Tropical Journal of Pharmaceutical Research

Original Research Article | OPEN ACCESS

Guideline for Adherence and Diabetes Control in Co-Morbid Conditions in a Tertiary Hospital in Malaysia

MZ Iqbal^1,2 , AH Khan¹, SA Sulaiman¹, MS Iqbal^2,3, Z Hussain¹

¹Department of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia; ²Department of Clinical Pharmacy, AIMST University, 08100 Kedah Malaysia; ³Department of Pharmacy Practice, School of Pharmacy, International Medical University Bukit Jalil, 57000, Kuala Lumpur, Malaysia.

For correspondence:- Iqbal Email: drmmziqbal@gmail.com Tel:+0060169729584

Received: 20 July 2013 Accepted: 22 August 2014 Published: 19 October 2014

Citation: Iqbal M, Khan A, Sulaiman S, Iqbal M, Hussain Z. Guideline for Adherence and Diabetes Control in Co-Morbid Conditions in a Tertiary Hospital in Malaysia. Trop J Pharm Res 2014; 13(10):1739-1744 doi: 10.4314/tjpr.v13i10.25

© 2014 The authors.
This is an Open Access article that uses a funding model which does not charge readers or their institutions for access and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0) and the Budapest Open Access Initiative (http://www.budapestopenaccessinitiative.org/read), which permit unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited..

Abstract

Purpose: To evaluate doctors’ adherence to Malaysian Clinical Practice Guideline (CPG) 2009 in established diabetic patients with hypertension, dyslipidemia, renal diseases, obesity, and also to assess factors associated with guideline adherence and diabetes mellitus control in Pulau Pinang Hospital, Malaysia.

Method: Prescriptions written by 24 doctors for 480 established diabetic patients with hypertension, dyslipidemia, renal diseases and obesity (20 patients per doctor) were noted. The control of the disease and CPG adherence were noted from the selected prescriptions.

Results: Three hundred and forty nine (72.7 %) patients received guideline-compliant pharmacotherapy. CPG adherence had statistically non-significant association (p < 0.301) with hypertension, hypertension with dyslipidemia (p < 0.078), dyslipidemia (p < 0.061), renal diseases (p < 0.544) and obesity (p < 0.073). Two hundred and ninety nine (62.3 %) patients were at goal blood glucose level. Diabetes Mellitus (DM) control had statistically significant association (j0; = 0.583, p < 0.001) with guideline compliance and statistically non-significant association (p < 0.066) with co-morbidities and also non-significant association (p < 0.300) with therapies.

Conclusion: Prescribing practices were fairly compliant with guidelines. Doctors poorly adhered to guidelines in diabetic patients with hypertension, dislipidemia, renal diseases and obesity. Significantly better diabetic control was seen in patients who were on monotherapy and guidelines-adherent therapy.

Keywords: Guidelines, Adherence, Diabetes control, Diabetes mellitus (DM), Co-morbidities