A353 p= 0.03), use of 3rd generation SU ; p= 0.002), and chronic renal disease ; p= 0.01). ConClusions: In conclusion, multiple factors, including efficacy and hypoglycemia, are associated with discontinuation of SU treatment after insulin initiation.objeCtives: Sulfonylurea (SU) may be discontinued or down-titrated due to hypoglycemia. Hypoglycemia may be more concerning for patients not receiving aggressive efficacy-driven treatment such as the dual-therapy of SU and insulin. A retrospective cohort study using the MarketScan database was conducted to assess the association between hypoglycemia and therapy changes (discontinuation or down-titration) among adults receiving SU therapy without insulin. Methods: Patients with the first SU prescription (Rx) (index date) in 2009-2011, ≥ 18 years of age on the index date, and with ≥ 1 year continuous enrollment pre-and postindex were included. Patients were excluded if they received insulin within the 1-year pre-or post-index, had ≥ 2 SUs on the index date, or had type 1, gestational or secondary diabetes. Therapy changes were determined during the 1-year postindex period. Discontinuation occurred when consecutive SU fills were ≥ 90 days apart. Down-titration occurred when an SU fill had a lower equivalent dose than the index dose. Hypoglycemic events were identified using ICD-9 code between the index date and the therapy change or the end of the 1-year post-index period. Cox regression was used to evaluate the association between hypoglycemic events and therapy changes. Results: 97,570 patients were included in the study, of which 50,854 (52.1%) experienced therapy changes within 1-year post-index. Patients with hypoglycemic events were at significantly higher risk for therapy changes (HR= 1.86 [1.75, 1.97]; p< . 01). Specifically, they were 197% more likely to down-titrate (HR= 2.97 [2.53, 3.46]; p< . 01) and 80% more likely to discontinue (HR= 1.80 [1.69, 1.92]; p< . 01). ConClusions: Post-index hypoglycemic events are significantly associated with therapy changes among patients receiving SU without insulin, especially down-titration. PDB122 guIDelIne aDHerence anD control of DIaBetes mellItus wItH co-morBIDItIes In a tertIary-care HosPItal In malaysIa

A279 practices about ECPs use. Data was analyzed by Statistical Package for the Social Sciences (SPSS) version 22.0 using various descriptive and inferential statistical tests. Results: Total 200 CPs were approached and a sample size of 109 (52% response rate) was obtained by convenient sampling method. Inadequate knowledge, strong negative attitudes and misconceptions were exposed. One quarter did not aware that ECPs do not cause abortion. Only a small proportion (27%) were aware about the precise use of ECPs. Interesting finding was that 41% of them believed that specific and particular general practitioners or clinics are the main sources of information about ECPs. Around 12% felt that information about ECPs should not be public. Few of the respondents had never heard of availability ECPs without prescription. ConClusions: The awareness of ECPs is quite high among CPs in Punjab, Pakistan but with insufficient knowledge, objectionable attitudes and redundant delusions. This study advocates that there is a clear need of accurate and appropriate information and awareness about safe and effective use of ECPs among CPs in Punjab, Pakistan.

The costs including lab investigation charges, unit costs of treatment per bed, medication charges, food costs, transportation costs and loss of productivity were calculated per asthma episode. Data was analysed by Statistical Package for the Social Sciences (SPSS) version 18.0 using various descriptive and inferential statistical tests. Results: A median medical cost of acute exacerbation of asthma under Ministry of Health's (MOH) perspective was USD 105.00 (RM338.47) per episode. Medication cost comprised the majority (52.38%) of the total medical costs. A median medical cost of acute exacerbation of asthma under patient's perspective was USD 1.55 (RM4.99) per episode. ConClusions: Asthma exacerbation and length of stay in the hospital were proportional to the direct medical costs. In Malaysia, a substantial proportion of the direct medical cost of asthma treatment is heavily subsidised for the locals.

The costs including lab investigation charges, unit costs of treatment per bed, medication charges, food costs, transportation costs and loss of productivity were calculated per asthma episode. Data was analysed by Statistical Package for the Social Sciences (SPSS) version 18.0 using various descriptive and inferential statistical tests. Results: A median medical cost of acute exacerbation of asthma under Ministry of Health's (MOH) perspective was USD 105.00 (RM338.47) per episode. Medication cost comprised the majority (52.38%) of the total medical costs. A median medical cost of acute exacerbation of asthma under patient's perspective was USD 1.55 (RM4.99) per episode. ConClusions: Asthma exacerbation and length of stay in the hospital were proportional to the direct medical costs. In Malaysia, a substantial proportion of the direct medical cost of asthma treatment is heavily subsidised for the locals.

A 1 -A 3 1 8 A279 practices about ECPs use. Data was analyzed by Statistical Package for the Social Sciences (SPSS) version 22.0 using various descriptive and inferential statistical tests. Results: Total 200 CPs were approached and a sample size of 109 (52% response rate) was obtained by convenient sampling method. Inadequate knowledge, strong negative attitudes and misconceptions were exposed. One quarter did not aware that ECPs do not cause abortion. Only a small proportion (27%) were aware about the precise use of ECPs. Interesting finding was that 41% of them believed that specific and particular general practitioners or clinics are the main sources of information about ECPs. Around 12% felt that information about ECPs should not be public. Few of the respondents had never heard of availability ECPs without prescription. ConClusions: The awareness of ECPs is quite high among CPs in Punjab, Pakistan but with insufficient knowledge, objectionable attitudes and redundant delusions. This study advocates that there is a clear need of accurate and appropriate information and awareness about safe and effective use of ECPs among CPs in Punjab, Pakistan.objeCtives: In developing countries like Pakistan, perilous abortion is a major health threat for women who make numerous attempts for the termination of unintended pregnancy. Community pharmacists (CPs) can act as a conduit between public and their health services. This study explores CPs knowledge, attitudes and practices regarding use of emergency contraceptive pills (ECPs) in Punjab, Pakistan. Methods: A cross-sectional study was conducted at various pharmacies in three cities of Punjab, Pakistan to evaluate CPs knowledge, attitudes and