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Zhao M, Woodward M, Vaartjes I, Millett ERC, Klipstein-Grobusch K, Hyun K, Carcel C, Peters SAE. Sex Differences in Cardiovascular Medication Prescription in Primary Care: A Systematic Review and Meta-Analysis. J Am Heart Assoc 2020; 9:e014742. [PMID: 32431190 PMCID: PMC7429003 DOI: 10.1161/jaha.119.014742] [Citation(s) in RCA: 102] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background Sex differences in the management of cardiovascular disease have been reported in secondary care. We conducted a systematic review with meta‐analysis of systematically investigated sex differences in cardiovascular medication prescription among patients at high risk or with established cardiovascular disease in primary care. Methods and Results PubMed and Embase were searched between 2000 and 2019 for observational studies reporting on the sex‐specific prevalence of aspirin, statins, and antihypertensive medication prescription, including beta blockers, calcium channel blockers, angiotensin‐converting enzyme inhibitors, and diuretics, in primary care. Random effects meta‐analysis was used to obtain pooled women‐to‐men prevalence ratios for each cardiovascular medication prescription. Metaregression models assessed the impact of age and year on the findings. A total of 43 studies were included, involving 2 264 600 participants (28% women) worldwide. Participants’ mean age ranged from 51 to 76 years. The pooled prevalence of cardiovascular medication prescription for women was 41% for aspirin, 60% for statins, and 68% for any antihypertensive medications. Corresponding rates for men were 56%, 63%, and 69% respectively. The pooled women‐to‐men prevalence ratios were 0.81 (95% CI, 0.72–0.92) for aspirin, 0.90 (95% CI, 0.85–0.95) for statins, and 1.01 (95% CI, 0.95–1.08) for any antihypertensive medications. Women were less likely to be prescribed angiotensin‐converting enzyme inhibitors (0.85; 95% CI, 0.81–0.89) but more likely with diuretics (1.27; 95% CI, 1.17–1.37). Mean age, mean age difference between the sexes, and year of study had no significant impact on findings. Conclusions Sex differences in the prescription of cardiovascular medication exist among patients at high risk or with established cardiovascular disease in primary care, with a lower prevalence of aspirin, statins, and angiotensin‐converting enzyme inhibitors prescription in women and a lower prevalence of diuretics prescription in men.
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Affiliation(s)
- Min Zhao
- Julius Global Health Julius Centre for Health Sciences and Primary Care Utrecht Medical Centre Utrecht University Utrecht Netherlands
| | - Mark Woodward
- The George Institute for Global Health University of Oxford United Kingdom.,The George Institute for Global Health University of New South Wales Sydney Australia.,Department of Epidemiology John Hopkins University Baltimore MD
| | - Ilonca Vaartjes
- Julius Global Health Julius Centre for Health Sciences and Primary Care Utrecht Medical Centre Utrecht University Utrecht Netherlands.,Global Geo and Health Data center Utrecht University Utrecht The Netherlands
| | | | - Kerstin Klipstein-Grobusch
- Julius Global Health Julius Centre for Health Sciences and Primary Care Utrecht Medical Centre Utrecht University Utrecht Netherlands.,Division of Epidemiology & Biostatistics School of Public Health Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Karice Hyun
- Faculty of Medicine and Health Westmead Applied Research Centre University of Sydney Australia
| | - Cheryl Carcel
- The George Institute for Global Health University of New South Wales Sydney Australia.,Sydney School of Public Health Sydney Medical School University of Sydney New South Wales Australia
| | - Sanne A E Peters
- Julius Global Health Julius Centre for Health Sciences and Primary Care Utrecht Medical Centre Utrecht University Utrecht Netherlands.,The George Institute for Global Health University of Oxford United Kingdom
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2
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Mroueh L, Ayoub D, El-Hajj M, Awada S, Rachidi S, Zein S, Al-Hajje A. Evaluation of medication adherence among Lebanese diabetic patients. Pharm Pract (Granada) 2019; 16:1291. [PMID: 30637030 PMCID: PMC6322979 DOI: 10.18549/pharmpract.2018.04.1291] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 10/22/2018] [Indexed: 01/05/2023] Open
Abstract
Background: Diabetes type 2 is considered one of the main public health concerns. Lack of
adherence to treatment leads to poor therapeutic outcome, poor glycemic
control, and high risk for developing diabetes complications. Objectives: The aim of this study is to evaluate adherence to oral antidiabetic
medication in Diabetes type 2 Lebanese patients, and to evaluate factors
leading to low adherence. Methods: A cross-sectional study was conducted in outpatients endocrinology clinics of
two hospitals and four private clinics located in Beirut-Lebanon. Data was
collected using a well-structured questionnaire by trained pharmacists.
