Prevalence, medication adherence, and determinants of type 2 diabetes mellitus during Coronavirus Disease 2019 pandemic among adults in Tanzania
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ABSTRACT:
SUBMITTER: Yustus I
PROVIDER: S-EPMC10908235 | biostudies-literature | 2024 Jan
REPOSITORIES: biostudies-literature
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Project description:Background and aimMedication nonadherence is common in patients with inflammatory bowel disease (IBD) and has been associated with worse outcomes. The coronavirus disease 2019 (COVID-19) pandemic led to significant consumer and medical concern regarding the possible risks of immunosuppressive medications during the pandemic. This study aimed to examine medication adherence and complementary and alternative medicine (CAM) usage during the COVID-19 pandemic.MethodsAn online survey was sent to patients from two tertiary IBD units. The survey included medication nonadherence attributed to the COVID-19 pandemic, complementary therapy, and IBD medication use. Validated measures of IBD disease activity, medication adherence, and beliefs about medicines were obtained.ResultsOf 262 respondents (median age of 46, 58% female) 14 (5%) patients reported self-initiated missed doses or dose reduction of IBD medications directly attributed to the COVID-19 pandemic. Positive associations with medication nonadherence included current corticosteroid requirement (P = 0.022), higher disease activity scores (P = 0.026), and higher concern about medicines score (P = 0.04). CAM usage was common, aimed at treating mental health in most cases, and infrequently attributed to the COVID-19 pandemic.ConclusionsEven in the setting of low COVID-19 prevalence, the pandemic reduced IBD medication adherence in 1 in 20 patients. This reduced adherence was co-associated with increased disease activity and corticosteroid use. Understanding the underlying beliefs driving suboptimal IBD medication adherence is critical to prevent avoidable adverse IBD outcomes.
| S-EPMC8114986 | biostudies-literature
Project description:Background The exposure of health care professionals (HCP) to patients with coronavirus disease-2019 (COVID-19) in the course of performing their professional duties may expose them to contracting the virus. This may likely increase their tendency to self-medicate for prevention or treatment of perceived infection. Aim This study determined the prevalence of COVID-19 related self-medication and its determinants among HCPs in three tertiary hospitals in Southern Nigeria. Method This was a cross-sectional study that enrolled 669 adult HCPs from three tertiary hospitals in three Southern Nigerian States using a non-probability convenience sampling method. A structured self-administered questionnaire was used for data collection. Data entry and analysis were done using IBM SPSS version 22. Results The mean age of the respondents was 35.6 ± 8.7 years. Two hundred and forty-three respondents (36.3%) reported having practiced COVID-19 related self-medication. The commonly used medications were ivermectin, azithromycin, vitamin C, chloroquine and zinc. Factors associated with self-medication were older age (p = < 0.0001), being pharmacist (p = 0.03), higher income (p = < 0.0001), previous COVID-19 testing (p < 0.001). Predictors of self medication were > 44 years (Adjusted Odd Ratio[AOR]:2.77,95% Confidence Interval [CI]: 1.62-4.75, p = < 0.0001), previous COVID-19 testing (AOR = 2.68, 95% CI: 1.82-3.94, p = < 0.0001). Conclusion About one-third of HCPs practiced COVID-19 related self-medication. HCPs that are often assumed to be health literate may not necessarily practice safe health behavior. Regular health education of the HCPs on implications of self-medications is highly recommended. There should also be formulation and effective implementation of policies that regulate purchase of medications.
