Changes in drug therapy and disease control in a subset of diabetic patients at public primary healthcare facilities in Trinidad
West Indian med. j
; 65(Supp. 3): 50-51, 2016.
Article
in English
| MedCarib
| ID: med-18110
Responsible library:
TT2.1
Localization: TT5; W1, WE389
ABSTRACT
OBJECTIVE:
To determine changes in drug treatment over a five-year period in a subset of diabetic patients who were either uncontrolled on monotherapy or required polypharmacy with or without insulin. These changes were assessed in their ability to be able to achieve glycaemic control.SUBJECTS ANDMETHOD:
A cross-sectional survey was conducted between June and August 2015 at 24 primary healthcare facilities across Trinidad. Demographic details, drug use, blood glucose readings and self-reported adherence to drug therapy, dietary restrictions and exercise were collected. Additionally, patients files were reviewed for drug changes and blood glucose readings over the previous five-year period.RESULTS:
A total of 236 patients were enrolled and 49% had random blood glucose greater than 180 mg/dL (uncontrolled). Most patients (91%) were prescribed metformin or gliclazide (67.5%) either singly or in combination; 92 patients (39%) were prescribed insulin. Over the five-year period, monotherapy declined from 26.9% to 8.4%; conversely, polypharmacy increased from 68.2% to 82.4%. Additionally, doses of all antidiabetic drugs increased. However, despite these changes, only modest decreases in random blood glucose were observed, ranging from 18 mg/dL to 43 mg/dL for the various drug combinations. On average, none of these combinations produced blood glucose levels below 180 mg/dL to achieve glycaemic control.CONCLUSION:
Over the five-year period, there was a shift from monotherapy to polypharmacy, with increasing doses of individual drugs and further addition of insulin. Despitethese therapeutic changes, accompanied by moderate decreases in random blood glucose, they were insufficient to achieve glycaemic control in a significant number of patients.
Search on Google
Collection:
International databases
Health context:
Sustainable Health Agenda for the Americas
/
SDG3 - Health and Well-Being
Health problem:
Goal 9: Noncommunicable diseases and mental health
/
Goal 10: Communicable diseases
/
Target 3.4: Reduce premature mortality due to noncommunicable diseases
Database:
MedCarib
Main subject:
Trinidad and Tobago
/
Public Health Practice
/
Diabetes Mellitus
/
Drug Therapy
Limits:
Humans
Country/Region as subject:
English Caribbean
/
Trinidad and Tobago
Language:
English
Journal:
West Indian med. j
Year:
2016
Document type:
Article
/
Congress and conference
Institution/Affiliation country:
The University of the West Indies/Trinidad and Tobago