Adherence level was measured by the Lebanese Medication Adherence Scale
(LMAS-14). Bivariate and multivariate analyses were conducted using SPSS
version 20. Results: Overall, 245 patients were included in the study with the majority being
females (54.3%) and obese (47.8%). Only 29% of the
participants had controlled glycemia (HbA1c <7%) with
31.8% of subjects had high adherence to their medication compared to
68.2% with low adherence. Increased working hours/day was associated
with a decrease in adherence to oral antidiabetic medication (OR=0.31;
95% CI 0.11:0.88; p=0.029). Other factors significantly associated
with decreased adherence to treatment were forgetfulness, high drug costs,
complex treatment regimens, experiencing side effects, and perception of
treatment inefficacy. Postponing physician office visits also decreased the
probability of being adherent to oral antidiabetic medication (OR=0.36;
95% CI 0.15:0.86; p=0.022). Skipping or doubling the dose in case of
hypo/hyperglycemia and the sensation of treatment burden also decreased
medication adherence (OR=0.09; 95% CI 0.02:0.34; p=0.001, and
OR=0.04; 95% CI 0.01:0.13; p<0.001 respectively). Conclusions: Adherence to oral antidiabetic medication is low for Lebanese patients, which
leads to a poor glycemic control and increases the diabetes complications.
Intervention programs including patient education strategies are essential
to improve medication adherence.
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Affiliation(s)
- Lara Mroueh
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University. Beirut (Lebanon).
| | - Dana Ayoub
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University. Beirut (Lebanon).
| | - Maya El-Hajj
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University. Beirut (Lebanon).
| | - Sanaa Awada
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University. Beirut (Lebanon).
| | - Samar Rachidi
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University. Beirut (Lebanon).
| | - Salam Zein
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University. Beirut (Lebanon).
| | - Amal Al-Hajje
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University. Beirut (Lebanon).
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Al-Lawati JA. Diabetes Mellitus: A Local and Global Public Health Emergency! Oman Med J 2017; 32:177-179. [PMID: 28584596 DOI: 10.5001/omj.2017.34] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
- Jawad A Al-Lawati
- Directorate General of Primary Health Care, Ministry of Health, Muscat, Oman
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4
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Al-Rubaee FR, Al-Abri MH. Characteristics of Registered Diabetics in Dhank Province in the Sultanate of Oman. Oman Med J 2016; 31:205-10. [PMID: 27162591 PMCID: PMC4852079 DOI: 10.5001/omj.2016.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 01/03/2016] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE The aim of this study was to estimate the prevalence of registered diabetics and describe the clinical and epidemiological characteristics of patients with type 2 diabetes mellitus (T2DM) in three primary health care centers in the Dhank province of Oman. METHODS This cross-sectional study included 567 individuals aged > 20 years old. Clinical data were obtained retrospectively from physical registers and electronic clinical records. RESULTS Of the total 567 patients with T2DM (age-stratified prevalence = 10.2%), 44.8% were men. The mean age of the patients was 55.8±15.6, and they had a mean body mass index (BMI) of 29.7±6.0. Diabetes duration was 5.9±4.0 years. Overall, 28.4% of the patients had glycated hemoglobin values < 7%. The percentages of patients who did not reach the recommended targets for high-density lipoprotein (HDL) (< 1.0 mmol/L), low-density lipoprotein (LDL) (> 2.59 mmol/L) and triglycerides (TG) (< 1.69 mmol/L) were 63.3%, 60.0%, and 34.6%, respectively. Almost half of all patients (43.40%) had a BMI > 30. Obesity and overweight were more prevalent in patients in the 30-59 age group compared to patients aged < 30 or > 60 years (p < 0.001). Almost all patients (93%) had an estimated Glomerular Filtration Rate (eGFR) of more than 60 mL/min/1.73m(2). The number of patients diagnosed with T2DM aged < 60 years has been increasing gradually from 2008 to 2015 compared to those > 60 years (p = 0.017). Patients were managed by lifestyle measures (14.2%), oral hypoglycemic agents (one or two; 50%), and insulin therapy (35.7%). CONCLUSIONS The prevalence of registered T2DM patients in Dhank is less than the national figure. This may be due to the location of Dhank as a border province. Further qualitative studies are recommended to elaborate on the factors that lead to poor glycemic control.
