4
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Prescribing statins among patients with type 2 diabetes: The clinical gap between the guidelines and practice

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background:

          Statins are recommended for cardiovascular protection for people with diabetes (high-risk groups). This study aimed to evaluate the gap between the guidelines of statin utilization and clinical practice among outpatients with type 2 diabetes regarding the patient's age and gender, to assess if this preventive drug is being satisfactorily utilized or not.

          Materials and Methods:

          In this cross-sectional study, patients aged <40 or >75 years, pregnant patients, and patients with type 1 diabetes, human immunodeficiency virus, or liver cirrhosis were excluded. Demographics, laboratory parameters, and prevalence of exposure to statin therapy were evaluated. This study was guided by the 2013 American College of Cardiology/American Heart Association cholesterol guidelines. IBM SPSS software was used for data management.

          Results:

          The study cohort involved 576 patients, with age being 58.3 ± 8.9 years. There were 50.5% of females and 49.5% of males. Overall 81.1% of patients aged 58.8 ± 8.8 years were statin users and 18.9% of patients aged 56.2 ± 9 years were statin nonusers. About 83.2% of females and 78.9% of males were prescribed statins. Statin medications included simvastatin 79.2%, atorvastatin 11.6%, lovastatin 5.8%, rosuvastatin 2.1%, and pravastatin 1.3%. Statin users’ and nonusers’ adherence was 56.5%, and 41.3% ( P = 0.004), respectively. The adherence to medication plan of females and males was 55.7% and 51.6%, respectively ( P = 0.004).

          Conclusion:

          Patients with diabetes who are at high risk of cardiovascular events, exposure to statin treatment is significantly less than perfect position both in females and males. Nearly one-fifth of the patients with type 2 diabetes are not using statins despite therapeutic necessities.

          Related collections

          Most cited references22

          • Record: found
          • Abstract: not found
          • Article: not found

          10. Older Adults.

          (2016)
            Bookmark
            • Record: found
            • Abstract: found
            • Article: found
            Is Open Access

            Criterion validity of 8-item Morisky Medication Adherence Scale in patients with asthma

            The 8-item Morisky Medication Adherence Scale (MMAS-8) is reliable and valid in patients with hypertension, but to our knowledge validity has not been established for patients with asthma. The aim of the study was to determine the criterion validity of the MMAS-8 in patients with asthma. In the cross-sectional study patients older than 12 year were recruited when dispensed asthma medications in community pharmacies. Criterion validity of the scale was assessed through associations with asthma control and quality of life. Asthma control was assessed by the Asthma Control Test (ACT) and quality of life was evaluated by the Saint George Respiratory Questionnaire (SGRQ). A total of 208 patients (mean age 56 years, 59% female) were included in the study. Almost all patients were prescribed inhaled corticosteroids (96%). Asthma was not controlled in 37% of the patients and 22% experienced at least one exacerbation requiring emergency room visit, hospitalization or treatment with oral corticosteroid therapy in the previous year. The 8-item MMAS was significantly associated with asthma control and quality of life. Patients who scored 8 points, 6 points and ≤6 points on the scale were considered to have high, medium and low adherence, respectively. High, medium and low adherence was found in 53%, 23% and 24% of the patients, respectively. As adherence improved from low to medium or from medium to high, the odds of asthma control increased by 1.7 times (OR 1.65, p = 0.027). Patients with high and medium adherence had SGRQ scores that were 6.1 and 5.3 points lower, respectively, compared with patients with low adherence. The MMAS-8 was found to be valid for assessing medication adherence and predicting health outcomes in patients with asthma.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Effect of age and gender on pharmacokinetics of atorvastatin in humans.

              Atorvastatin is a new 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitor that reduces plasma cholesterol by inhibiting cholesterol synthesis and increasing cellular uptake of low density lipoproteins. The effects of age and gender on the pharmacokinetics of atorvastatin after administration of single 20-mg tablets of atorvastatin were studied in 16 young and 16 elderly volunteers (8 men and 8 women in each age group). Plasma equivalent concentrations of atorvastatin were quantitated by a validated enzyme inhibition bioassay. Atorvastatin was well tolerated by the participants. The equivalent maximum concentration (Cmax) of atorvastatin was 42.5% higher in elderly participants (age, 66-92 years) than in young participants (age, 19-35 years) and 17.6% higher in women than in men. In addition, mean area under the concentration-time curve (AUC0-infinity) and half-life (t1/2) were 27.3% greater and 36.2% longer, respectively, in elderly adults than in young adults and 11.3% lower and 19.9% shorter, respectively, in women than in men. Because the primary site of action for HMG-CoA reductase inhibitors is the liver and atorvastatin is subject to extensive first-pass hepatic metabolism, it is unclear whether these age- and gender-related differences in the pharmacokinetics of atorvastatin will be clinically important. Results of subsequent safety and efficacy trials should help clarify the clinical significance of these pharmacokinetic differences.
                Bookmark

                Author and article information

                Journal
                J Res Med Sci
                J Res Med Sci
                JRMS
                Journal of Research in Medical Sciences : The Official Journal of Isfahan University of Medical Sciences
                Medknow Publications & Media Pvt Ltd (India )
                1735-1995
                1735-7136
                2019
                25 February 2019
                : 24
                : 15
                Affiliations
                [1]Department of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Malaysia
                [1 ]Endocrinology Clinics, Department of Internal Medicine, Penang General Hospital, Penang, Malaysia
                Author notes
                Address for correspondence: Dr. Mohamed Anwar Hammad, K19A – 102, Aman Damai, Universiti Sains Malaysia, Penang, Malaysia. E-mail: m_anwaaar@ 123456hotmail.com
                Article
                JRMS-24-15
                10.4103/jrms.JRMS_100_18
                6421885
                30988683
                ce14187e-b894-4e6b-b9b3-4199698ca8c8
                Copyright: © 2019 Journal of Research in Medical Sciences

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 12 February 2018
                : 09 April 2018
                : 27 November 2018
                Categories
                Original Article

                Medicine
                age,clinical gap,gender,malaysia,practice guidelines,statin medication,type 2 diabetes
                Medicine
                age, clinical gap, gender, malaysia, practice guidelines, statin medication, type 2 diabetes

                Comments

                Comment on this article