Adherence to oral hypoglycemic medication among patients with diabetes in Saudi Arabia.

INTRODUCTION: Diabetes mellitus is a chronic progressive disease characterized by numerous health complications. Medication adherence is an important determinant of therapeutic outcome. The objective of this study was to assess hypoglycemic medication adherence. MATERIALS AND METHODS: This is a descriptive cross-sectional web-based study. The eight-item Morisky medication adherence scale was used to assess adherence. RESULTS: A convenience sample of 290 patients with diabetes was studied; of them, 10.7% had a high adherence, 34.5% had a medium adherence, and 54.8% had a low adherence level. Adherence score was a positively and significantly correlated with age (P < 0.05). Similar significant correlation was found between adherence level and gender (P < 0.05). However, adherence was not significantly associated with diabetes duration of disease (P > 0.05) and number of hypoglycemic medications (P >0.05). CONCLUSION: The majority of patients with diabetes in this study had low adherence rate. The three main factors may contribute to non-adherence to medication are non-adherence to regular follow-up in diabetes clinic, non-adherence to healthy diet, and non-adherence to instruction to take medication.

Impact of clinical pharmacist intervention in anticoagulation clinic in Sudan.

Background Many trials have compared anticoagulation management provided by a pharmacist led anticoagulation clinic versus usual physician care showing the role for clinical pharmacist in the management of anticoagulant therapy, and demonstrating excellent outcomes. In Sudan, there is no published research evaluating the role of pharmacist in providing pharmaceutical care for patients taking warfarin. Objective The objective of the study is to assess the role of clinical pharmacist intervention in warfarin patients compared to usual medical care. Setting This study was conducted in Ahmed Gasim cardiac surgery and renal transplant center warfarin clinic. Methods One hundred thirty-five patients were randomly selected from adult patients on warfarin therapy The history of INR records, and adverse effects for the past year, were recorded. Then patients' warfarin dose adjustments according to INR, was done by the clinical pharmacist for one year. Patients received continuous verbal education and written information about warfarin. Main outcome measure The primary outcome for this study was the INR control, while the secondary outcomes were the bleeding events and hospitalization due to warfarin. Results After the clinical pharmacist intervention there was significant (P < 0.01) improvement in INR control and a significant (P < 0.05) reduction in incidence of bleeding after clinical pharmacist intervention. Hospitalization due to warfarin related complications (bleeding, high INR, low INR) was also significantly (P < 0.001) reduced. Conclusion Clinical pharmacists intervention in warfarin therapy improve INR control, reduce bleeding and hospitalization due to warfarin complications.

A study evaluating the postprandial plasma glucose control among type 2 diabetes patients attending a teaching hospital in Malaysia.

BACKGROUND AND OBJECTIVE: Type 2 DM is rapidly rising as a global health care problem that threatens to reach pandemic levels by 2030. Type 2 diabetes mellitus is a disease with no cure and chronic disease that results in major morbidity and mortality. The main objective of this study is to evaluate postprandial plasma glucose level and to determine factors affect on postprandial plasma glucose level among type 2 diabetes outpatients attending endocrinology clinics at Hospital Universiti Sains Malaysia, Teaching Hospital. SUBJECTS AND METHODS: The study design was observational prospective longitudinal follow-up study, the study was conducted with sample of 1077 type 2 diabetes mellitus outpatient recruited via attended the diabetes clinics at Hospital Universiti Sains Malaysia (HUSM) in Kelantan. Post prandial plasma glucose (PPG) parameter to measure the glycaemic control. Logistic regression analysis was used to assess the independent variables that affect the PPG control. RESULTS: About 426 (39.6%) of the patients did not achieve the optimal postprandial plasma glucose level (<10mmol/l). In this study, the possible factors that affect postprandial plasma glucose levels (PPG) were found to be gender (OR=0.77) and the duration of diabetes (OR=1.12). CONCLUSION: It has been found that gender and the duration of diabetes are the factors affecting PPG. New strategy to improve the current status of control of diabetes is needed. The study recommends that health-care providers should pay more attention to type 2 DM male patients and patients who had diabetic for long time.