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1. BASAMAK SAĞLIK HİZMETLERİNDE İLAÇ KULLANIMININ HASTANE BAŞVURULARINA ETKİSİ: TİP 2 DİYABET ÖRNEĞİ

Year 2024, Volume: 14 Issue: 28, 882 - 894, 30.11.2024
https://doi.org/10.53092/duiibfd.1494771

Abstract

Son yıllarda toplumlarda obezite, hareketsiz yaşam tarzı benimsenmesi ve yaşlanmanın artmasıyla birlikte küresel olarak tip 2 diyabet görülme sıklığında önemli artış yaşanmıştır. Özellikle 1. basamak sağlık hizmetleri düzeyinde tip 2 diyabet nedeniyle hastaneye başvuruların azaltılarak olumsuz sağlık sonuçlarının üstesinden gelmenin yolları aranmaktadır. Bunlardan biri de ilaç kullanımıdır. Bu çalışmada, 1. basamak sağlık hizmetlerinde tip 2 diyabet tedavisinde ilaç kullanımının hastane başvurularına etkisi incelenmiştir. Araştırmanın evrenini Ekonomik İşbirliği ve Gelişme Teşkilatı (OECD) ülkeleri oluşturmuştur. Antihipetansif ve kolesterol düşürücü ilaç kullanımı bağımsız değişkenler ve tip 2 diyabet nedeniyle hastaneye başvurular bağımlı değişken olarak analize dahil edilmiştir. Analiz sonucunda, her iki ilaç kullanımının da 1. basamakta tip 2 diyabet nedeniyle hastaneye başvuruları istatistiksel olarak anlamlı ve negatif yönde etkilediği bulunmuştur. Bu bakımdan, uygun şekilde yönetilen tip 2 diyabetin, hastaneye başvuru ihtiyacını azaltarak hem mikro hem de makro düzeyde olumlu sağlık sonuçları ve maliyet tasarrufu sağlayabilecektir.

