BURDEN OF THERAPY IN PATIENTS SUFFERING FROM DIABETES MELLITUS AND HYPERTENSION

Objective: To estimate a) monthly expenditure for treatment of diabetes mellitus (DM), hypertension (HTN) and both (DM+HTN) and b) economic burden (EB) and psychological burden (PB) of therapy of DM, HTN and DM+HTN.Methods: An observational questionnaire-based study was conducted among 180 patients. The monthly cost of drug therapy was assessed based on the drugs they were taking and the cost of individual drugs. The EB and PB were assessed using a validated questionnaire and data analysed by ANOVA followed by post hoc test.Results: Among 216 patients who were interviewed, 180 fulfilled the selection criteria. Among 180, 75 had DM, 40 HTN and 65 had both. Prevalence of DM and DM+HTN was higher among females and of HTN equal among males and females. The average total monthly cost of therapy for DM was INR 2077, for HTN INR 1464 and for DM+HTN INR 2269.Significant correlation was found between income and percentage of expenditure (p<0.001) in all the groups. The PB was found to correlate with low income (p<0.001), poor education (p<0.05) occupation (p<0.01) in DM+HTN and number of tablets (p<0.01) in DM and DM+HTN groups.Conclusion: The cost of therapy was higher for DM+HTN and DM. The percentage of expenditure was higher in low-income group and burden of therapy was directly proportional to the number of tablets, poor educational and occupational status; and inversely proportional to income.

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SOCIODEMOGRAPHIC FACTORS AFFECTING PATIENT COMPLIANCE TO LONG-TERM THERAPIES

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2021.v14i7.41868 ◽

2021 ◽

pp. 59-62

Author(s):

SHAKEEL AHMAD MIR

Keyword(s):

Patient Compliance ◽

Low Income ◽

Income Group ◽

Sociodemographic Factors ◽

High Income Group ◽

Factors Affecting ◽

Validated Questionnaire ◽

Adherence Scale ◽

Study Population

Objective: The aim is to study the effect of various sociodemographic factors on patient compliance in long-term therapies. Methods: This is a questionnaire-based study of 195 adult outdoor patients suffering from chronic illnesses and receiving long-term drug therapy. Various sociodemographic factors were noted in a validated questionnaire. Questions about drugs being taken were asked. The compliance was measured by General Medication Adherence Scale. Results: The study population consists of 51.3% of males and 48.7% of females. About 39.0% of participants were literate and 61.0% were illiterate. About 72.3% belonged to the rural area, 13.3% urban, and 14.4% to the main city. About 33.3% were self-employed or unemployed, 17.4% government employees, and 49.3% were private employees. About 20.0% belonged to high-income group, and 40.0% to middle- and 40.0% to low-income group. Statistically significant correlation was found between compliance and age, gender, area of residence, education, and marital status (p<0.05). Better compliance was observed in men, unmarried,middle-aged, literate, and urban populations. Conclusions: We conclude that some sociodemographic factors correlate with compliance to long-term therapies.

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Cost-effectiveness study of antidiabetic drugs in type 2 diabetes mellitus patients from Mumbai, India

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20173653 ◽

2017 ◽

Vol 4 (9) ◽

pp. 3180 ◽

Cited By ~ 1

Author(s):

Dnyanesh Limaye ◽

Krishna Todi ◽

Jay Shroff ◽

Ashutosh Ramaswamy ◽

Priyanka Kulkarni ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Cost Effectiveness ◽

