Evaluation of prescription pattern and glycaemic control among diabetes patients in an ambulatory tertiary care setting in southwestern Nigeria

Abstract

Background: Drug prescription in diabetes is complex, thereby making diabetes patients a high-risk group. Thus, treating the patient with diabetes remains a practice that entails constant re-evaluation and assessment of patient’s therapy and response.

Objective: To evaluate pattern of antidiabetes and adjunctive medications prescribed for patients as well as extent of glycaemic control.

Method: A cross-sectional concurrent review of case-notes of diabetes patients attending the endocrinology out-patient clinic of the University College Hospital, Ibadan, for 4-consecutive weeks. In-patient case-notes, newly diagnosed, and those with incomplete data were excluded. Data were summarised using descriptive statistics. Chi-square was used to investigate categorical variables at p<0.05.

Results: Mean age and duration of diagnosis were 60.6±13.0 and 10.2±7.9 years, respectively. Type-1-diabetes accounted for 4 (6.9%) and type-2-diabetes (54; 93.1%). Co-administered combination of metformin and glimepiride (15; 25.9%) was most commonly prescribed. Mean glycosilated haemoglobin was 6.9±1.8%. Nineteen (59.4%) were adjudged to have good glycaemic control (HbA1c<7%). Calcium-channel-blockers (23; 19.5%), statins (23; 19.5%), angiotension-converting-enzyme inhibitors (22; 18.6%) and low-dose aspirin (20; 17.0%) were the commonly prescribed adjuncts. Of the 16 (27.6%) patients whose adherence status was documented, 8 (50.0%) who were regular on medication were subjectively adjudged adherent.

Conclusion: Metformin-based regimen, specifically, the co-administered combination of metformin and glimepiride is mostly prescribed. Overall blood glucose profile indicates fair glycaemic control. There is a greater likelihood of evidence-based prescriptions for the patients. However, there is a need for concerted efforts by providers in ensuring improved medication adherence, in order to ensure better therapeutic outcomes.

Keywords: Antidiabetes medication, glycaemic control, diabetes patients, ambulatory