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5
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Abuyassin B, Laher I. Diabetes epidemic sweeping the Arab world. World J Diabetes 2016; 7:165-174. [PMID: 27114755 PMCID: PMC4835661 DOI: 10.4239/wjd.v7.i8.165] [Citation(s) in RCA: 101] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 01/23/2016] [Accepted: 02/17/2016] [Indexed: 02/05/2023] Open
Abstract
The prevalence of type-2 diabetes mellitus (T2DM) has increased dramatically during the last 2 decades, a fact driven by the increased prevalence of obesity, the primary risk factor for T2DM. The figures for diabetes in the Arab world are particularly startling as the number of people with diabetes is projected to increase by 96.2% by 2035. Genetic risk factors may play a crucial role in this uncontrolled raise in the prevalence of T2DM in the Middle Eastern region. However, factors such as obesity, rapid urbanization and lack of exercise are other key determinants of this rapid increase in the rate of T2DM in the Arab world. The unavailability of an effective program to defeat T2DM has serious consequences on the increasing rise of this disease, where available data indicates an unusually high prevalence of T2DM in Arabian children less than 18 years old. Living with T2DM is problematic as well, since T2DM has become the 5th leading cause of disability, which was ranked 10th as recently as 1990. Giving the current status of T2DM in the Arab world, a collaborative international effort is needed for fighting further spread of this disease.
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6
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Ashur ST, Shah SA, Bosseri S, Fah TS, Shamsuddin K. Glycaemic control status among type 2 diabetic patients and the role of their diabetes coping behaviours: a clinic-based study in Tripoli, Libya. Libyan J Med 2016; 11:31086. [PMID: 27005896 PMCID: PMC4803895 DOI: 10.3402/ljm.v11.31086] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 02/23/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Achieving good glycaemic control is important in diabetes management. However, poor glycaemic control is widely reported. This article assessed the prevalence of uncontrolled and poor glycaemic control among Libyans with type 2 diabetes and examined the relative contribution of diabetes coping behaviours to their glycaemic control status. METHODS A cross-sectional study was undertaken in 2013 in a large diabetes centre in Tripoli. The study included 523 respondents. Diabetes coping behaviours were measured using the revised version of the Summary of Diabetes Self-Care Activities measure (SDSCA) and the eight-item Morisky Medication Adherence Scale (MMAS-8(©)), while glycaemic control status was based on the HbA1c level. RESULTS Mean HbA1c was 8.9 (±2.1), and of the 523 patients, only 114 (21.8%) attained the glycaemic control target of HbAc1 of less than 7.0%. Females (OR=1.74, 95% CI=1.03-2.91), patients on insulin and oral hypoglycaemic agents (OR=1.92, 95% CI=1.05-3.54), patients on insulin (OR=3.14, 95% CI=1.66-6.03), and low-medication adherents (OR=2.25, 95% CI=1.36-3.73) were more likely to have uncontrolled and poor glycaemic control, while exercise contributed to glycaemic control status as a protective factor (OR=0.85, 95% CI=0.77-0.94). CONCLUSION The findings from this study showed the considerable burden of uncontrolled and poor glycaemic control in one of the largest diabetes care settings in Libya. Medication adherence as well as exercise promotion programs would help in reducing the magnitude of poor glycaemic control.
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Affiliation(s)
- Sana Taher Ashur
- Department of Community Health, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Shamsul Azhar Shah
- Department of Community Health, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Soad Bosseri
- National Centre for Diabetes and Endocrinology, Tripoli, Libya
| | - Tong Seng Fah
- Department of Family Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Khadijah Shamsuddin
- Department of Community Health, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia;
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D'Souza MS, Venkatesaperumal R, Ruppert SD, Karkada SN, Jacob D. Health Related Quality of Life among Omani Men and Women with Type 2 Diabetes. J Diabetes Res 2016; 2016:8293579. [PMID: 26682234 PMCID: PMC4670671 DOI: 10.1155/2016/8293579] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Revised: 04/04/2015] [Accepted: 05/06/2015] [Indexed: 12/27/2022] Open
Abstract
The aim of this study was to explore predictors of health related quality of life (HRQoL) among men and women with type 2 diabetes. This cross-sectional descriptive study consisted of a random sample of 300 adults with type 2 diabetes in a selected public hospital. Euro-QoL and Revised Summary of Diabetes Self-Care Activities scales were used to collect data between January and June 2010. Schooling and ability to manage positively were highly significant predictors of quality of life (QoL) among women as compared to men. Age, prevention of activities of daily living and knowledge/management of diabetes were significant predictors of Health state among women as compared to men. Findings demonstrate that 30.6% (versus 35.7%) of the variance in the total QoL and 14% (versus 23%) of the variance in health state could be explained by personal and clinical characteristics among women and men, respectively. The study underlines the importance for nurse educators to assess HRQoL among men and women and to develop effective self-care management strategies based on personal and clinical characteristics.
