A Study on Prescription Pattern of Oral Hypoglycemic Agents and Insulin Therapy in Chronic Renal Failure Patients and Assessment of Medication Adherence

摘要

Diabetes mellitus (DM) is recognized as a leading cause of chronic kidney disease (CKD).End stage renal disease (ESRD) and dialysis add to the complexity of glycemic management in this population .The present study aims at management of diabetes in CKD patients. The objective is to assess the prescription pattern of oral hypoglycemic agents and insulin therapy and also to assess the medication adherence of chronic renal failure patients to hypoglycemic agents. This was a Prospective Observational study, was carried out for a period of six months at Medicine department of Basaveshwara Medical College & Hospital, Chitradurga and in Suneetha kidney Care and Dialysis Centre, Chitradurga, karnataka. A total of 107 patients in which 77 were males and 30 were females. .Commonly prescribed anti-diabetic agent was insulin (49.5%), followed by combination of insulin and sulphonylureas (25.2%). Low medication adherence has been noticed in most of the patients which was improved after patient counseling during next follow up by using Morisky Medication Adherence Scale (MMAS). MMAS results showed the P value at the first visit medication adherence was poor, and shows significant change in follow up was 0.000.The study concludes that Antidiabetic regimens such as sulphonyl ureas and insulin therapy, were found to have a significant association with glycemic control and also pharmacist provided patient education found to have significant influence on advancement in the patient’s knowledge towards medication and their disease and which shows positive impact on adherence to prescribed therapy.