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References

  • American Diabetes Association. (2019). Standards of medical care in diabetes 2019. Diabetes care, 42(Suppl 1), S124-38.
  • Chatterjee, S., Khunti, K., & Davies, M. J. (2017). Type 2 diabetes. The lancet, 389(10085), 2239-2251.
  • Childs, B. P. (2005). The complexity of diabetes care. Diabetes spectrum, 18(3), 130-131.
  • DeFronzo, R. A., Ferrannini, E., Groop, L., Henry, R. R., Herman, W. H., Holst, J. J., ... & Weiss, R. (2015). Type 2 diabetes mellitus. Nature reviews disease primers, 1(1), 1-22.
  • Diabetes Prevention Program Research Group. (2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England journal of medicine, 346(6), 393-403.
  • García-Pérez, L. E., Alvarez, M., Dilla, T., Gil-Guillén, V., & Orozco-Beltrán, D. (2013). Adherence to therapies in patients with type 2 diabetes. Diabetes therapy : research, treatment and education of diabetes and related disorders, 4(2), 175–194. https://doi.org/10.1007/s13300-013-0034-y.
  • Global Burden of Disease Collaborative Network (2020). Global burden of disease study 2019. Results. ınstitute for health metrics and evaluation. (https://vizhub.healthdata.org/gbd-results/).
  • Holman, R. R., Bethel, M. A., Mentz, R. J., Thompson, V. P., Lokhnygina, Y., Buse, J. B., ... & Hernandez, A. F. (2017). Effects of once-weekly exenatide on cardiovascular outcomes in type 2 diabetes. New England journal of medicine, 377(13), 1228-1239.
  • Holman, R. R., Paul, S. K., Bethel, M. A., Matthews, D. R., & Neil, H. A. W. (2008). 10-year follow-up of intensive glucose control in type 2 diabetes. New England journal of medicine, 359(15), 1577-1589.
  • Inzucchi, S. E., Bergenstal, R. M., Buse, J. B., Diamant, M., Ferrannini, E., Nauck, M., ... & Matthews, D. R. (2015). Management of hyperglycemia in type 2 diabetes, 2015: a patient-centered approach: update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes care, 38(1), 140-149.
  • Juanamasta, I. G., Aungsuroch, Y., Gunawan, J., Suniyadewi, N. W., & Nopita Wati, N. M. (2021). Holistic care management of diabetes mellitus: an ıntegrative review. International journal of preventive medicine, 12, 69. https://doi.org/10.4103/ijpvm.IJPVM_402_20.
  • Kaul, K., Tarr, J.M., Ahmad, S.I., Kohner, E.M., & Chibber, R. (2013). Introduction to diabetes mellitus. In Ginter, E., and Simko, V. (Eds). Type 2 diabetes mellitus, pandemic in 21st century. Diabetes: an old disease, a new insight, (ss. 1-11). Landes Bioscience and Springer Science+Business Media.
  • Khan, M. A. B., Hashim, M. J., King, J. K., Govender, R. D., Mustafa, H., & Al Kaabi, J. (2020). Epidemiology of type 2 diabetes - global burden of disease and forecasted trends. Journal of epidemiology and global health, 10(1), 107–111. https://doi.org/10.2991/jegh.k.191028.001.
  • Lipscombe, L., Booth, G., Butalia, S., Dasgupta, K., Eurich, D. T., Goldenberg, R., ... & Diabetes Canada Clinical Practice Guidelines Expert Committee. (2018). Pharmacologic glycemic management of type 2 diabetes in adults. Canadian journal of diabetes, 42, S88-S103.
  • Martín-Timón, I., Sevillano-Collantes, C., Segura-Galindo, A., & Del Cañizo-Gómez, F. J. (2014). Type 2 diabetes and cardiovascular disease: Have all risk factors the same strength?. World journal of diabetes, 5(4), 444–470. https://doi.org/10.4239/wjd.v5.i4.444.
  • NICE [National Institute for Health and Clinical Excellence] (2009). Type 2 diabetes: the management of type 2 diabetes. Clinical guideline 87. London: National Institute of Health and Clinical Excellence.
