Prevalence of Under-Prescription in Elderly Type 2 Diabetic Patients in the Primary Care Unit of a University Hospital

Abstract

Objectives: This study aimed to assess the prevalence of under-prescription among elderly type 2 diabetic patients in the primary care unit of a university hospital in southern Thailand and identify the associated factors.Material and Methods: A 1-year retrospective medical record review was conducted in elderly type 2 diabetic patients treated continuously in the primary care unit. Under-prescription was the primary outcome assessed from criteria developed from the START criteria (2015), Thailand’s clinical practice guideline for diabetes (2014), and for hypertension (2015).Results: This study included 458 medical records that fit our inclusion criteria. The median age was 69.1 years old and more than 80% of them had a comorbidity of dyslipidemia or hypertension. The prevalence of under-prescription in elderly type 2 diabetic patients was 84.5%. The most commonly omitted medication was aspirin for primary prevention of cardiovascular disease. An increased number of medications received and having cardiovascular disease was associated with a lower risk of under-prescription.Conclusion: The prevalence of the omission of beneficial medications in elderly type 2 diabetic patients in the primary care unit of a university hospital was high, especially under-prescription of aspirin for primary prevention of cardiovascular disease.

Potentially inappropriate prescribing for adults living with diabetes mellitus: a scoping review

“…Most people with DM have MM or complications that can include hypertension, dyslipidaemia, nephropathy, neuropathy, retinopathy, cardiovascular, cerebrovascular or peripheral vascular diseases and as a result receive multiple medications. Correspondingly, PIP among people with DM has been reported to be high in a range of international studies [14][15][16][17][18].…”

Effectiveness of mobile application (EASYDM) for diabetes control focusing on diabetes medication adherence among uncontrolled diabetes patients attending primary care units in Bangkok Thailand: a randomized controlled trial

“…A study in Thailand was based at primary care unit of Songlanagarind Hospital to explore prevalence of under-prescription of diabetes medication and associated factors with it. The study showed that the prevalence of under prescription among elderly type 2 diabetes was 84.5% , however, having number of medications received increased, and a status of cardiovascular diseases are found to have lower risk of under prescription (Ananchaisarp et al, 2018).…”