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1.
Diabetes Res Clin Pract ; 120: 142-8, 2016 Oct.
Article in English | MEDLINE | ID: mdl-27552073

ABSTRACT

AIM: The present study was undertaken to assess the cost-effectiveness of good glycemic control in a population of Bangladeshi people with type 2 diabetes mellitus (T2DM). METHODS: A cross-sectional study was conducted among 496 registered patients with >1year duration of diabetes. Glycated hemoglobin A1c level <7% was judged as the cut-off value for good glycemic control. All treatment-related records from the last year were collected from patients' guide books and all cost components were calculated. RESULTS: Among patients, 31% had good glycemic control. The average annual cost was US$ 314 per patient. Patients with poor glycemic control were significantly more likely to have complications [(p=0.049) OR 1.5] and comorbidities [(p=0.02) OR 1.5]. The annual cost increased rapidly with complications/comorbidities. In multivariable logistic regression analysis, gender (p=0.003) and cost of care (p=0.006) were significantly associated with glycemic control, and the presence of any comorbidities/complications was associated with 1.8-fold higher odds of poor glycemic control (p=0.013 95% CI: 1.131-2.786). CONCLUSION: Good glycemic control can lead to substantial cost saving through prevention and control of complications.


Subject(s)
Cost-Benefit Analysis , Diabetes Mellitus, Type 2/drug therapy , Hyperglycemia/economics , Hypoglycemia/economics , Bangladesh , Blood Glucose/analysis , Cross-Sectional Studies , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/economics , Female , Glycated Hemoglobin/analysis , Humans , Hyperglycemia/etiology , Hyperglycemia/prevention & control , Hypoglycemia/etiology , Hypoglycemia/prevention & control , Male , Middle Aged , Tertiary Healthcare
2.
BMC Res Notes ; 8: 497, 2015 Sep 29.
Article in English | MEDLINE | ID: mdl-26420245

ABSTRACT

BACKGROUND: The management of diabetes requires a fundamental change in the lifestyle of patients, and one of the important outcome criteria is the quality of life. We assessed the health-related quality of life (HR-QoL) and examined the factors associated with it in type 2 diabetes. METHODS: An analytical cross-sectional study was conducted among 500 type 2 diabetes patients (age >25 years and duration of diabetes >1 year). They were selected conveniently from the Out-Patient department of the Bangladesh Institute of Health Sciences Hospital. The HR-QoL was assessed using an adapted and validated Bangla version of the EQ-5D (© 1990 EuroQol Group. EQ-5D™) questionnaire. It has five domains: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression and two levels (problem and no problem) on each dimension. The responses to the EQ-5D were further translated into a single summary EQ-5D index using the UK TTO value set. RESULTS: Of the patients, 50.2% were female, and 49.4% were aged >55 years. Only 28.4% had completed higher secondary education, and 50.8% were from lower-middle-income families. Around 78.8% either had overweight or were obese. About 50.4% had problems in mobility, 28.2% in self-care, 47.6% in usual activities, 72.8% in pain/discomfort, and 73.6% in anxiety/depression. Results of binary logistic regression analysis showed that age, gender, lower-middle income, and HbA1C were significantly (p < 0.05) associated with mobility. Self-care was significantly (p < 0.05) related to age, family history and duration of diabetes mellitus (DM). Gender, family history of DM, and lower-middle income had a significant (p < 0.05) association with usual activities. Pain was significantly (p < 0.05) associated with age, lower-middle income, and upper-middle income. Rural area, higher education, and HbA1C were significantly (p < 0.05) related to anxiety. Results of multiple linear regression analysis showed that age (p = 0.0001), female gender (p = 0.0001), and prescribed treatment (p = 0.048) were associated with the EQ-5D index. CONCLUSIONS: The large majority (73%) of the patients had problems in pain/discomfort and anxiety/depression; 50% had problems in mobility and usual activities; and three in ten in self-care. Age, female gender, income, education, family history and duration of DM, and prescribed treatment are important factors that are associated with the HR-QoL in type 2 diabetes.


