Diabetes Care in Iran: Where We Stand and Where We Are Headed

Noshad, Sina; Afarideh, Mohsen; Heidari, Behnam; Mechanick, Jeffrey I.; Esteghamati, Alireza

doi:10.1016/j.aogh.2015.10.003

Cited by 77 publications

(60 citation statements)

References 48 publications

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“…The limited-time available to each patient frequently translates into a simplistic laboratory test-prescription exchange and leaves other humanistic aspects of effective diabetes treatment unaddressed. (e.g., patient education, individualized treatment and self-management of diabetes) (23). The results of this study showed that the average life expectancy and QALE for 20 years in the private sector are higher than the public sector (0.22 life expectancy and QALE gained), but this difference is minimal.…”

Section: Discussionmentioning

confidence: 62%

Private Diabetes Care Delivery in Iran, is it Cost-Effective?

Davari

Bayazidi

Kebriaeezadeh

et al. 2020

Preprint

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BackgroundThe quality of health care provided to diabetic patients has a significant impact on long-term costs and health outcomes. This study aims to determine the long-term cost-effectiveness analysis between private and public Diabetic Centers in Iran.MethodsUsing the localized UKPDS model, we performed a cost-effectiveness analysis to forecast 20 years quality-adjusted life expectancy (QALE) gains and direct medical costs(management of complications and Treatment Costs) in under-treatment patients referred to private and public Diabetic Centers in Iran. Costs and utility decrements derived from 1978 patients with type 2 diabetes from 7 private and eight Public diabetes centers in 5 provinces. We used statistical techniques (internal loops (Monte-Carlo trials) and bootstraps) to examine the robustness of the results.ResultsIn a 20-year time horizon, the private sector will be more effective and more costly(5.17 vs 4.95 QALE and 15385 vs 8092 ). The incremental cost-effectiveness ratio (ICER) was $33,148.02 per QALE gained that was higher than our country threshold.Conclusion Although the pattern and quality of care in private-sector diabetes centers resulted in a slight increase in the life expectancy of T2DM patients, it is associated with unfavorable costs too.

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Section: Discussionmentioning

confidence: 62%

Private Diabetes Care Delivery in Iran, is it Cost-Effective?

Davari

Bayazidi

Kebriaeezadeh

et al. 2020

Preprint

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“…This means that the percentage of achieving ABC care goals has not changed significantly over the 5 years. (22). In this study, we attempted to investigate the levels of access to each.…”

Section: Resultsmentioning

confidence: 99%

Quality of Care in Patients with Type 2 Diabetes in Iran: A 5-year retrospective study

Bayazidi

Davari²,

Kebriaeezadeh

et al. 2019

Preprint

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Background The object of this study was to evaluate the quality of care indicators (process- and outcome-related) in patients with type 2 diabetes using patient-level data during the last 5 years in Iran, in private and public diabetes centers in five provinces (Tehran, Isfahan, Yazd, Mazandaran, and Kurdistan).Method Our study was a cross-sectional study carried out on patients with type 2 diabetes at 13 diabetes centers (private and public). Annual tests for hemoglobin A1C, serum lipid (LDL) and screening for nephropathy (urine protein or urine albumin quantitative test) were used to evaluate process-related and hemoglobin A1C, blood pressure and lipids levels were used to assess outcome-related outcomes.Findings Among 1976 patients, 54% were women with an average of 15 years of diabetes duration and approximately 83% of patients were obese or overweight. About 9% of patients had a hemoglobin A1C test every three months. The values obtained were favorable for controlling lipid profile but less than standard for screening for nephropathy and only about 30% of patients were within the optimal range for simultaneous control of process-related indicators. Findings for outcome- related indicators show that the achievement of blood glucose, blood pressure, and low-density lipoprotein targets were 31, 49 and 70%, respectively and concurrent achievement was 13.8% in the last year.Conclusion The performance of the health system has much room for improvement and diabetes control programs have not been favorable in any of the provinces studied and have not led to optimal control.

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“…In Iran, 4.6 million people are estimated to live with DM. The prevalence of DM and its social and economic consequences have increased in recent decades in Iran (3).…”

Section: Introductionmentioning

confidence: 99%

Medication Adherence and its Predictors in Type 2 Diabetic Patients Referring to Urban Primary Health Care Centers in Kerman City, Southeastern Iran

Benrazavy

Khalooei

2019

Shiraz E-Med J

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Background: Medication adherence (MA) is one of the crucial aspects in the management of chronic diseases such as diabetes. Objectives: This study aimed to evaluate MA and its predictors in type 2 diabetic patients referring to urban primary health care centers. Methods: This cross-sectional study was carried out among type 2 diabetic patients referring to urban primary health care centers in 2017. The data were collected by the Persian version of the eight-item Morisky MA scale. Demographic and disease-related data were also collected. The data were analyzed using SPSS version 22. Results: Of 589 patients under study, more than 70% used oral hypoglycemic agents as the medication regimen and 29.2% received insulin as monotherapy or in combination with oral antidiabetic agents. Over half of the diabetic patients (51.1%) had other comorbid chronic diseases; moreover, 51.3% of them had at least one of diabetes-related complications. The mean MA score was 6.27 ± 1.81. One-third (33.3%, n = 196) of the patients had a moderate level of MA while 35.4% (n = 208) and 31.3% (n = 184) showed low and high MA levels, respectively. Binary logistic regression analysis showed that education level, type of medication, age, and treatment duration were the predicting factors of MA. Conclusions: MA was at a suboptimal level among diabetic patients referring to the urban primary health care centers. Poor medication adherence can have negative outcomes for diabetic patients. Thus, primary health care providers should consider self-care behaviors of patients and monitor their medication adherence, as well as other aspects of diabetes management.

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Diabetes Care in Iran: Where We Stand and Where We Are Headed

Abstract: Substantial opportunities and challenges in the areas of prevention, diagnosis, and management of diabetes exist in Iran that need to be addressed to further improve the quality of care and clinical outcomes.

Cited by 77 publications

References 48 publications

Private Diabetes Care Delivery in Iran, is it Cost-Effective?

Private Diabetes Care Delivery in Iran, is it Cost-Effective?

Quality of Care in Patients with Type 2 Diabetes in Iran: A 5-year retrospective study

Medication Adherence and its Predictors in Type 2 Diabetic Patients Referring to Urban Primary Health Care Centers in Kerman City, Southeastern Iran

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