Attitudes and perceptions towards hypoglycaemia in patients with diabetes mellitus: A multinational cross-sectional study

Naser, Abdallah Y; Wong, Ian C. K.; Whittlesea, Cate; Alwafi, Hassan; Abuirmeileh, Amjad; Alsairafi, Zahra Khalil; Turkistani, Fawaz Mohammad; Bokhari, Nedaa Saud; Beykloo, Maedeh Y; Al‐Taweel, Dalal; Almane, Mai B.; Li, Wei

doi:10.1371/journal.pone.0222275

Cited by 15 publications

(13 citation statements)

References 44 publications

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“…Patient-provider awareness of relevant ADRs associated with patients’ medications and adequate patient-provider communication were important aspects in the management of ADRs in less-controlled healthcare environment such as primary care [ 14 ]. However, only about one-third of patients in the community had received information on ADRs [ 109 , 110 ]. Healthcare professionals are often hesitant in giving information about important ADRs due to potential nocebo effects (i.e., perceived adverse effects as the result of negative expectancies) [ 111 ], nevertheless, a previous study showed the opposite, i.e, not receiving information on potential side effects from healthcare professional was associated with increased risk of self-reported ADRs and decreased satisfaction [ 43 ].…”

Section: Discussionmentioning

confidence: 99%

“…It is possible that patients who receive such information will better manage the drug reactions and become less worried [ 43 , 112 ]. In specific therapeutic areas such as diabetes management, previous studies found that up to 48% patients were often uninformed about drug-induced hypoglycemia risk and thus unable to recognise this reaction [ 109 , 110 , 113 ]. This highlights the need for better education strategies by their primary care providers as the majority of patients with chronic diseases were routinely managed in the primary care setting [ 114 ].…”

Section: Discussionmentioning

confidence: 99%

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Prevalence of adverse drug reactions in the primary care setting: A systematic review and meta-analysis

et al. 2021

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Background Adverse drug reactions (ADRs) represent a major cause of iatrogenic morbidity and mortality in patient care. While a substantial body of work has been undertaken to characterise ADRs in the hospital setting, the overall burden of ADRs in the primary care remains unclear. Objectives To investigate the prevalence of ADRs in the primary care setting and factors affecting the heterogeneity of the estimates. Methods Studies were identified through searching of Medline, Embase, CINAHL and IPA databases. We included observational studies that reported information on the prevalence of ADRs in patients receiving primary care. Disease and treatment specific studies were excluded. Quality of the included studies were assessed using Smyth ADRs adapted scale. A random-effects model was used to calculate the pooled estimate. Potential source of heterogeneity, including age groups, ADRs definitions, ADRs detection methods, study setting, quality of the studies, and sample size, were investigated using sub-group analysis and meta-regression. Results Thirty-three studies with a total study population of 1,568,164 individuals were included. The pooled prevalence of ADRs in the primary care setting was 8.32% (95% CI, 7.82, 8.83). The percentage of preventable ADRs ranged from 12.35–37.96%, with the pooled estimate of 22.96% (95% CI, 7.82, 38.09). Cardiovascular system drugs were the most commonly implicated medication class. Methods of ADRs detection, age group, setting, and sample size contributed significantly to the heterogeneity of the estimates. Conclusion ADRs constitute a significant health problem in the primary care setting. Further research should focus on examining whether ADRs affect subsequent clinical outcomes, particularly in high-risk therapeutic areas. This information may better inform strategies to reduce the burden of ADRs in the primary care setting.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prevalence of adverse drug reactions in the primary care setting: A systematic review and meta-analysis

et al. 2021

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“…At the practice level, antidiabetic therapy de-intensification, treatment protocols revisions, and enhancing patients' awareness of symptoms and prevention methods are needed. 41 Regular HbA1c…”

Section: Discussionmentioning

confidence: 99%

Cost of hospitalisation and length of stay due to hypoglycaemia in patients with diabetes mellitus: a cross-sectional study

Naser¹,

Alwafi²,

Alsairafi³

2020

Pharm Pract (Granada)