Subject(s)
Diabetes Mellitus, Type 2/epidemiology , Quality of Life , Surveys and Questionnaires , Adult , Bangladesh/epidemiology , Confidence Intervals , Cross-Sectional Studies , Female , Humans , Logistic Models , Male , Middle Aged , Odds Ratio
3.
Work ; 50(3): 379-86, 2015.
Article in English | MEDLINE | ID: mdl-25672956

ABSTRACT

BACKGROUND: Physiotherapy and occupational therapy professionals are at high risk of developing occupational musculoskeletal injuries globally. Musculoskeletal pain is the most common problem. OBJECTIVE: To determine the extent of discomfort that physiotherapy and occupational therapy health professionals report while working at a physical rehabilitation centre. PARTICIPANTS: Physiotherapy and occupational therapy professionals which include both graduate and diploma physiotherapists and occupational therapists as well as physiotherapy and occupational therapy assistants. METHODS: A self administered questionnaire (survey) was conducted on a convenient sample of 101 physiotherapy and occupational therapy personnel. RESULTS: The mean age of the 101 participants was 27.8 (± 4.5) years and most of the participants (62%) had less than 5 years of work experience. Ninety-five percent of the participants complained of work related pain. Most of the participants reported pain in the lower back (n=84) followed by upper back (n=71) and neck (n=66). Significant associations were found for pain in ankles/feet with age (p=0.05) and pain in neck with gender (p=0.01). CONCLUSION: Physiotherapy and occupational therapy professionals suffer from pain in relation to the work they do as therapists which may be due to non-practice of appropriate body mechanics. Mechanism to assess level of practice during dealing with patients may be introduced to enable corrective measures. Incentives should be considered for appropriate practice.


Subject(s)
Low Back Pain/epidemiology , Musculoskeletal Pain/epidemiology , Neck Pain/epidemiology , Occupational Diseases/epidemiology , Occupational Therapy , Physical Therapy Specialty , Adult , Ankle , Bangladesh/epidemiology , Female , Humans , Male , Middle Aged , Prevalence , Rehabilitation Centers , Sex Factors , Young Adult
4.
BMC Public Health ; 14: 431, 2014 May 07.
Article in English | MEDLINE | ID: mdl-24885315

ABSTRACT

BACKGROUND: Non-adherence to lifestyle modification among diabetic patients develops the short-term risks and the long-term complications as well as declines the quality of life. This study aimed to find out the association between non-adherence to self-care practices, medication and health related quality of life (HR-QoL) among type 2 diabetic patients. METHODS: At least 1 year diagnosed patients with type 2 diabetes (N = 500), age>25 years were conveniently selected from the Out-Patient Department of Bangladesh Institute of Health Sciences Hospital. Patients' self-care practices were assessed via interviewer-administered questionnaires using an analytical cross-sectional design. HRQoL was assessed by an adapted and validated Bangla version of the EQ-5D (EuroQol Group, 2009) questionnaire which has five domains- mobility, self-care, usual activities, pain/discomfort and anxiety/depression and two levels on each dimension. EQ-5D responses were further translated into single summery EQ-5D index using UK TTO value set. Patients' were considered as non-adhered to self-care practices according to the guidelines of Diabetic Association of Bangladesh. Multivariable linear regression was used to assess the association between non-adherence towards self-care practices and HRQoL. RESULTS: Among the study patients, 50.2% were females and mean ± SD age was 54.2 (±11.2) years. Non-adherence rate were assessed for: blood glucose monitoring (37%), diet (44.8%), foot care (43.2%), exercise (33.2%) and smoking (37.2%). About 50.4% patients had problem in mobility, 28.2% in self-care, 47.6% in usual activities, 72.8% in pain/discomfort and 73.6% in anxiety/depression. On chi-squared test, significant association was found between non adherence to foot care and problem with mobility, self-care and usual activities (p < 0.05). Significant association was also found between non-adherence to exercise and poor mobility, self- care, usual activities, pain and anxiety (p < 0.05). Non-adherence to diet was associated with poor mobility (p < 0.05). In multivariable linear regression non-adherence to foot care (p = 0.0001), exercise (p = 0.0001), and smoking (p = 0.047) showed significant association with EQ-5D index after adjusting co-variates. CONCLUSIONS: In this study, patients who have a non-adherence rate also have a lower quality of life.


Subject(s)
Attitude to Health , Diabetes Mellitus, Type 2/psychology , Health Behavior , Patient Compliance/statistics & numerical data , Quality of Life/psychology , Self Care/statistics & numerical data , Bangladesh/epidemiology , Cross-Sectional Studies , Diabetes Mellitus, Type 2/epidemiology , Female , Humans , Male , Middle Aged , Patient Compliance/psychology , Self Care/methods , Self Care/psychology , Surveys and Questionnaires
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