  • Przezak, A., Bielka, W., & Pawlik, A. (2022). Hypertension and type 2 diabetes-the novel treatment possibilities. International journal of molecular sciences, 23(12), 6500. https://doi.org/10.3390/ijms23126500.
  • Rushforth, B., McCrorie, C., Glidewell, L., Midgley, E., & Foy, R. (2016). Barriers to effective management of type 2 diabetes in primary care: qualitative systematic review. British journal of general practice, 66(643), e114-e127.
  • Seuring, T., Archangelidi, O., & Suhrcke, M. (2015). The economic costs of type 2 diabetes: a global systematic review. Pharmacoeconomics, 33, 811-831.
  • Shrivastav, M., Gibson Jr., W., Shrivastav, R., Elzea, K., Khambatta, C., Sonawane, R., ... & Vigersky, R. (2018). Type 2 diabetes management in primary care: the role of retrospective, professional continuous glucose monitoring. Diabetes spectrum, 31(3), 279-287.
  • Sim, R., Chong, C. W., Loganadan, N. K., Fong, A. Y., Navaravong, L., Hussein, Z., ... & Lee, S. W. H. (2022). Comparative effectiveness of cardiovascular, renal and safety outcomes of second‐line antidiabetic drugs use in people with type 2 diabetes: a systematic review and network meta‐analysis of randomised controlled trials. Diabetic medicine, 39(3), e14780.
  • Soumerai, S. B., McLaughlın, T. J., & Avorn, J. (2005). Improving drug prescribing in primary care: a critical analysis of the experimental literature. The milbank quarterly, 83(4).
  • Sugandh, F., Chandio, M., Raveena, F., Kumar, L., Karishma, F., Khuwaja, S., Memon, U. A., Bai, K., Kashif, M., Varrassi, G., Khatri, M., & Kumar, S. (2023). Advances in the management of diabetes mellitus: a focus on personalized medicine. Cureus, 15(8), e43697. https://doi.org/10.7759/cureus.43697.
  • Twigg, M. J., Desborough, J. A., Bhattacharya, D., & Wright, D. J. (2013). An audit of prescribing for type 2 diabetes in primary care: optimising the role of the community pharmacist in the primary healthcare team. Primary health care research & development, 14(3), 315-319.
  • Vos, T., Allen, C., Arora, M., Barber, R. M., Bhutta, Z. A., Brown, A., ... & Boufous, S. (2016). Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. The lancet, 388(10053), 1545-1602.
  • Wei, N. J., Wexler, D. J., Nathan, D. M., & Grant, R. W. (2013). Intensification of diabetes medication and risk for 30‐day readmission. Diabetic medicine, 30(2), e56-e62.
  • Welschen, L. M., Bloemendal, E., Nijpels, G., Dekker, J. M., Heine, R. J., Stalman, W. A., & Bouter, L. M. (2005). Self-monitoring of blood glucose in patients with type 2 diabetes who are not using insulin: a systematic review. Diabetes care, 28(6), 1510-1517.
  • WHO. (2023). Diabetes. https://www.who.int/news-room/fact-sheets/detail/diabetes. (Accessed on 10/2023).
  • Zelniker, T. A., Wiviott, S. D., Raz, I., Im, K., Goodrich, E. L., Bonaca, M. P., ... & Sabatine, M. S. (2019). SGLT2 inhibitors for primary and secondary prevention of cardiovascular and renal outcomes in type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcome trials. The lancet, 393(10166), 31-39.
  • Zhou, Q., & Liao, J. K. (2009). Statins and cardiovascular diseases: from cholesterol lowering to pleiotropy. Current pharmaceutical design, 15(5), 467–478. https://doi.org/10.2174/138161209787315684.
  • Zhou, B., Lu, Y., Hajifathalian, K., Bentham, J., Di Cesare, M., Danaei, G., ... & Gaciong, Z. (2016). Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4· 4 million participants. The lancet, 387(10027), 1513-1530.