| S-EPMC8754192 | biostudies-literature
Project description:PurposeEmerging evidence suggests that the coronavirus disease 2019 (COVID-19) pandemic is disrupting health behaviors such as medication adherence. The objective of this study was to determine whether adherence to ocular hypotensive medication was affected by the pandemic and to identify factors associated with this change.DesignIn this cohort study, we used a controlled interrupted time series design in which the interruption was the declaration of the COVID-19 pandemic in the United States on March 13, 2020. The 300-day monitoring period, which evenly bracketed this declaration, started on October 16, 2019, and ended on August 10, 2020.ParticipantsPatients with primary open-angle glaucoma enrolled in an ongoing longitudinal National Institutes of Health-funded study initiated before the onset of the pandemic were selected if they were prescribed ocular hypotensive medication and had adherence data spanning the 300-day period.MethodsWe applied segmented regression analysis using a "slope change following a lag" impact model to obtain the adherence slopes in the periods before and after the segmentation. We compared the 2 slopes using the Davies test.Main outcome measuresThe main outcome measure was daily adherence to ocular hypotensive medication, defined as the number of doses taken divided by the number of doses prescribed, expressed in percent. Adherence was measured objectively using Medication Event Monitoring System caps. We assessed the associations between change in adherence and demographic, clinical, and psychosocial factors.ResultsThe sample included 79 patients (mean age, 71 years [standard deviation, 8 years]). Segmented regression identified a breakpoint at day 28 after the declaration of the pandemic. The slope in the period after the breakpoint (-0.04%/day) was significantly different from zero (P < 0.001) and from the slope in the period before the breakpoint (0.006%/day; P < 0.001). Mean adherence in the period before the segmentation breakpoint was significantly worse in Black patients (median, IQR: 80.6%, 36.2%) compared with White patients (median, IQR: 97.2%, 8.7%; chi-square, 15.4; P = 0.0004). A significant positive association was observed between the Connor-Davidson resilience score and the change in slope between the periods before and after the breakpoint (P = 0.002).ConclusionsAdherence to ocular hypotensive medication worsened during the COVID-19 pandemic and seems to be related to patient resilience. This collateral consequence of the pandemic may translate into vision loss that may manifest beyond its containment.
| S-EPMC8523310 | biostudies-literature
Project description:Diabetes is associated with poor clinical outcomes in hospitalized patients with coronavirus disease 2019 (COVID-19). During this pandemic, many hospitals have already become overwhelmed around the world and are rapidly entering crisis mode. While there are global efforts to boost personal protective equipment (PPE) production, many centers are improvising care strategies, including the implementation of technology to prevent healthcare workers' exposures and reduce the waste of invaluable PPE. Not optimizing glycemic control due to clinical inertia driven by fear or lack of supplies may lead to poor outcomes in patients with diabetes and COVID-19. Individualized care strategies, novel therapeutic regimens, and the use of diabetes technology may reduce these barriers. However, systematic evaluation of these changes in care is necessary to evaluate both patient- and community-centered outcomes.
| S-EPMC7673193 | biostudies-literature
Project description:Background: Patients with chronic diseases often experience difficulty adhering to recommended treatments as instructed by their healthcare professionals. Recently, diabetes has been associated with the severity of the novel coronavirus disease (Covid-19), which raises the importance of improving medication adherence for diabetic patients to enhance the right use of antidiabetics amid the Covid-19 pandemic. Methods: This work assesses medication adherence among type 2 diabetes mellitus patients in the United Arab Emirates (UAE) and identifies the set of key demographic and health factors significantly associated with medication adherence. A descriptive cross-sectional study was conducted on an appropriate sample of type 2 diabetic patients in the UAE, with 180 patients of both genders and various social levels. A validated version of the eight-item Morisky Medication Adherence Scale (MMAS) was used for data collection. Results: The average MMAS score was 4.88, with 95% confidence intervals (CI) 4.6 and 5.2. 61.67% (n=111), 28.89% (n=52), and 9.44% (n=17) of patients were categorized into low, medium, and high adherent groups, respectively. These findings indicate that a high level of non-compliance to antidiabetic regimens among the population in the UAE. Conclusions : Patients demonstrated low level of compliance to antidiabetic regimens. Therefore, they must receive up-to-date knowledge about the disease and the treatment and enable easy access to their health care providers to enhance medication adherence.
