Epidemic status of patients with hypertension and diabetes among adults aged 35 years and older in Shanghai / 上海预防医学

Objective:To understand the epidemic status of patients with hypertension and diabetes among residents aged ≥35 years in Shanghai. Methods:The data of "Monitoring of Chronic Diseases and Behavioral Risk Factors in Shanghai in 2013" were used for analysis. Residents aged ≥35 years were selected to analyze the prevalence， awareness， treatment and control in patients with hypertension and diabetes. Results:The prevalence rate of patients with both hypertension and diabetes was 11.25% （95%CI：10.29%-12.29%） among residents aged ≥35 years in Shanghai. The older the age was， the higher the prevalence rated. The rate was the highest in urban area， second in rural area， and the lowest in urban-rural area. Education level of senior high school or above had lower rate than junior high school or below. The non-occupational group had the highest rate and the non-agricultural occupation group had the lowest. The widowed/separated/divorced groups had the highest rate and the married group had the lowest. The rate in obese people was the highest and normal people was the lowest. People with sleep time ≥6 h had a lower rate than those with sleep <6 h. All the above differences were statistically significant （χ2=890.98， 28.91， 61.92， 315.34， 123.72， 441.45， 8.77，all P<0.05）. The awareness rate was 50.09% （95%CI：46.54%-53.64%）， the highest in 60-74 years old group and the lowest in 35-44 years old group. The awareness rate in urban area was higher than that in the urban-rural junction， and the rural area was the lowest. The treatment rate was 45.67% （95%CI：42.45%-48.92%） and the age was proportional to the treatment rate. The treatment rate from high to low in order was city， urban and urban-rural junction， rural areas. The differences in age， region awareness rate and treatment rate were statistically significant （χ2=43.27， 35.19， 37.59， 37.56，all P<0.05）. Control rates was 6.45% （95%CI：5.17%-8.01%）， 60-74 age group had the highest， and the age group from 35 to 44 years old had the lowest， and the difference was statistically significant （χ2=20.35，P<0.05）. The treatment control rate was 14.11% （95%CI：11.54%-17.15%）. Conclusion:The prevalence rate of patients with co-existing hypertension and diabetes in Shanghai residents is high， the awareness rate and treatment rate are general， and the control rate is low. It is urgent to improve the comprehensive prevention and treatment level of patients with hypertension and diabetes.

Effectiveness of intervention by accredited social health activists in the control of hypertension and diabetes in a rural population of Kolar district, Karnataka

Background: Non-communicable diseases are the leading causes of death globally, of which cardiovascular diseases are the most common. Cost-effective strategies, such as task shifting, are needed to mitigate the rising epidemic by controlling hypertension and diabetes in our country.Methods: This was a non-randomized interventional study undertaken in six (3 intervention and 3 control) villages of Lakkur primary health centre (PHC) area under Malur taluk, Kolar district, Karnataka, from November 2013 to April 2015. After obtaining written informed consent, baseline survey was done among 180 diabetics and hypertensives (adults>30 years). In the intervention villages, ASHAs who were trained did the intervention for 6 months. In non-intervention villages, standard usual care was given and repeat survey was done after 6 months to re-measure.Results: This study demonstrated that there was an increase of 44.8% in the proportion of hypertensives whose blood pressure was under control and increase of 26.5% in the proportion of diabetics whose blood sugar was under control in villages that received household visits by trained ASHAs (intervention villages). There was an increase in the medication adherence levels (29.6%) and reduction in tobacco usage (median difference of 4 times per day) among hypertensives and diabetics who are on medication in intervention villages.Conclusions: Findings from this study will provide policy makers and other stakeholders needed information to recommend scalable and cost-effective policy in respect to cardiovascular risk reduction, hypertension and diabetes control in resource-poor settings.

Cross sectional study on prevalence and medication adherence of hypertension and diabetes in a tertiary care hospital in Karimnagar, India

Background: The study aimed to assess the prevalence of Hypertension (HTN), Diabetes mellitus(DM) and other diseases along with comorbid conditions, disease complications and also to assess medication adherence in a tertiary hospital in Karimnagar, Telangana, India.Methods: A Cross sectional study is performed by analysing a total of 500 patient抯 individual case safety reports (ICSR). Prevalence of Hypertension and Diabetes along with most prescribed drugs are analysed. Medication adherence is analysed by using Morisky Medication adherence questionnaire scale (MMAS-4).Results: Patients with past history of DM, HTN and other diseases which was found to be 245 (49%) patients. Patients with highest disease prevalence were found to be with HTN (56.73%), DM (31.83%) followed by other diseases like asthma (8.57%), Cerebrovascular accident (4.89%) etc., Total of 66 Patients were ruled out with comorbid diseases. Patients with HTN+DM (47) were found to be highest followed by DM+HTN+CVA (4). MMAS-4 revealed 208 patients were using medication out of 245 patients with previous history. According to MMAS-4 most of the patients were with medium adherence (76). Prevalent drug used for HTN include Amlodipine and for DM Telmisartan+Hydrochlorthiazide.Conclusions: The study revealed that almost half of the admitted patients were with HTN and DM. The patients were counselled properly to adhere strictly to the prescription. Medication adherence to HTN and DM was found to be good in this study. Since the disease complications were also ruled out, the health care professionals are recommended to spread awareness on DM and HTN and disease management in order to control disease and improve health outcomes.

Evaluation of Oral Health Promotion Program Connected with Hypertension and Diabetes Management Programs: Use of a Logical Model / 치위생과학회지

This study aimed to design and operate a complementary integrated health management program based on the connection between the hypertension and diabetes management programs and the oral health programs at a public health center. It also proposed to suggest the phased evaluation indicators. In this study, 48 adults registered in the hypertension and diabetes management program were selected from the Gangneung public health center. The clinic-specific programs were led by dental hygienists and operated for visitors twice every two weeks. The programs were designed based on the logical model, and indicators for evaluating the structure, process, and outcome were presented and applied to the input, process, output, and outcome. The evaluation indices consisted of quantitative and qualitative indicators, and the planning and operation, goal achievement, and effect of each program were assessed. The process evaluations were assessed by the appropriateness of the managers and the operating fidelity of the programs. Indicators for evaluating the outcomes were gingival bleeding, oral health knowledge, oral health awareness, and the satisfaction of the participant and the manager. The clinic-specific programs resulted in positive changes in the evaluated outcomes. The integrated health management of visitors to the hypertension and diabetes management program is important as the general and oral health has common risk factors. Furthermore, long-term operation and continuous monitoring of oral health programs are necessary to evaluate the common factors in chronic disease management.

Effects of Nutritional Education Practice Program for Cardiocerebrovascular High-risk Group at the Education Information Center / 대한지역사회영양학회지

This research was performed to investigate the effects of NEP (Nutritional Education Practice) program developed by KHyDDI (Korea Hypertension Diabetes Daegu Initiative) for hypertension and diabetes patients. The subjects were 116 patients (hypertension 70, diabetes 46) who had completed basic education program at the education information center and four-session program was implemented for them. Nutrient intake was analyzed and compared before and after the program by 24-hr recall method and evaluate weight, waist circumference, body fat, blood pressure and eating habits in terms of nutrition knowledge, eating behavior, salty taste assessment. The improved results after the program were observed in weight, waist circumference, body fat ratio, blood pressure, slightly salty taste in salty taste assessment, nutrition knowledge, eating behavior, sodium, energy, carbohydrate and protein intake ratio to total energy (p < 0.001). Therefore, this program is effective in the improvement of weight, waist circumference and eating behavior, and the continued management would lead to the prevention of cardio-cerebrovascular diseases in the community.