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:	2020
Subjects:	Q Science (General)
Online Access:	http://ir.unimas.my/id/eprint/39664/1/Alison%20Chai%20Ling%20Pao%20ft.pdf
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id	my-unimas-ir.39664
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spelling	my-unimas-ir.396642023-03-06T04:31:00Z The Effectiveness of Diabetes Medication Therapy Adherence Clinic on Glycaemic Control in Health Clinic 2020-05 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 http://ir.unimas.my/id/eprint/39664/ http://ir.unimas.my/id/eprint/39664/1/Alison%20Chai%20Ling%20Pao%20ft.pdf text en validuser http://www.e-mjm.org masters Universiti Malaysia Sarawak Faculty of Medicine and Health Sciences
institution	Universiti Malaysia Sarawak
collection	UNIMAS Institutional Repository
language	English
topic	Q Science (General) Q Science (General)
spellingShingle	Q Science (General) Q Science (General) 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
qualification_level	Master's degree
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
granting_institution	Universiti Malaysia Sarawak
granting_department	Faculty of Medicine and Health Sciences
publishDate	2020
url	http://ir.unimas.my/id/eprint/39664/1/Alison%20Chai%20Ling%20Pao%20ft.pdf
_version_	1783728514011234304

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

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