| S-EPMC8649966 | biostudies-literature
Project description:To determine the associations between medical, demographic, socioeconomic, and ocular factors and adherence to topical glaucoma ocular hypotensive therapy.One hundred sixteen patients with ocular hypertension or open-angle glaucoma from 2 tertiary glaucoma services participated in this prospective study. Adherence to ocular hypotensive therapy was measured using an electronic dose monitor (Travatan Dosing Aid, Alcon Laboratories Inc., Fort Worth, TX) and collected data at 3 months after enrollment. We used 3 different definitions of adherence: 1) Definition 1: the proportion of days taking the prescribed number of drops within 3 hours of the prescribed dosing time; 2) Definition 2: the proportion of days taking any drops within 3 hours of the prescribed dosing time; and 3) Definition 3: the proportion of days taking any drops within 6 hours of the prescribed dosing time. Univariate and multivariate models were used to determine the association between the 3 adherence definitions, medical, demographic, socioeconomic, and ocular factors at 3-month follow-up. The main outcome measures for this study were risk factors for poor objective medication adherence.Adherence, using Definition 1, Definition 2, and Definition 3, was 64%, 75%, and 80%, respectively. Age, total number of other eye diseases, and race were significantly associated with full treatment adherence (Definition 1), with race alone significantly predicting 11% of full treatment adherence. For Definition 2, age, income, level of education, and total number of eye diseases were significantly associated with partial adherence (3 h), again race alone significantly predicted 15% of partial adherence (any drops within 3 h). For Definition 3, race, income, level of education, and total number of other eye diseases significantly predicted partial adherence (any drops within 6 h), both race and income predicted 19% of partial treatment adherence. Significant differences for adherence rates between patients of European descent and those of African descent were found for all 3 definitions with those who were less adherent more likely to be of African descent.Electronic dose monitors provide important information regarding adherence to topical ocular hypotensive medications in glaucoma patients. Electronic dose monitors show low adherence in a significant number of participants. Future studies are needed to determine the reasons for these differences in health behaviors related to glaucoma treatment, which should guide treatment of poor adherence with glaucoma therapy.
| S-EPMC3183317 | biostudies-other
Project description:Self-medication is very common especially in developing countries and is documented to be associated with many health risks including antibiotic resistance. This study investigated the prevalence, determinants and knowledge of self-medication among residents of Siha District in Tanzania. A cross-sectional study was conducted among 300 residents in a rural District of Kilimanjaro region, North-eastern Tanzania from 1st to 28th April 2017. A semi-structured questionnaire was used to collect information regarding drugs used, knowledge, history and reasons for antibiotic self-medication. Log-binomial regression analysis was done using STATA 13 to examine factors associated with self-medication. A slightly majority of the respondents (58%) admitted to self-medication. Antibiotics most commonly utilized were amoxycillin (43%) and an antiprotozoal drug metronidazole (10%). The most common symptoms that led to self-medication were cough (51.17%), headache/ fever/ malaria (25.57%) and diarrhoea (21.59%). The most common reasons for self-medication were emergency illness (24.00%), health facility charges (20.33%), proximity of pharmacy to home (17.00%) and no reason (16.66%). Almost all reported that self-medication is not better than seeking medical consultation, 98% can result into harmful effects and 96% can result to drug resistance. The level of self-medication in this study is comparable with findings from other studies in developing countries. Pharmacies were commonly used as the first point of medical care. There is therefore a need for educative antibiotic legislative intervention to mitigate the adverse effects of antibiotic self-medication in Siha district in Tanzania.
