scholarly journals Forgone Care in Patients With Type 2 Diabetes: A Cross-Sectional Study

Author(s):  
Habib Jalilian ◽  
Somayeh Heydari ◽  
Habibeh Mir ◽  
Saeedeh Fehresti ◽  
Nasser Hatamzadeh ◽  
...  

Abstract Background and objective: Diabetes mellitus is a complex chronic disease requiring appropriate continuous medical care and delayed, or forgone care may exacerbate the severity of the disease. This study aimed to investigate the factors affecting forgone care in diabetic patients.Materials and methods: This was a cross-sectional study involving 1139 patients with type 2 diabetes aged 18 years and older in East Azerbaijan. Data collected using a researcher-made questionnaire and analyzed using SPSS software version 22. Results: Of the 1139 patients, 510 patients (45%) reported forgone care during the last year. The percentage of forgoing care was higher in patients without supplementary insurance coverage (P=0.01), those with complications (P=0.01) and those with the history of hospitalization (P=0.006). The majority of patients (41.5%) reported that the most important reason for forgoing care is financial barriers resulting from disease treatment costs. Of the main four factors, quality of care had the highest impact on forgone care at 61.28±39.74, followed by accessibility (37.01±25.12), awareness and attitude towards disease (18.52±18.87) and social support (17.22±18.80).Conclusion: The results showed that, despite the implementation of the Islamic Republic of Iran on a fast-track to beating non-communicable diseases (IraPEN), a considerable number of diabetics had a history of forgoing care, and the most important reasons for forgoing care were related to the financial pressure and dissatisfaction with the quality of care. Therefore, not only more financial support programs should be carried out, but the quality of care should be improved.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Habib Jalilian ◽  
Somayeh Heydari ◽  
Nazanin Mir ◽  
Saeedeh Fehresti ◽  
Rahim Khodayari-Zarnaq

Abstract Background and objective Diabetes mellitus is a complex chronic disease requiring appropriate continuous medical care and delayed, or forgone care may exacerbate the severity of the disease. This study aimed to investigate the factors affecting forgone care in patients with type2 diabetes. Materials and methods This was a cross-sectional study involving 1139 patients with type 2 diabetes aged> 18 years in 2019 in Tabriz, Iran. The researcher-made questionnaire was used for data collection. Data were analyzed using IBM SPSS software version 22 and IBM AMOS 22. Exploratory Factor Analysis (EFA) was performed for dimension reduction of the questionnaire, and Confirmatory Factor Analysis (CFA) used to verify the result of EFA. We applied the binary logistic regression model to assess the factors affecting forgone care. Results Of the 1139 patients, 510 patients (45%) reported forgone care during the last year. The percentage of forgoing care was higher in patients without supplementary insurance coverage (P = 0.01), those with complications (P = 0.01) and those with a history of hospitalization (P = 0.006). The majority of patients (41.5%) reported that the most important reason for forgoing care is financial barriers resulting from disease treatment costs. Of the main four factors affecting, quality of care had the highest impact on forgone care at 61.28 (of 100), followed by accessibility (37.01 of 100), awareness and attitude towards disease (18.52 of 100) and social support (17.22 of 100). Conclusion The results showed that, despite the implementation of the Islamic Republic of Iran on a fast-track to beating non-communicable diseases (IraPEN), a considerable number of patients with type2 diabetes had a history of forgoing care, and the most important reasons for forgoing care were related to the financial pressure and dissatisfaction with the quality of care. Therefore, not only more financial support programs should be carried out, but the quality of care should be improved.


2021 ◽  
Vol 15 (3) ◽  
Author(s):  
Supriya Patil ◽  
Yamini Patil ◽  
Sanjay Kumar Patil

Diabetes is a chronic metabolic disorder that disturbs the quality of life (QOL) of patients. Therefore, evaluation of diabetes- related QOL could be a key outcome measure for its management. This study assessed the QOL in type 2 diabetes mellitus (T2DM) patients using the World Health Organization (WHO) quality of life (QOL)˗BREF questionnaire and disease-specific appraisal of diabetes scale (ADS). In this cross-sectional study, 520 T2DM patients were included. Patients’ demographic data, clinical information was collected through interviews, and the WHOQOL-BREF instrument and ADS were used for the QOL of patients. Statistical analysis was performed by using R software (Version 3.6.0). The mean ADS scores were lower in controlled diabetic subjects (18.50±3.08) and higher in uncontrolled diabetic subjects (19.29±2.73) (P<0.05). For WHOQOL-BREF, the mean scores for all the domains (overall general health, physical, psychological, social, and environmental) were significantly higher in controlled diabetic subjects (P<0.001). In addition, the age, duration of diabetes, associated comorbidities, treatment, and HbA1c level of patients showed a highly significant correlation with WHOQOL-BREF (P<0.001). Diabetic patients had poor-to-average QOL. Therefore, public health measures and education of diabetic patients are essential to create more awareness for improving the QOL of T2DM.


