Assessment of certain cardio-protective medications' prescription and compliance in type II diabetic patients.
Background
Diabetes Mellitus is one of the most prevalent diseases in Egypt, where, there are around 8.7 million patients between the age of 20-79 years suffering from diabetes. Egypt is ranked at the eighth position on the list of the top ten countries for number of people with diabetes according to the IDF data in 2015. Cardiovascular diseases are the most common cause of morbidity and mortality among diabetic patients. Many of these patients are hypertensive, hyperlipidemic and/or have other cardiovascular risk factors. American Diabetes Association (ADA) guidelines 2016 have strongly recommended some pharmacological interventions that were proven to reduce the risk of cardiovascular disease in diabetic patients. These interventions include: metformin, ACE inhibitors/ ARBs and statins as a cardio-protective medications.
Aim
To describe the rate of prescribing metformin, statins and ACEI/ARBs in eligible type II diabetic patients and to describe the rate of patients` adherence to these medications.
Method
A cross-sectional survey of 77 diabetic patients selected randomly from different population representative areas of Alexandria, Egypt. The data were collected by filling a standardized questionnaire. The questionnaire was designed to collect data on patient demographics, prescribed medications and patients’ eligibility according to ADA 2016 guidelines, and patients` adherence to these medications.
Results
The questionnaire was completed and returned by 75 diabetic patients (97.4% of selected participants). Among patients eligible to receive metformin according to ADA 2016 guidelines, 85% received a metformin prescription and 16.4% of them reported low compliance to the medication, 8.2% of them reported moderate compliance and 75.4% of them reported high compliance to the medication. Among patients eligible to receive statin therapy according to ADA 2016 guidelines, 37% received a statin prescription and 22.2% of them reported low compliance to the medication.22.2% of them reported moderate compliance to the medication and 55.6% of them reported high compliance to the medication. Among 77 patients, 56 were diabetic and hypertensive and 53% were prescribed ACEI/ARBS. 11.1% of them reported low compliance 3.7% reported moderate compliance and 85.2% reported high compliance to the medication.
Discussion
The survey results suggest that physicians were adherent to diabetes guidelines in managing type II diabetic patients with metformin prescription, however, the adherence was suboptimal with statins and ACEIs/ARBS.