| S-EPMC6209340 | biostudies-literature
Project description:ObjectiveThis study aims to assess medication adherence and explore its predictors in outpatients with type 2 diabetes.MethodThis cross-sectional study collected socio-demographics, disease-related information, and different biomedical variables for type 2 diabetes patients attending a Jordanian Diabetes center. The four-item medication adherence scale (4-IMAS) and the beliefs about medications questionnaire (BMQ) which includes necessity and concerns were used. Stepwise backward quartile regression models were conducted to evaluate variables associated with the Necessity and Concerns scores. Stepwise ordinal regression was conducted to evaluate variables associated with adherence.Results287 diabetic patients participated in the study. Almost half of the participants (46.5%) reported moderate adherence and 12.2% reported low adherence. Significant predictors of the adherence were necessity score (OR = 14.86, p <0.01), concern score (OR = 0.36, p <0.05), and frequency of medication administration (OR = 0.88, p- <0.01). Education was a significant predictor of Necessity and Concerns scores (β = 0.48, -0.2, respectively).ConclusionSimplifying the medication regimen, emphasizing medication necessity and overcoming medication concerns should be targeted in future diabetes intervention programs to improve medication adherence and hence glycemic control among diabetic patients.
| S-EPMC8382191 | biostudies-literature
Project description:BackgroundDiabetes often coexists with other medical conditions and is a contributing cause of death in 88% of people who have it. The study aimed at evaluating medication adherence, self-care behaviours and diabetes knowledge among patients with type 2 diabetes mellitus in Ghana.MethodsA total of 330 participants were recruited into the study from three public hospitals in the Tamale metropolis. A validated medication adherence questionnaire and the Summary of Diabetes Self-care Activities tool were used to assess medication adherence and self-care activities respectively. Logistic and linear regressions were used to determine factors positively associated with non-adherence to medication and self-care behaviours respectively.ResultsOf the 330 participants whose data were analysed, the mean (SD) age was 57.5 (11.8) years. The majority (84.5%) were adherent to anti-diabetes medication. Participant's age, educational level, and practice of self-care behaviours influenced adherence to anti-diabetes medication. Participants aged 70 years and above were 79% less likely to be non-adherent to medication as compared to those below 50 years [OR = 0.21 (95%CI: 0.06-0.74), p = 0.016]. Participants with senior high school education were 3.7 times more likely to be non-adherent to medication than those with tertiary education [OR = 3.68 (95%CI: 1.01-13.44), p = 0.049]. Participants with tertiary education had an increase in the level of practice of self-management by 1.14 (p = 0.041). A unit increase in knowledge score also increased the level of practice of self-management by 3.02 (p<0.001).ConclusionThe majority of participants were adherent to anti-diabetes medication. Non-adherence to medication was associated with younger age and low level of education. Interventions to improve adherence should target younger and newly diagnosed patients through aggressive counselling to address healthy self-management behaviours.
| S-EPMC7446850 | biostudies-literature
Project description:Background and objectivesPoor adherence to medications is one of the major public health challenges. Only one-third of the population reported successful control of blood pressure, mostly caused by poor drug adherence. However, there are relatively few reports studying the adherence levels and their associated factors among Chinese patients. This study aimed to study the adherence profiles and the factors associated with antihypertensive drug adherence among Chinese patients.MethodsA cross-sectional study was conducted in an outpatient clinic located in the New Territories Region of Hong Kong. Adult patients who were currently taking at least one antihypertensive drug were invited to complete a self-administered questionnaire, consisting of basic socio-demographic profile, self-perceived health status, and self-reported medication adherence. The outcome measure was the Morisky Medication Adherence Scale (MMAS-8). Good adherence was defined as MMAS scores greater than 6 points (out of a total score of 8 points).ResultsFrom 1114 patients, 725 (65.1%) had good adherence to antihypertensive agents. Binary logistic regression analysis was conducted. Younger age, shorter duration of antihypertensive agents used, job status being employed, and poor or very poor self-perceived health status were negatively associated with drug adherence.ConclusionThis study reported a high proportion of poor medication adherence among hypertensive subjects. Patients with factors associated with poor adherence should be more closely monitored to optimize their drug taking behavior.
| S-EPMC3636185 | biostudies-literature