BJGP Open ◽  
2019 ◽  
Vol 3 (1) ◽  
pp. bjgpopen18X101636 ◽  
Author(s):  
Bjørn Gjelsvik ◽  
Anh Thi Tran ◽  
Tore J Berg ◽  
Åsne Bakke ◽  
Ibrahimu Mdala ◽  
...  

BackgroundCoronary heart disease (CHD) and stroke are the major causes of death among people with diabetes.AimTo describe the prevalence and onset of CHD and stroke among patients with type 2 diabetes mellitus (T2DM) in primary care in Norway, and explore the quality of secondary prevention.Design & settingA cross-sectional study of data was undertaken from electronic medical records (EMRs) of 10 255 patients with T2DM in general practice. The study took place in five counties of Norway (Oslo, Akershus, Rogaland, Hordaland, and Nordland). Quality of care was assessed based on national guideline recommendations.MethodSummary statistics with adjustments and binary logistic regression models were used.ResultsIn total, 2260 patients (22.1%) had CHD and 759 (7.4%) had stroke. South Asians had significantly more CHD than ethnic Norwegians (29.5%, 95% confidence interval [CI] = 26.1 to 33.0 versus 21.5%, CI = 20.6 to 22.3) and other ethnic groups, and experienced onset of CHD or stroke at a mean of 7 years before Norwegians. In 47.9% of the patients, CHD was diagnosed before T2DM. Treatment target for low-density lipoprotein (LDL) cholesterol was reached for 30.0% and for systolic blood pressure (SBP) for 65.1% of the patients with CHD. Further, 20.9% of patients with CHD were present smokers, and only 5.0% of patients reached all four treatment targets (no smoking, HbA1c ≤7.0%, SBP <135 mmHg, LDL-cholesterol <1.8 mmol/l).ConclusionThe diagnosis of CHD preceded the diagnosis of T2DM in half of the patients. The prevalence of CHD was highest and onset earlier among ethnic South Asians. More intensive treatment of lipids, blood pressure, and smoking are needed in patients with T2DM and CHD.


2008 ◽  
Vol 8 (1) ◽  
Author(s):  
Yolanda V Martínez ◽  
Carlos A Prado-Aguilar ◽  
Ramón A Rascón-Pacheco ◽  
José J Valdivia-Martínez

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251506
Author(s):  
Shambel Nigussie ◽  
Nigussie Birhan ◽  
Firehiwot Amare ◽  
Getnet Mengistu ◽  
Fuad Adem ◽  
...  

Objective To assess the rate of glycemic control and associated factors among type 2 diabetes mellitus patients at Dilchora Referral Hospital, Dire Dawa, Eastern Ethiopia. Methods A cross-sectional study was conducted from 13 May to 16 August 2019. Type 2 diabetic patients on follow up at Dilchora Referral Hospital who fulfilled the inclusion criteria of the study were included. Systematic random sampling was used to select study participants. Data was collected by a face-to-face interview and review of medical records. The primary outcome was the level of blood glucose during three consecutive visits. Poor glycemic control was defined as a blood sugar level of more than 154 mg/dL based on the average of measurements from three consecutive visits. Multivariate logistic regression analysis was used to identify determinants of glycemic control. Result A total of 394 participants responded to the interview and were included in the final analysis. The overall prevalence of poor glycemic control was 45.2% (95%CI: 40.6%-50.0%). Patients who were on oral anti-diabetic drug plus insulin had more than two times greater chance of poor glycemic control than patients on oral anti-diabetic drug alone: 2.177(95%CI:1.10–4.29). The odds of poor glycemic control in patients who did not understand the pharmacist’s instructions was two times higher than patients with good understanding of instructions 1.86(95%CI: 1.10–3.13). Patients who had poor level of practice were found to have poor glycemic control: 1.69(95% CI: 1.13–2.55). Conclusion The overall prevalence of poor glycemic control was high among type 2 diabetes patients. Oral anti-diabetic drugs in combination with insulin, lack of understanding of pharmacist’s advice, and poor practice of diabetic patients were significant factors of poor glycemic control. Pharmacists should reassure the understanding of patients before discharge during counseling. Optimization of the dose of antidiabetic medications and combination of oral hypoglycemic agents should be considered.


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