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Affiliation(s)
- Melba Sheila D'Souza
- Department of Adult Health and Critical Care, College of Nursing, Sultan Qaboos University, 123 Muscat, Oman
- *Melba Sheila D'Souza:
| | - Ramesh Venkatesaperumal
- Department of Adult Health and Critical Care, College of Nursing, Sultan Qaboos University, 123 Muscat, Oman
| | - Susan D. Ruppert
- The University of Texas Health Science Center at Houston School of Nursing, Houston, TX 77030, USA
| | | | - Devakirubai Jacob
- Department of Adult Health and Critical Care, College of Nursing, Sultan Qaboos University, 123 Muscat, Oman
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Al-Sinani S, Al-Mamari A, Woodhouse N, Al-Shafie O, Amar F, Al-Shafaee M, Hassan M, Bayoumi R. Quality of diabetes care at outpatient clinic, sultan qaboos university hospital. Oman Med J 2015; 30:48-54. [PMID: 25830001 DOI: 10.5001/omj.2015.09] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 01/05/2015] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To assess the clinical care of type 2 diabetes mellitus (T2D) patients at Sultan Qaboos University Hospital (SQUH), a countrywide tertiary referral center in Muscat, Oman. . METHODS We performed a retrospective, observational, cross-sectional study using a total of 673 Omani T2D patients from the Diabetes and Family Medicine Clinics at SQUH. We collected patient data from June 2010 to February 2012 from the Hospital Information System (HIS). Patients had to be Omani, aged more than 18 years old, and have T2D with active follow-up and at least three visits within one year to be included in the study. Ninety-three percent of the patients (n=622) were on oral hypoglycemic drugs and/or insulin, and 70% were on statins. Patients' anthropometric data, biochemical investigations, blood pressure, and duration of diabetes were recorded from the HIS. . RESULTS Using the recommended standards and guidelines of medical care in diabetes (American Diabetes Association and the American National Cholesterol Education Program III NCDP NIII standards), we observed that 22% of the patients achieved a HbA1C goal of <7%, 47% achieved blood pressure goal of <140/80mm Hg, 48% achieved serum low density lipoprotein cholesterol goal of <2.6mmol/L, 67% achieved serum triglycerides goal of <1.7 mmol/L, 59% of males and 43% of females achieved high density lipoprotein cholesterol goals (males>1.0; females >1.3mmol/L). Almost 60% of the patients had urinary microalbumin/creatinine ratio within the normal range. . CONCLUSIONS The clinical outcomes of the care that T2D patients get at SQUH were lower than those reported in Europe and North America. However, it is similar to those reported in other countries in the Arabian Gulf.
