Adherence to insulin treatment in children with type I diabetes mellitus at a hospital in Malaysia

Chong Lai Ying, Noraida Mohamed Shah

Research output: Contribution to journalArticle

Abstract

Objective: This study aimed to evaluate adherence to insulin treatment and identify factors that influence adherence in children with Type 1 diabetes mellitus (T1DM) at a tertiary care hospital in Malaysia. Methods: Patients were identified from the pharmacy computer system based on the prescribed insulin therapy from 2010 to 2014. Medical records of screened patients were then retrieved from the medical record department. Adherence was assessed through the medication possession ratio (MPR) and glycated hemoglobin A1c value. Patients were classified as adherent or non-adherent if the MPR calculated for the prescribed insulin regimen was ≥80% or <80%, respectively. Patients with A1c values <7.5% based on medical records were also classified as adherent. Results: A total of 57 patients were included in this study, with a 57.9% of male predominance and a mean age of 14.39±3.41 years. 39 (68.4%) and three patients (5.3%) were classified as adherent to insulin treatment according to MPR and A1c values, respectively. Poor agreement between the MPR and A1c value in determining adherence was found based on kappa analysis (kappa=-0.108, p=0.009). There was no association between age, sex, race, presence of comorbidities, or duration of T1DM diagnosed and adherence based on the A1c value (p>0.05). These predictors were also found to be insignificant based on multiple logistic regression analysis (p>0.05). Conclusion: Adherence to insulin treatment based on the A1c measurement was generally poor among children with T1DM. Further, prospective research should be performed in this area to identify reasons for the non-adherence to insulin treatment so that appropriate interventions can be instituted to improve adherence and ultimately prevent complications from the disease.

Original languageEnglish
Pages (from-to)356-361
Number of pages6
JournalAsian Journal of Pharmaceutical and Clinical Research
Volume10
Issue number11
DOIs
Publication statusPublished - 1 Nov 2017

Fingerprint

Malaysia
Type 1 Diabetes Mellitus
Insulin
Hospital Medical Records Department
Therapeutics
Computer Systems
Glycosylated Hemoglobin A
Tertiary Healthcare
Tertiary Care Centers
Medical Records
Logistic Models
Regression Analysis
Research

Keywords

  • Adherence
  • Children
  • Malaysia
  • Type I diabetes mellitus

ASJC Scopus subject areas

  • Pharmacology
  • Pharmaceutical Science
  • Pharmacology (medical)

Cite this

Adherence to insulin treatment in children with type I diabetes mellitus at a hospital in Malaysia. / Ying, Chong Lai; Mohamed Shah, Noraida.

In: Asian Journal of Pharmaceutical and Clinical Research, Vol. 10, No. 11, 01.11.2017, p. 356-361.

Research output: Contribution to journalArticle

@article{0b34ff0196bd4b0ea2a5c1d8b538deb9,
title = "Adherence to insulin treatment in children with type I diabetes mellitus at a hospital in Malaysia",
abstract = "Objective: This study aimed to evaluate adherence to insulin treatment and identify factors that influence adherence in children with Type 1 diabetes mellitus (T1DM) at a tertiary care hospital in Malaysia. Methods: Patients were identified from the pharmacy computer system based on the prescribed insulin therapy from 2010 to 2014. Medical records of screened patients were then retrieved from the medical record department. Adherence was assessed through the medication possession ratio (MPR) and glycated hemoglobin A1c value. Patients were classified as adherent or non-adherent if the MPR calculated for the prescribed insulin regimen was ≥80{\%} or <80{\%}, respectively. Patients with A1c values <7.5{\%} based on medical records were also classified as adherent. Results: A total of 57 patients were included in this study, with a 57.9{\%} of male predominance and a mean age of 14.39±3.41 years. 39 (68.4{\%}) and three patients (5.3{\%}) were classified as adherent to insulin treatment according to MPR and A1c values, respectively. Poor agreement between the MPR and A1c value in determining adherence was found based on kappa analysis (kappa=-0.108, p=0.009). There was no association between age, sex, race, presence of comorbidities, or duration of T1DM diagnosed and adherence based on the A1c value (p>0.05). These predictors were also found to be insignificant based on multiple logistic regression analysis (p>0.05). Conclusion: Adherence to insulin treatment based on the A1c measurement was generally poor among children with T1DM. Further, prospective research should be performed in this area to identify reasons for the non-adherence to insulin treatment so that appropriate interventions can be instituted to improve adherence and ultimately prevent complications from the disease.",
keywords = "Adherence, Children, Malaysia, Type I diabetes mellitus",
author = "Ying, {Chong Lai} and {Mohamed Shah}, Noraida",
year = "2017",
month = "11",
day = "1",
doi = "10.22159/ajpcr.2017.v10i11.20130",
language = "English",
volume = "10",
pages = "356--361",
journal = "Asian Journal of Pharmaceutical and Clinical Research",
issn = "0974-2441",
publisher = "Asian Journal of Pharmaceutical and Clinical Research",
number = "11",

