Introduction: Patients with type II diabetes mellitus (T2DM) and hypertension (HTN) are at increased threat for long experiencing various problems related to medicine as they frequently received different medications for managing their condition. Recently, there were no studies done locally on drug-related problems (DRPs) among T2DM patients with HTN. Thus, this study aims to assess the DRPs among T2DM patients with HTN admitted at Kibuye Referral Hospital (KRH). DRPs were drug safety problems, drug effectiveness problems and other drug problems.
Methods: A retrospective cross-sectional study involved patients' files with T2DM and HTN, who were admitted at KRH from January 2013 to December 2017. The identification and classification of DRPs were based on pharmaceutical care network Europe (PCNE) classification system version 8.02. A simple random sampling technique was used to choose study participants from the target population. Data that met inclusion and exclusion criteria were analyzed using STATA version 13. The Fisher exact test (bivariate analysis) and logistic regression (multivariate) were used to test association and p-value ≤ 0.05 was considered as statistically significant. An adjusted odd ratio (AOR) with a confidence interval (CI) of 95% was determined using binary logistic regression.
Results: Findings revealed that the prevalence of DRPs was 81.29% (313/385) and most of them each patient had at least two DRPs (69.05%). The patients aged above 55 years old were more likely to develop DRPs than those with age below 35 years (AOR = 1.2; P = 0.02; 95% CI: 0.2–2.3). Nevertheless, there was no significant association between DRPs and middle age (between 35 and 54 age of old). The patients who consumed more than or equal to 5 drugs were 2.4 times more likely to develop DRPs than those who took the number of medicines less than 5 (AOR = 15.4; P < 0.001; 95% CI: 8.8–26.8). Also, traditional medicines use ((AOR = 1.9; P = 0.016; 95% CI: 1.1–3.5) and having drug-related complication (AOR = 2.4; P < 0.001; 95% CI: 1.9–3) had shown significant associations. The total causes of DRPs identified were 1626 and most causes of DRPs were arisen from drug use (45.01%) and prescribing (37.83%). The drug/dose selections were the most frequent causes of DRPs (36.97%).
Conclusions: Since the prevalence of DRPs were relatively high, various factors influencing DRPs were established and most causes of DRPs were arising from drug use & drug prescribing among T2DM patients with HTN. Early detection needed to enhance patient’s life quality. Conducting studies in other hospitals needed to establish the national planning of DRPs to eradicate DRPs among patients T2DM with HTN.
Objective: A meta-analysis of randomized trials was performed to assess the injured degree of median nerve and sural nerve in patients with diabetic peripheral neuropathy (DPN).Methods: we searched Pubmed Database, China Biomedical Literature Database, VIP Database, ChinaNet for studies. Then evaluated these studies in order to find the researches in line with the requirements of the study; Each relevant research was carefully read to extract relevant data; The current perception threshold (CPT) value of median nerve and sural nerve were compared at 2000Hz, 250Hz and 5Hz between patients with DPN and the normal control group.Results: Finally 10 articles that meet the standards were included, with 1054 cases in the patient group and 719 cases in the normal group. The CPT values of median nerve and sural nerve at 2000 Hz, 250 Hz and 5 Hz of patients group were higher than those of normal control group (P<0.05 for all). Conclusion: Systematic reviews showed that the sensitivity of the median nerve and sural nerve in DPN patients was generally reduced. Sensory nerve quantitative detector could detect nerve damage early, accurately and monitor the effect treatment in patients with DPN.
Objective: This meta-analysis evaluated the efficacy and safety of Chinese herbal medicine (CHM) combined with angiotensin-converting enzyme inhibitors (ACEIs) and/or angiotensin-receptor blockers (ARBs)for treatment of incipient diabetic nephropathy(IDN). Methods: Nine data bases were searched for randomized controlled trials of Chinese herbal medicine(CHM) and ACEI/ARB for treatment of IDN. Included articles were published between January2006 and December 2016. All studies were divided into prescriptions containing both Astragali Radix and Rehmanniae Radix (i subgroup), Astragali Radix(Huangqi) or Rehmanniae Radix(Dihuang) (ii subgroup), neither Astragali Radix nor Rehmanniae Radix (iii subgroup). Review Manager 5.3was used for subgroup analysis. Results: In total, 28 RCTs with 2017 patients were included. The results showed 1)the urinary albumin excretion rate (UAER) can be reduced significantly using CHM with ACEI or ARB for treatment of IDN compared to ACEI or ARB alone, and reduction of the UAER of the i subgroup was superior to that of the other two subgroups;2)serum creatinine (Scr) levels can be reduced significantly using CHM combined with ACEI or ARB, and reduction of Scr in the ii subgroup was superior to that in the iii subgroup;3)reduction of BUN in group A was not better than that in group B. Conclusion: In summary, CHMs combined with ACEI/ARB can decrease UAER and Scr significantly compared to the use of ACEI/ARB during IDN treatment. The effect was more significant in the CHM group containing Astragali Radix or Rehmanniae Radix. The application of Astragali Radix and Rehmanniae Radix should be emphasized in third stage diabetic nephropathy.
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