). Methods: A cross-sectional study was conducted in Dec. 15 2019 through Aug. 15 2020, among 800 diabetics attending tertiary diabetes centers, Baghdad. Data was collected by self-administered questionnaire. SPSS was used for data analysis by (mean, standard deviation and T-test) for quantitative variables and (frequency, percentage, Chi-square test and Kappa index) for qualitative variables. P-Value less than 0.05 was considered significant. Results: 800 diabetics for last 5-40 years, 95.6% with type2. Aged 52.1±13.2 years, with male: female ratio 1.03:1, 63.6% were with no income, sCr level was 0.86±0.3 mg/dl, and eGFR by Cockcroft Gault (CG) and CKD-EPI equations was 100.4±36.5 & 92.2±25.5 ml/min/1.73m2 respectively. CKD prevalence based on sCr, and eGFR assessed by above equations was 13.3%, 20% and 15.9% respectively (p<0.001). Those with CKD were hypertensive, females, and living in peripheries. Conclusions: Diabetic patients, mainly those with risk factors are more likely to develop CKD. It is better to detect CKD intially by estimating the GFR, rather than serum creatinine level alone. Furthermore, using CKD-EPI equation might be better than the CG formula to estimate the GFR.

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Frequency of Metabolic Abnormalities of Vesical Calculus in Children Younger than 10 Yrs of Age

10.53350/pjmhs211561243 ◽

2021 ◽

Vol 15 (6) ◽

pp. 1243-1245

Author(s):

H.U Rahman ◽

S. F. Shah ◽

A. J. Sheikh ◽

I. U. Memon ◽

W. S. Bhatti ◽

...

Keyword(s):

Cross Sectional Study ◽

P Value ◽

Metabolic Abnormalities ◽

Urine Ph ◽

College Hospital ◽

Cross Sectional ◽

Vesical Calculus ◽

Medical College ◽

Presenting Symptoms ◽

Calcium Magnesium

Aim: To assess the metabolic abnormalities in children younger than 10 years of age with vesical calculus. Study design: Retrospective cross-sectional study Place and duration of study: Department of Urology, Khairpur Medical College Hospital, Khairpur from 1st October 2014 to 30th September 2016. Methodology: Two hundred and six children age <10 years of age and either gender presented with vesical calculus were enrolled. Demographic information like age, gender, residence, serum electrolytes, calcium, magnesium, phosphate, uric acid, blood, and urine pH were recorded for the purpose of metabolic workup. Results: The mean age was 4.76±1.22 years and 157 (76.2%) were males and 49 (23.8%) were females. The frequency of metabolic abnormalities was observed in 153 (74.3%) of the patients. A significantly higher prevalence of metabolic abnormalities was observed with male gender (p-value 0.006), dark colored urine as presenting symptoms (p-value 0.022), frequent urination (p-value 0.045), and hematuria (p-value 0.016). Of 153 patients with metabolic abnormalities, hypercalciuria was observed in 45 (29.4%), hypocitraturia in 73 (47.7%), hyperoxaluria in 21 (13.7%), and hyperuricosuria in 14 (9.2%) patients. Conclusion: The frequency of metabolic abnormalities was high among children with vesical calculus. Moreover, hypocitraturia in these children was observed in majority followed by hypercalciuria, hyperoxaluria, and hyperuricosuria. Keywords: Metabolic abnormalities, Children, Vesical calculus

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ROLE OF ABSOLUTE EOSINOPHIL COUNT AS A MODALITY OF INVESTIGATION IN SUSPECTED CASES OF HELMINTHIC INFESTATION IN CHILDREN AGED BETWEEN 5 TO 15 YEARS WITH COMPARISON TO STOOL ROUTINE AND MICROSCOPY

10.36106/gjra/6111669 ◽

2021 ◽

pp. 112-113

Author(s):

Meghashree N ◽

Rohini D ◽

Mahendar Reddy M ◽

A.M Koppad

Keyword(s):