Cross Sectional Study ◽

Antidiabetic Drugs ◽

Cross Sectional ◽

Validated Questionnaire ◽

The Cost

Background: Diabetes is fast gaining the status of a potential epidemic in India, with >62 million individuals currently diagnosed with the disease. India currently faces an uncertain future in relation to the potential burden that diabetes may impose on the country. An estimated US$ 2.2 billion would be needed to sufficiently treat all cases of type 2 diabetes mellitus (T2DM) in India. Many interventions can reduce the burden of this disease. However, health care resources are limited; thus, interventions for diabetes treatment should be prioritized. The present study assesses the cost-effectiveness of antidiabetic drugs in patients with T2DM from Mumbai, India.Methods: A prospective cross-sectional study was performed to assess the cost-effectiveness of antidiabetic drugs in patients with T2DM. Face-to-face interviews were conducted by using a validated questionnaire in a total of 152 (76 males, 76 females) patients with T2DM from F-North Ward, Mumbai, India. Cost-effectiveness was determined on the basis of cost of antidiabetic drug/s, efficacy, adverse drug reactions, safety of administration, frequency of administration, and bioavailability. Results: For treatment of T2DM in non-obese participants, Glimepiride+Pioglitazone costed least (`3.7) per unit of effectiveness followed by Glimepiride (`6.6), Gliclazide (`8.1), Repaglinide (`24.5), and Vildagliptin (`45.2). For treatment of T2DM in obese participants, Metformin cost least (` 6.7) per unit of effectiveness followed by Glimepiride + Metformin (`5.9) and Repaglinide (`24.5). Conclusions: In case of non-obese participants, cost effectiveness and prescribed treatments did not show a match, while for obese participants prescribed treatments were in line with cost effectiveness.

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Effectiveness of Coriander Seed Extract in decreasing Blood Glucose level among Diabetic Patients

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11i3.2367 ◽

2020 ◽

Vol 11 (3) ◽

pp. 2879-2883

Author(s):

Sheela R ◽

Merlin Shiny Sheeba ◽

Poornima ◽

Priya

Keyword(s):

Diabetes Mellitus ◽

Blood Glucose ◽

Blood Glucose Level ◽

Glucose Level ◽

Low Income ◽

Seed Extract ◽

Medical Expenditure ◽

Diabetic Patients ◽

Treatment Of Diabetes ◽

Coriander Seed

Diabetes Mellitus (DM) belongs to a group of metabolic disorders. It is characterised by Chronic Hyperglycemia and disturbance of carbohydrate, lipid and protein metabolism. The cause for this condition arises from a disease in insulin secretion. The International Diabetes Federation (IDF) expresses that worldwide 415 million individuals have Diabetes Mellitus. It also predicts that by 2040 this will ascend to 642 billion. The other prediction is that 77% of individuals with Diabetes live in middle and low-income countries. 12% of the worldwide population spend on the treatment of Diabetes. With the escalating medical expenditure in treating Diabetes, a person from middle or low income may find it challenging to meet the expenses. It is an expected tendency for an individual from this category to opt for a more straightforward treatment that suits their pocket. In the recent past, all over the world, people from all walks of life know essential things about natural remedies. A lot of researches are going on in support of using natural products per se. One such study is this – on the Effectiveness of Coriander Seed Extract in decreasing Blood Glucose level among Diabetic Patients.Coriandrum Sativum is a plant that has been utilised in the administration of Diabetes. It is a herbaceous plant originally from the Mediterranean and Middle Eastern locales, having a place in the family Apiaceae. It is known to have antifungal, antibacterial, free radical searching, and lipid peroxidation activities. The study was conducted to assess the level of pretest and posttest blood glucose level. And, also to evaluate the effect of coriander seed extract in the treatment of Diabetes Mellitus. An experimental study was chosen to assess the effectiveness of coriander seed extract among diabetic clients. The present study was conducted at Mappedu. 60 male and female who come under inclusion criteria were selected by purposive sampling technique. Data was collected by using a socio-demographic variable, and random blood glucose was assessed by CBG machine. The results revealed that coriander seed extract has a significant effect on decreasing blood glucose level among diabetic patients.

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Assessment of the Cost of the Mediterranean Diet in a Low-Income Region: Adherence and Relationship with Available Incomes

BMC Public Health ◽

10.1186/s12889-021-12433-w ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

Alessia Rubini ◽

Cristina Vilaplana-Prieto ◽

Marta Flor-Alemany ◽

Lorena Yeguas-Rosa ◽

Miriam Hernández-González ◽

...