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Affiliation(s)
- Sawsan Al-Sinani
- Department of Biochemistry, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Ali Al-Mamari
- Department of Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Nicolas Woodhouse
- Department of Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Omaiyma Al-Shafie
- Department of Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Fatima Amar
- Department of Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Mohammed Al-Shafaee
- Department of Family & Community Medicine, College of Medicine and Health Sciences, Sultan Qaboos University,
Muscat, Oman
| | - Mohammed Hassan
- Department of Physiology, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Riad Bayoumi
- Department of Biochemistry, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
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9
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D'Souza MS, Karkada SN, Hanrahan NP, Venkatesaperumal R, Amirtharaj A. Do Perceptions of Empowerment Affect Glycemic Control and Self-Care Among Adults with Type 2 Diabetes? Glob J Health Sci 2015; 7:80-90. [PMID: 26156908 PMCID: PMC4803921 DOI: 10.5539/gjhs.v7n5p80] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 12/23/2014] [Indexed: 12/17/2022] Open
Abstract
Background: The Arab adult with T2DM is understudied with less known facts about the perception of empowerment and its relationship with self-care and glycemic control. Purpose: The purpose of this study was to determine the extent to which perception of empowerment by Arab adults living with Type 2 Diabetes Mellitus (T2DM) was associated with better glycemic control and self-care management. Methods: A cross-sectional descriptive study was led among 300 Arab adults living in Oman with T2DM in an outpatient diabetes clinic. The Diabetes Empowerment Scale (DES), glycosylated haemaglobin (HbA1c) and Body mass index was assessed. The DES was found to be valid and reliable for the population. ANOVA, Regression analysis, and Structural equation modeling was used for analysis. Results: The composite score and three subscales of DES were a significant and strong predictor of good glycemic control among Omani adults with T2DM (p<0.001). Age, education, duration of DM, prior DM education program and medications were significantly associated with DES. Conclusion: Diabetes nurse educators engaged in the care of adults with T2DM should assess self-empowerment and tailor interventions to increase empowerment for better glycemic control. Patient empowerment plays an essential role in maintaining self-care behaviours and HbA1c.
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Al-Lawati J, Morsi M, Al-Riyami A, Mabry R, El-Sayed M, El-Aty MA, Al-Lawati H. Trends in the Risk for Cardiovascular Disease among Adults with Diabetes in Oman. Sultan Qaboos Univ Med J 2015; 15:e39-e45. [PMID: 25685383 PMCID: PMC4318604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 06/22/2014] [Accepted: 07/10/2014] [Indexed: 06/04/2023] Open
Abstract
OBJECTIVES This study aimed to investigate trends in the estimated 10-year risk for developing cardiovascular disease (CVD) among adults with diagnosed diabetes in Oman. In addition, the effect of hypothetical risk reductions in this population was examined. METHODS Data from 1,077 Omani adults aged ≥40 years with diagnosed diabetes were collected and analysed from three national surveys conducted in 1991, 2000 and 2008 across all regions of Oman. The estimated 10-year CVD risk and hypothetical risk reductions were calculated using risk prediction algorithms from the Systematic COronary Risk Evaluation (SCORE), Diabetes Epidemiology Collaborative Analysis of Diagnostic Criteria in Europe (DECODE) and World Health Organization/International Society of Hypertension (WHO/ISH) risk tools. RESULTS Between 1991 and 2008, the estimated 10-year risk of CVD increased significantly in the total sample and among both genders, regardless of the risk prediction algorithm that was used. Hypothetical risk reduction models for three scenarios (eliminating smoking, controlling systolic blood pressure and reducing total cholesterol) identified that reducing systolic blood pressure to ≤130 mmHg would lead to the largest reduction in the 10-year risk of CVD in subjects with diabetes. CONCLUSION The estimated 10-year risk for CVD among adults with diabetes increased significantly between 1991 and 2008 in Oman. Focused public health initiatives, involving recognised interventions to address behavioural and biological risks, should be a national priority. Improvements in the quality of care for diabetic patients, both at the individual and the healthcare system level, are required.
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Affiliation(s)
- Jawad Al-Lawati
- Departments of Non-Communicable Disease Control, Muscat, Oman
| | | | | | - Ruth Mabry
- Office of the World Health Organization, Muscat, Oman
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Al Balushi KA, Al-Haddabi M, Al-Zakwani I, Al Za'abi M. Glycemic control among patients with type 2 diabetes at a primary health care center in Oman. Prim Care Diabetes 2014; 8:239-243. [PMID: 24472420 DOI: 10.1016/j.pcd.2014.01.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 12/12/2013] [Accepted: 01/03/2014] [Indexed: 10/25/2022]
Abstract
AIMS To determine the status of blood sugar control by using fasting blood sugar (FBS) of ≤6.1 mmol/l and glycosyted hemoglobin A1c (HbAc1) of <7% as indictors of glycemic control and to assess the influence of demographic, blood pressure (BP) and lipid characteristics on glycemic control. METHODS This retrospective study included all Omani patients with type 2 diabetes (N=177) attended a primary health care center in Al-Dakhiliya region, Oman. RESULTS The overall mean age of the cohort was 53±12 years (range: 24-91) with females representing 60% (n=106) of the study sample. The study found that only 9.6% (n=17) and 35% (n=62) of the patients attained optimal FBS and HbAc1 levels, respectively. Higher HbA1c was significantly associated with higher diastolic BP (84 versus 80 mm Hg; p=0.006), higher total cholesterol (5.2 versus 4.7 mmol/l; p=0.002) and higher low-density lipoprotein cholesterol (3.8 versus 3.0 mmol/l; p=0.034). CONCLUSIONS The results demonstrated poor glycemic control in Oman type 2 diabetic patients comparable to local and global studies especially in those hypertensive and dyslipidemic patients. Implementation of early and aggressive management of diabetes mellitus at the primary care setting is warranted.