}

TY - JOUR

T1 - Adherence to insulin treatment in children with type I diabetes mellitus at a hospital in Malaysia

AU - Ying, Chong Lai

AU - Mohamed Shah, Noraida

PY - 2017/11/1

Y1 - 2017/11/1

N2 - Objective: This study aimed to evaluate adherence to insulin treatment and identify factors that influence adherence in children with Type 1 diabetes mellitus (T1DM) at a tertiary care hospital in Malaysia. Methods: Patients were identified from the pharmacy computer system based on the prescribed insulin therapy from 2010 to 2014. Medical records of screened patients were then retrieved from the medical record department. Adherence was assessed through the medication possession ratio (MPR) and glycated hemoglobin A1c value. Patients were classified as adherent or non-adherent if the MPR calculated for the prescribed insulin regimen was ≥80% or <80%, respectively. Patients with A1c values <7.5% based on medical records were also classified as adherent. Results: A total of 57 patients were included in this study, with a 57.9% of male predominance and a mean age of 14.39±3.41 years. 39 (68.4%) and three patients (5.3%) were classified as adherent to insulin treatment according to MPR and A1c values, respectively. Poor agreement between the MPR and A1c value in determining adherence was found based on kappa analysis (kappa=-0.108, p=0.009). There was no association between age, sex, race, presence of comorbidities, or duration of T1DM diagnosed and adherence based on the A1c value (p>0.05). These predictors were also found to be insignificant based on multiple logistic regression analysis (p>0.05). Conclusion: Adherence to insulin treatment based on the A1c measurement was generally poor among children with T1DM. Further, prospective research should be performed in this area to identify reasons for the non-adherence to insulin treatment so that appropriate interventions can be instituted to improve adherence and ultimately prevent complications from the disease.

AB - Objective: This study aimed to evaluate adherence to insulin treatment and identify factors that influence adherence in children with Type 1 diabetes mellitus (T1DM) at a tertiary care hospital in Malaysia. Methods: Patients were identified from the pharmacy computer system based on the prescribed insulin therapy from 2010 to 2014. Medical records of screened patients were then retrieved from the medical record department. Adherence was assessed through the medication possession ratio (MPR) and glycated hemoglobin A1c value. Patients were classified as adherent or non-adherent if the MPR calculated for the prescribed insulin regimen was ≥80% or <80%, respectively. Patients with A1c values <7.5% based on medical records were also classified as adherent. Results: A total of 57 patients were included in this study, with a 57.9% of male predominance and a mean age of 14.39±3.41 years. 39 (68.4%) and three patients (5.3%) were classified as adherent to insulin treatment according to MPR and A1c values, respectively. Poor agreement between the MPR and A1c value in determining adherence was found based on kappa analysis (kappa=-0.108, p=0.009). There was no association between age, sex, race, presence of comorbidities, or duration of T1DM diagnosed and adherence based on the A1c value (p>0.05). These predictors were also found to be insignificant based on multiple logistic regression analysis (p>0.05). Conclusion: Adherence to insulin treatment based on the A1c measurement was generally poor among children with T1DM. Further, prospective research should be performed in this area to identify reasons for the non-adherence to insulin treatment so that appropriate interventions can be instituted to improve adherence and ultimately prevent complications from the disease.

KW - Adherence

KW - Children

KW - Malaysia

KW - Type I diabetes mellitus

UR - http://www.scopus.com/inward/record.url?scp=85034029824&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85034029824&partnerID=8YFLogxK

U2 - 10.22159/ajpcr.2017.v10i11.20130

DO - 10.22159/ajpcr.2017.v10i11.20130

M3 - Article

VL - 10

SP - 356

EP - 361

JO - Asian Journal of Pharmaceutical and Clinical Research

JF - Asian Journal of Pharmaceutical and Clinical Research

SN - 0974-2441

IS - 11

ER -