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Objective: This study aims to estimate the length of stay and hospitalisation cost of hypoglycaemia, and to identify determinants of variation in the length of stay and hospitalisation cost among individual patients with type 1 or 2 diabetes mellitus. Methods: A cross-sectional study was conducted using inpatients records for patients with diabetes mellitus who had been hospitalised due to hypoglycaemic events in two private hospitals in Amman, Jordan between January 2009 and May 2017. All hospitalisation costs were inflated to the equivalent costs in 2017. Hospitalisation cost was estimated from the patient’s perspective in Jordanian dinars (JOD). Descriptive analyses and correlation between sociodemographic or clinical characteristics with the cost and length of stay were explored. Predictors of hypoglycaemic hospitalisation cost and length of stay were determined using logistic regression. Results: During the study period a total of 126 patients with diabetes mellitus were hospitalised due to an incident of hypoglycaemia. The mean patient age was 64.2 (SD=19.6) years; half were male. Patients admitted for hypoglycaemia stayed in hospital for a median duration of two days (IQR=2 days). The median cost of hospitalisation for hypoglycaemia was 163.2 JOD (USD 230.1) (IQR=216.3 JOD). We found that the Glasgow coma score was positively associated with length of stay (0.345, p=0.008), and older age was correlated with higher hospitalisation cost (0.207, p=0.02). Patients with a family history of diabetes had higher hospitalisation costs and longer duration of stay (0.306 and 0.275, p<0.05). In addition, being a male patient (0.394, p<0.05) and with an absence of smoking history was associated with longer duration of stay (0.456, p<0.01), but not with higher hospitalisation cost. Conclusions: Costs associated with the incidence of hypoglycaemic events are not low and constitute a large cost component of managing and treating diabetes mellitus. Male patients and patients having a family history of diabetes should receive extra care and education on the prevention of hypoglycaemic events, and a treatment de-intensification approach should be considered if necessary, so we can prevent its associated hospitalisation costs and length of stay.

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“…At the same time, physicians should provide further education to their patients on how to self‐manage their hypoglycaemic events, as majority of these events are of mild to moderate severity and do not need hospitalisation. A previous study in Jordan highlighted that patients with diabetes mellitus have moderate problem‐solving ability towards their hypoglycaemic events, specifically, physicians need to emphasise in their education on the overall problem‐solving perception of hypoglycaemia and its immediate management 44 …”

Section: Discussionmentioning

confidence: 99%

The perspectives of physicians regarding antidiabetic therapy de‐intensification and factors affecting their treatment choices—A cross‐sectional study

et al. 2020

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Background: Comprehensive diabetes management includes an appropriate dietary plan, exercise, and antidiabetic medications. Nevertheless, the target glycaemic control is not always achieved using single antidiabetic, patients may need to start treatment intensi cation by increasing the dose of the single antidiabetic agent or by the administration of antidiabetic combination therapy. However, it has been shown that intensive antidiabetic therapy should be used carefully as it is associated with an increased risk of adverse events and death. The aim of this study is to understand physicians' perspectives regarding treatment de-intensi cation and factors affecting their treatment choice for patients with type 2 diabetes mellitus. Methods: A cross-sectional study was conducted in governmental specialised primary and secondary care units in Saudi Arabia using online questionnaire. Two previously validated questionnaires were used to understand physicians' awareness of, agreement with, and their practices of individualising HbA1c goals and antidiabetic treatment de-intensi cation, and to assess factors affecting physicians' treatment choice when prescribing antidiabetic treatment for patients with type 2 diabetes mellitus. Study population were physicians who are treating patients with diabetes mellitus during the period between October 2018 and May 2019. Results: A total of 205 physicians have participated in the study. Approximately 50% of physicians had family medicine speciality (n = 98, 47.8%). The majority of physicians (n = 183, 89.3%) were familiar with the concept of HbA1c goals individualisation. However, only 66.3% of them (n = 136) reported that they apply it either always or most of the time. 58.5% (n = 120) of physicians reported that they would not initiate conversations about de-intensifying antidiabetic therapy even if their patients had a stable HbA1c values for one year. Physicians showed higher consideration to objective patient clinical data and their assessment of patient's health status, with minor consideration to patient-related factors. Conclusions: Healthcare professionals should focus more on implementing contemporary practices and applying any necessary treatment de-intensi cation. Subjective patient factors should be taken into account, as these factors are associated with better disease management.

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Attitudes and perceptions towards hypoglycaemia in patients with diabetes mellitus: A multinational cross-sectional study

Cited by 15 publications

References 44 publications

Prevalence of adverse drug reactions in the primary care setting: A systematic review and meta-analysis

Prevalence of adverse drug reactions in the primary care setting: A systematic review and meta-analysis

Cost of hospitalisation and length of stay due to hypoglycaemia in patients with diabetes mellitus: a cross-sectional study

The perspectives of physicians regarding antidiabetic therapy de‐intensification and factors affecting their treatment choices—A cross‐sectional study

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