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Affiliation(s)
- Khalid A Al Balushi
- Department of Pharmacology & Clinical Pharmacy, College of Medicine & Health Sciences, Sultan Qaboos University, Al-Khod, Oman.
| | - Mahmod Al-Haddabi
- Department of Pharmacology & Clinical Pharmacy, College of Medicine & Health Sciences, Sultan Qaboos University, Al-Khod, Oman.
| | - Ibrahim Al-Zakwani
- Department of Pharmacology & Clinical Pharmacy, College of Medicine & Health Sciences, Sultan Qaboos University, Al-Khod, Oman; Gulf Health Research, Muscat, Oman.
| | - Mohammed Al Za'abi
- Department of Pharmacology & Clinical Pharmacy, College of Medicine & Health Sciences, Sultan Qaboos University, Al-Khod, Oman.
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12
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Al-Shafaee M, Al-Farsi Y, Al-Kaabi Y, Banerjee Y, Al-Zadjali N, Al-Zakwani I. Quality of diabetes care in primary health centres in north Al-batinah of oman. Open Cardiovasc Med J 2014; 8:48-54. [PMID: 25024774 PMCID: PMC4093660 DOI: 10.2174/1874192401408010048] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 05/06/2014] [Accepted: 05/07/2013] [Indexed: 01/01/2023] Open
Abstract
Objective: To assess the quality of diabetic care provided in primary health care settings in Oman. Methods: This was a cross-sectional study of randomly selected 500 patients with diabetes mellitus (DM) attending 6 primary care diabetic clinics in the north Al-Batinah region of Oman from January to December 2010. Nine standards on the quality of diabetes care were audited. Results: The mean age of the sample was 51±13 years, ranging from 15 to 87 years; the majority (61%) were females. The mean duration of DM was 4±3 years, ranging from 1 to 18 years. Seventy-seven percent of the patients attended diabetic clinics at least 4 times per year. Of the 9 assessed diabetic standards, HbA1c was documented in 33% of the patients, body mass index in 12%, low-density lipoprotein cholesterol (LDL-C) in 40%, urinary albumin:creatinine ratio in 28%, creatinine in 63% and blood pressure (BP) in 96%. Optimal control among the documented indicators was noted in 32, 21, 25, 85, 95 and 19%, respectively. Twenty percent of the patients had their ECGs done while only 39% of the patients had foot examination. No patient had attained control in all of HbA1c., BP and LDL-C. Conclusion: There is a gap between the recommended DM care guidelines and current practice with consequent poor quality of care in these patients.
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Affiliation(s)
- Mohammed Al-Shafaee
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Yousuf Al-Farsi
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Yousuf Al-Kaabi
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Yajnavalka Banerjee
- Department of Biochemistry, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman ; Familial Hypercholesterolemia Study Group, Oman Society for Lipid and Atherosclerosis (OSLA), Muscat, Oman
| | - Najat Al-Zadjali
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Ibrahim Al-Zakwani
- Department of Pharmacology & Clinical Pharmacy, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman ; Gulf Health Research, Muscat, Oman
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Arrieta F, Piñera M, Iglesias P, Nogales P, Salinero-Fort MA, Abanades JC, Botella-Carretero JI, Calañas A, Balsa JA, Zamarrón I, Rovira A, Vázquez C. Metabolic control and chronic complications during a 3-year follow-up period in a cohort of type 2 diabetic patients attended in primary care in the community of Madrid (Spain). ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.endoen.2013.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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14
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Metabolic control and chronic complications during a 3-year follow-up period in a cohort of type 2 diabetic patients attended in primary care in the Community of Madrid (Spain). ACTA ACUST UNITED AC 2014; 61:11-7. [DOI: 10.1016/j.endonu.2013.09.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2013] [Revised: 08/09/2013] [Accepted: 09/04/2013] [Indexed: 01/17/2023]
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