Keyword(s):

Mediterranean Diet ◽

Low Income ◽

Urban Areas ◽

Economic Cost ◽

Population Based ◽

Disposable Income ◽

Median Cost ◽

Monthly Cost ◽

The Mediterranean ◽

The Cost

Abstract Background The Mediterranean Diet (MD) is recognized as heart-healthy, but the economic cost associated with this type of diet has scarcely been studied. The objective of the present study is to explore the cost and adherence of a low-income region population to the MD and its relationship with income. Methods A population-based study was carried out on 2,833 subjects between 25 and 79 years of age, 54% women, selected at random from the municipalities of Vegas Altas, La Siberia and La Serena in the province of Badajoz, Extremadura (Spain). Average monthly cost of each product included in the MD was computed and related to adherence to the MD using the Panagiotakos Index and average disposable income. Results The monthly median cost was 203.6€ (IQR: 154.04-265.37). Food-related expenditure was higher for men (p<0.001), age cohort between 45 and 54 years (p<0.013) and those living in urban areas (p<0.001). A positive correlation between food-related expenditure and the MD adherence was found. Monthly median cost represents 15% of average disposable income, ranging between 11% for the group with low MD adherence and 17% for the group with high MD adherence. Conclusions The monthly cost of the MD was positively correlated with the degree of adherence to this dietary pattern. Given that the estimated monthly cost is similar to that of other Spanish regions with a higher income level, the economic effort required to be able to afford the Mediterranean diet is higher. This may represent a barrier to access, which should be analyzed in detail by public decision-makers.

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PHYTOCHEMICAL MANAGEMENT OF DIABETIC COMPLICATIONS, EXPERIMENTAL EVIDENCES

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2019.v12i9.34442 ◽

2019 ◽

pp. 46-50

Author(s):

REKHA BISHT

Keyword(s):

Diabetes Mellitus ◽

Medicinal Plants ◽

Low Income ◽

Low Cost ◽

Microvascular Complications ◽

Low Income Countries ◽

Diabetes Incidence ◽

Traditional Medicines ◽

Treatment Of Diabetes

It is progressively obvious that not only is a cure for the current worldwide diabetes epidemic required but also for its major complications, affecting both small and large blood vessels. These complications occur in the majority of individuals with both Type-1 and Type-2 diabetes. Incidence and pervasiveness of diabetes mellitus are rapid becoming high in middle- and low-income countries where about 80% of people living in those countries depend on traditional medicines. Innumerable and diverse reports abound in the literature on studies conducted to investigate the ameliorative effects of medicinal plants on various pathophysiological complications of diabetes mellitus. Traditional medicines derived from medicinal plants are used by about 60% of the world’s population. Although there are various perspectives to reduce the ill effects of diabetes and its secondary complications, herbal formulations are preferred due to lesser side effects and low cost. The present review emphasizes on medicinal plants that could be beneficial for the treatment of diabetes-induced macrovascular and microvascular complications.

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Evaluation of the mediterranean diet cost in Extremadura: adherence and relationship with available income

European Journal of Preventive Cardiology ◽

10.1093/eurjpc/zwab061.445 ◽

2021 ◽

Vol 28 (Supplement_1) ◽

Author(s):

A Rubini ◽

C Vilaplana Prieto ◽

L Yeguas Rosa ◽

M Flor-Alemany ◽

J Felix Garcia ◽

...

Keyword(s):

