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The Effectiveness of Diabetes Medication Therapy Adherence Clinic on Glycaemic Control in Health Clinic

In Malaysia, studies have shown that Diabetes Medication Therapy Adherence Clinic (DMTAC) in hospital settings significantly improved patients' glycaemic control and cardiovascular risk. In the review of previous studies, there were no randomised controlled trial of DMTAC done in a primary care...

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Main Author: Alison L P, Chai
Format: Thesis
Language:English
Published: The Medical Journal of Malaysia 2020
Subjects:
Q Science (General)
RA0421 Public health. Hygiene. Preventive Medicine
Online Access:http://ir.unimas.my/id/eprint/39664/1/Alison%20Chai%20Ling%20Pao%20ft.pdf
http://ir.unimas.my/id/eprint/39664/
http://www.e-mjm.org
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spelling my.unimas.ir.396642023-03-06T04:31:00Z http://ir.unimas.my/id/eprint/39664/ The Effectiveness of Diabetes Medication Therapy Adherence Clinic on Glycaemic Control in Health Clinic Alison L P, Chai Q Science (General) RA0421 Public health. Hygiene. Preventive Medicine In Malaysia, studies have shown that Diabetes Medication Therapy Adherence Clinic (DMTAC) in hospital settings significantly improved patients' glycaemic control and cardiovascular risk. In the review of previous studies, there were no randomised controlled trial of DMTAC done in a primary care setting – where the access to subspecialist services (endocrinologists, expensive medication, etc.) is limited. The objective of this research is to compare the glycaemic control among the uncontrolled diabetes mellitus patients between those received additional DMTAC service and those received normal clinic service in a primary care setting. The secondary objective is to investigate the common adverse outcomes of lowering HbA1c such as weight gain and severe hypoglycaemia. This was a randomized controlled study conducted in a health clinic of Sarawak. All eligible uncontrolled type 2 diabetes mellitus patients attending Kota Samarahan Health Clinic visit for at least six months before recruitment were randomly assigned to either intervention or control group (50 subjects per group). The control group received normal clinic visits with consultations by a medical officer. The intervention group, however, received four or more DMTAC visits in addition to normal clinic visits. The demographic data was collected during screening while health data including glycated haemoglobin (HbA1c) levels were collected at baseline, sixth month and one year. The main outcome for this study was HbA1c, the occurrence of severe hypoglycaemia, and weight gain. The result showed that the change in HbA1c in the intervention group (mean ± SD = -1.66 ± 2.21%) was significantly more than the control group (mean ± SD = -0.50 ± 2.21%) at 12th month (p = 0.005) with a weight mean difference of -1.16% [95% CI = -2.12, -0.21]. The regression analysis shows higher baseline HbA1c, simpler treatment plan and the intervention group yielded better HbA1c improvement. There was no difference in the BMI trend between both groups. There was no episode of severe hypoglycaemia detected among the subjects. In conclusion, the addition of DMTAC service in primary care can improve patient’s glycaemic control. The Medical Journal of Malaysia 2020-05 Thesis NonPeerReviewed text en http://ir.unimas.my/id/eprint/39664/1/Alison%20Chai%20Ling%20Pao%20ft.pdf Alison L P, Chai (2020) The Effectiveness of Diabetes Medication Therapy Adherence Clinic on Glycaemic Control in Health Clinic. Masters thesis, Universiti Malaysia Sarawak. http://www.e-mjm.org PMID: 32467540
institution Universiti Malaysia Sarawak
building Centre for Academic Information Services (CAIS)
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Malaysia Sarawak
content_source UNIMAS Institutional Repository
url_provider http://ir.unimas.my/
language English
topic Q Science (General)
RA0421 Public health. Hygiene. Preventive Medicine
spellingShingle Q Science (General)
RA0421 Public health. Hygiene. Preventive Medicine
Alison L P, Chai
The Effectiveness of Diabetes Medication Therapy Adherence Clinic on Glycaemic Control in Health Clinic
description In Malaysia, studies have shown that Diabetes Medication Therapy Adherence Clinic (DMTAC) in hospital settings significantly improved patients' glycaemic control and cardiovascular risk. In the review of previous studies, there were no randomised controlled trial of DMTAC done in a primary care setting – where the access to subspecialist services (endocrinologists, expensive medication, etc.) is limited. The objective of this research is to compare the glycaemic control among the uncontrolled diabetes mellitus patients between those received additional DMTAC service and those received normal clinic service in a primary care setting. The secondary objective is to investigate the common adverse outcomes of lowering HbA1c such as weight gain and severe hypoglycaemia. This was a randomized controlled study conducted in a health clinic of Sarawak. All eligible uncontrolled type 2 diabetes mellitus patients attending Kota Samarahan Health Clinic visit for at least six months before recruitment were randomly assigned to either intervention or control group (50 subjects per group). The control group received normal clinic visits with consultations by a medical officer. The intervention group, however, received four or more DMTAC visits in addition to normal clinic visits. The demographic data was collected during screening while health data including glycated haemoglobin (HbA1c) levels were collected at baseline, sixth month and one year. The main outcome for this study was HbA1c, the occurrence of severe hypoglycaemia, and weight gain. The result showed that the change in HbA1c in the intervention group (mean ± SD = -1.66 ± 2.21%) was significantly more than the control group (mean ± SD = -0.50 ± 2.21%) at 12th month (p = 0.005) with a weight mean difference of -1.16% [95% CI = -2.12, -0.21]. The regression analysis shows higher baseline HbA1c, simpler treatment plan and the intervention group yielded better HbA1c improvement. There was no difference in the BMI trend between both groups. There was no episode of severe hypoglycaemia detected among the subjects. In conclusion, the addition of DMTAC service in primary care can improve patient’s glycaemic control.
format Thesis
author Alison L P, Chai
author_facet Alison L P, Chai
author_sort Alison L P, Chai
title The Effectiveness of Diabetes Medication Therapy Adherence Clinic on Glycaemic Control in Health Clinic
title_short The Effectiveness of Diabetes Medication Therapy Adherence Clinic on Glycaemic Control in Health Clinic
title_full The Effectiveness of Diabetes Medication Therapy Adherence Clinic on Glycaemic Control in Health Clinic
title_fullStr The Effectiveness of Diabetes Medication Therapy Adherence Clinic on Glycaemic Control in Health Clinic
title_full_unstemmed The Effectiveness of Diabetes Medication Therapy Adherence Clinic on Glycaemic Control in Health Clinic
title_sort effectiveness of diabetes medication therapy adherence clinic on glycaemic control in health clinic
publisher The Medical Journal of Malaysia
publishDate 2020
url http://ir.unimas.my/id/eprint/39664/1/Alison%20Chai%20Ling%20Pao%20ft.pdf
http://ir.unimas.my/id/eprint/39664/
http://www.e-mjm.org
_version_ 1759693328330260480
score 13.211869

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