RESUMEN
Background: Poor glycemic control in type 2 diabetes mellitus (T2DM) causes damage to various organs and leads to the development of disabling and life-threatening complications. Objectives: To find out the prevalence of glycemic control and medication adherence (MA) and the factors affecting them. Methods: A cross-sectional study was conducted among patients with T2DM. The patients were categorized as good glycemic control (HbA1c <7.0%) and poor glycemic control (HbA1c ≥7.0%). MA was categorized as low (score <6), medium (score 6 or 7), and high (score 8). The Statistical Package for Social Science (version 11.5) was used for statistical analysis at a P value less than 0.05. Results: Of 129 patients, 65 (50.39%) were females. The mean age was 48.33 ± 12.86 years. The combination of metformin and glimepiride was prescribed to 37 (28.68%) patients. Diabetic knowledge was poor in 84 (65.12%) patients. Glycemic control was good in 108 (83.72%) patients. MA was medium in 72 (55.81%) patients. Patients taking regular fruit, having shorter duration of drug therapy, and having good diabetic knowledge had good glycemic control and were statistically significant (P value < 0.05). Patients having family support, nonalcoholic, taking regular fruit, being involved in daily jogging, having shorter duration of drug therapy, and having good diabetic knowledge had high MA and were statistically significant (P value < 0.05). Conclusion: The majority of the diabetic patients had good glycemic control and medium MA. Patients taking regular fruit, being involved in daily jogging, having a shorter duration of drug therapy, and having good diabetic knowledge were identified as factors that affect both glycemic control and MA.
RESUMEN
BACKGROUND: Antiretroviral drugs are lifeline for patients living with HIV. Adverse drug reactions can compromise the compliance to antiretroviral therapy. The objectives of the study were to estimate the prevalence of adverse drug reactions and to assess its risk factors in patients living with HIV and receiving antiretroviral therapy. METHODS: A prospective cohort study was conducted among 496 patients living with HIV at B.P. Koirala Institute of Health Sciences for a period of one year. Adverse drug reactions were evaluated based upon clinical history, clinical examination and investigations. RESULTS: Majority of patients were of 31-45 year age group (58.1%) and on first-line antiretroviral therapy regimen (94.3%). Total of 240 adverse drug reactions were documented. Prevalence of adverse drug reaction was 34.7%. Skin rash, anemia and nausea and vomiting were the three most common adverse drug reactions. The adverse drug reactions were more common in patients having non-communicable diseases, chronic co-infections, taking more than 3 non-HIV drugs, second and third-line antiretroviral regimen and it was statistically significant (P-value < 0.05). CONCLUSIONS: Prevalence of adverse drug reaction was high in the patients living with HIV. Age, gender, co-infections, non-communicable diseases, taking more than three non-HIV drugs and second and third-line antiretroviral regimen were identified as possible risk factor for occurrence of adverse drug reactions and their prior identification is important to optimize the best suited antiretroviral regimen.