Eosinophil Count ◽

Stool Specimen ◽

Cross Sectional Study ◽

Research Centre ◽

P Value ◽

College Hospital ◽

Cross Sectional ◽

Mean Values ◽

Medical College ◽

Absolute Eosinophil Count

Introduction: Eosinophilia is a well-known host immune response in helminthic infestation. This study was carried out to investigate whether a correlation exists between absolute eosinophil count in children with stool specimen positive for helminthic infestation. Aim And Objective: To determine average raised absolute eosinophil count in children who were having various helminthic infestation with stool specimen positive. Materials And Methods: A hospital based cross sectional study done at Navodaya medical college hospital and research centre during 2019 October to 2020 September for a period of 12 months. Both blood and stool samples were obtained from a total of 69 suspected children after examined, categorised into 2 groups. Among them 24 cases were positive of helminthic infestation and 45 cases were negative. T-test and descriptive statistics were used to analyse the data. Results: The study revealed that children infested with helminths found to have higher absolute eosinophil count (mean 4644/µl (95%CI; 3474-4212) than not infested (mean 801/µl (95%CI; 616-945) with p value <0.001. In this helminth's family; nematodes, trematodes, cestodes showed mean values of absolute eosinophil count were 5206/µl (4806-7151/µl), 4930/µl (4500-5382/µl) and 2179/µl (2500-1669/µl) respectively. Conclusions: Raised absolute eosinophil count has been observed in stool specimen positive cases of helminths, especially more in nematodes. Therefore, should be considered for a single dose of albendazole.

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Influence of Education Level of Older Patients on Polypharmacy, Potentially Inappropriate Medications Listed in Beer’s Criteria, and Unplanned Hospitalization: A Cross-Sectional Study in Lahore, Pakistan

Medicina ◽

10.3390/medicina54040057 ◽

2018 ◽

Vol 54 (4) ◽

pp. 57 ◽

Cited By ~ 5

Author(s):

Muhammad Sarwar ◽

Sadia Iftikhar ◽

Muhammad Sarfraz

Keyword(s):

Older People ◽

Older Patients ◽

Formal Education ◽

Cross Sectional Study ◽

Education Level ◽

P Value ◽

Potentially Inappropriate Medications ◽

Sectional Study ◽

Cross Sectional ◽

Inappropriate Medications

Objective: To evaluate influence of education level of older patients on polypharmacy, potentially inappropriate medications (PIMs) listed in Beer’s Criteria, and unplanned hospitalization. Methods: A cross-sectional study was conducted among older people aged ≥65 years between 1 December 2017 and 28 February 2018. For data analysis, descriptive statistics and logistic regression analysis were employed. Results: Among 385 older patients, 88.8% were prescribed PIMs and 56.4% underwent PIMs associated unplanned hospitalization. Older people were less exposed to polypharmacy or excessive polypharmacy as their education levels increased (no formal education vs. primary vs. secondary vs. tertiary, 74% vs. 69.8% vs. 60.5% vs. 58.1%). Patients having higher education were also accompanied by significantly lower prescription of PIMs (no formal education vs. primary vs. secondary vs. tertiary, 96% vs. 87.3% vs. 84.5% vs. 79.1%) as well as unplanned hospitalization (no formal education vs. primary vs. secondary vs. tertiary, 64.7% vs. 76.2% vs. 40.3% vs. 46.5%). Results of regression analysis revealed that no formal education (OR = 1.202, 95% CI = 1.032–2.146, p-value = 0.003) and primary education level (OR = 1.175, 95% CI = 1.014–1.538, p-value = 0.039) were significantly associated with the use of polypharmacy among older people. On the other hand, no formal education was significantly associated with the prescription of PIMs (OR = 1.898, 95% CI = 1.151–2.786, p-value = 0.007). Furthermore, older people with no formal education (OR = 1.402, 95% CI = 1.123–1.994, p-value = 0.010) and primary education level (OR = 1.775, 95% CI = 1.281–3.018, p-value = <0.001) were significantly more likely to undergo unplanned hospitalization. Conclusions: Patients having low literacy level are more likely to receive PIMs, polypharmacy, and undergo unplanned hospitalization in comparison to highly educated patients. Hence, promotion of health literacy for patients is crucial to overcome these problems.

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