Mediterranean Diet ◽

Low Income ◽

Urban Areas ◽

Geographical Area ◽

Developed Countries ◽

Alcoholic Beverages ◽

Monthly Cost ◽

National Budget ◽

The Mediterranean ◽

The Cost

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Carlos III Health Institute - Spain Background Cardiovascular diseases are the leading cause of death in developed countries. In this context, the Mediterranean diet (MD) is widely recognized as cardioprotective, although its implementation cost has been little studied and rarely employed as an argument for debate. Although previous Spanish studies have corroborated a higher monetary cost associated with increased adherence to the MD, there exist large disparities among studies, and none of them has related the cost of MD to available income, which is highly relevant for assessing the degree of affordability by families. Purpose The aim of this study is twofold. First, to estimate the cost and degree of adherence of the MD in a population of Extremadura. Second, to provide evidence on the cost of the MD in relation to available incomes. Methods A population study including 2.833 subjects between 25 and 79 years old (54% women), randomly selected from Don Benito-Villanueva de la Serena (Badajoz, Spain). Diet questionnaire contained 175 food items and 7 items related to alcoholic beverages. Consumption frequencies were translated in terms of grams or millilitres. Price for each item was obtained using price supermarket comparators from the same geographical area. Total monthly cost was obtained using monthly quantities consumed and the price of each category. Final cost was related to Panagiotakos adherence degree and to available income. Data of available income was obtained from the Income Tax Statistics by municipality. Results Median monthly cost was EUR 203.63 (IQR 154.04-265.37): 216.91 for men and 191.22 for women. Median monthly cost per age cohort showed an inverted U-shape, with a maximum in the 45-54 years-old cohort (EUR 212.1; IQR 155.47-274.63) and a minimum for the 75-79 years-old cohort (EUR 179; IQR 130.21-224.99). Median monthly cost was very similar for primary, secondary and higher educational levels (208.18, 206.57 and 205.70, respectively), but 14% lower for those without primary studies. MD cost was lower in rural compared with urban areas (188 versus 223 euros, respectively) The percentage of population showing a high MD adherence was 59% whereas the percentage with a low adherence was 12%. The cost associated with a high MD adherence was EUR 228.38. The average cost represents 14% of the available income, ranging from 10.5% for the group with low MD adherence, to 15.72% for the group with a high adherence. Conclusions Higher adherence to the MD can reach almost 20% of the available income. This can lead to low-income families opting for cheaper, energy-dense, and consequently, less healthy dietary patterns. Emphasis should be placed on education strategies to recreate the MD at an affordable price or to introduce changes to consumer taxes (VAT) that favor DM pattern.

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Abstract #295 GLP-1 Receptor Agonists and Death From Any Cause in Elderly Patients with Type 2 Diabetes Mellitus: A Post-Hoc Analysis

Endocrine Practice ◽

10.1016/s1530-891x(20)47140-x ◽

2018 ◽

Vol 24 ◽

pp. 80-81

Author(s):

Konstantinos Toulis ◽

Krishna Gokhale ◽

G. Neil Thomas ◽

Wasim Hanif ◽

Krishnarajah Nirantharakumar ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Elderly Patients ◽

Post Hoc Analysis ◽

Receptor Agonists ◽

Post Hoc

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Demonstrating Nutrient Cost Gradients: A Brooklyn Case Study

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000210 ◽

2014 ◽

Vol 84 (5-6) ◽

pp. 244-251 ◽

Cited By ~ 2

Author(s):

Robert J. Karp ◽

Gary Wong ◽

Marguerite Orsi

Keyword(s):

Low Income ◽

Energy Content ◽

Food Selection ◽

The United States ◽

United States Department ◽

Micronutrient Deficiencies ◽

Caloric Density ◽

Low Income Families ◽

The Cost ◽

The Impact

Abstract. Introduction: Foods dense in micronutrients are generally more expensive than those with higher energy content. These cost-differentials may put low-income families at risk of diminished micronutrient intake. Objectives: We sought to determine differences in the cost for iron, folate, and choline in foods available for purchase in a low-income community when assessed for energy content and serving size. Methods: Sixty-nine foods listed in the menu plans provided by the United States Department of Agriculture (USDA) for low-income families were considered, in 10 domains. The cost and micronutrient content for-energy and per-serving of these foods were determined for the three micronutrients. Exact Kruskal-Wallis tests were used for comparisons of energy costs; Spearman rho tests for comparisons of micronutrient content. Ninety families were interviewed in a pediatric clinic to assess the impact of food cost on food selection. Results: Significant differences between domains were shown for energy density with both cost-for-energy (p < 0.001) and cost-per-serving (p < 0.05) comparisons. All three micronutrient contents were significantly correlated with cost-for-energy (p < 0.01). Both iron and choline contents were significantly correlated with cost-per-serving (p < 0.05). Of the 90 families, 38 (42 %) worried about food costs; 40 (44 %) had chosen foods of high caloric density in response to that fear, and 29 of 40 families experiencing both worry and making such food selection. Conclusion: Adjustments to USDA meal plans using cost-for-energy analysis showed differentials for both energy and micronutrients. These differentials were reduced using cost-per-serving analysis, but were not eliminated. A substantial proportion of low-income families are vulnerable to micronutrient deficiencies.

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