THE EFFECT OF MEDICATION ON HOSPITAL ADMISSIONS IN PRIMARY HEALTHCARE SERVICES: THE CASE OF TYPE 2 DIABETES

Year 2024, Volume: 14 Issue: 28, 882 - 894, 30.11.2024
https://doi.org/10.53092/duiibfd.1494771

Abstract

In recent years, there has been a significant increase in the incidence of type 2 diabetes globally with the increase in obesity, adoption of sedentary lifestyle and aging in societies. Especially at the level of primary healthcare services, ways are sought to overcome negative health outcomes by reducing hospital admissions due to type 2 diabetes. One of these is the use of medication. In this study, the effect of medication use on hospital admissions in the treatment of type 2 diabetes in primary healthcare services was examined. The population of the study consisted of Organisation for Economic Co-operation and Development (OECD) countries. Antihypertensive and cholesterol-lowering drug use were included in the analysis as independent variables and hospital admissions due to type 2 diabetes were included as dependent variables. As a result of the analysis, it was found that the use of both drugs had a statistically significant and negative effect on hospital admissions due to type 2 diabetes in primary care. In this regard appropriately managed type 2 diabetes may reduce the need for hospital admissions, leading to positive health outcomes and cost savings at both micro and macro levels.

References

  • American Diabetes Association. (2019). Standards of medical care in diabetes 2019. Diabetes care, 42(Suppl 1), S124-38.
  • Chatterjee, S., Khunti, K., & Davies, M. J. (2017). Type 2 diabetes. The lancet, 389(10085), 2239-2251.
  • Childs, B. P. (2005). The complexity of diabetes care. Diabetes spectrum, 18(3), 130-131.
  • DeFronzo, R. A., Ferrannini, E., Groop, L., Henry, R. R., Herman, W. H., Holst, J. J., ... & Weiss, R. (2015). Type 2 diabetes mellitus. Nature reviews disease primers, 1(1), 1-22.
  • Diabetes Prevention Program Research Group. (2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England journal of medicine, 346(6), 393-403.
  • García-Pérez, L. E., Alvarez, M., Dilla, T., Gil-Guillén, V., & Orozco-Beltrán, D. (2013). Adherence to therapies in patients with type 2 diabetes. Diabetes therapy : research, treatment and education of diabetes and related disorders, 4(2), 175–194. https://doi.org/10.1007/s13300-013-0034-y.
  • Global Burden of Disease Collaborative Network (2020). Global burden of disease study 2019. Results. ınstitute for health metrics and evaluation. (https://vizhub.healthdata.org/gbd-results/).
  • Holman, R. R., Bethel, M. A., Mentz, R. J., Thompson, V. P., Lokhnygina, Y., Buse, J. B., ... & Hernandez, A. F. (2017). Effects of once-weekly exenatide on cardiovascular outcomes in type 2 diabetes. New England journal of medicine, 377(13), 1228-1239.
  • Holman, R. R., Paul, S. K., Bethel, M. A., Matthews, D. R., & Neil, H. A. W. (2008). 10-year follow-up of intensive glucose control in type 2 diabetes. New England journal of medicine, 359(15), 1577-1589.
  • Inzucchi, S. E., Bergenstal, R. M., Buse, J. B., Diamant, M., Ferrannini, E., Nauck, M., ... & Matthews, D. R. (2015). Management of hyperglycemia in type 2 diabetes, 2015: a patient-centered approach: update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes care, 38(1), 140-149.
  • Juanamasta, I. G., Aungsuroch, Y., Gunawan, J., Suniyadewi, N. W., & Nopita Wati, N. M. (2021). Holistic care management of diabetes mellitus: an ıntegrative review. International journal of preventive medicine, 12, 69. https://doi.org/10.4103/ijpvm.IJPVM_402_20.
  • Kaul, K., Tarr, J.M., Ahmad, S.I., Kohner, E.M., & Chibber, R. (2013). Introduction to diabetes mellitus. In Ginter, E., and Simko, V. (Eds). Type 2 diabetes mellitus, pandemic in 21st century. Diabetes: an old disease, a new insight, (ss. 1-11). Landes Bioscience and Springer Science+Business Media.
  • Khan, M. A. B., Hashim, M. J., King, J. K., Govender, R. D., Mustafa, H., & Al Kaabi, J. (2020). Epidemiology of type 2 diabetes - global burden of disease and forecasted trends. Journal of epidemiology and global health, 10(1), 107–111. https://doi.org/10.2991/jegh.k.191028.001.
  • Lipscombe, L., Booth, G., Butalia, S., Dasgupta, K., Eurich, D. T., Goldenberg, R., ... & Diabetes Canada Clinical Practice Guidelines Expert Committee. (2018). Pharmacologic glycemic management of type 2 diabetes in adults. Canadian journal of diabetes, 42, S88-S103.
  • Martín-Timón, I., Sevillano-Collantes, C., Segura-Galindo, A., & Del Cañizo-Gómez, F. J. (2014). Type 2 diabetes and cardiovascular disease: Have all risk factors the same strength?. World journal of diabetes, 5(4), 444–470. https://doi.org/10.4239/wjd.v5.i4.444.
  • NICE [National Institute for Health and Clinical Excellence] (2009). Type 2 diabetes: the management of type 2 diabetes. Clinical guideline 87. London: National Institute of Health and Clinical Excellence.
  • Przezak, A., Bielka, W., & Pawlik, A. (2022). Hypertension and type 2 diabetes-the novel treatment possibilities. International journal of molecular sciences, 23(12), 6500. https://doi.org/10.3390/ijms23126500.
  • Rushforth, B., McCrorie, C., Glidewell, L., Midgley, E., & Foy, R. (2016). Barriers to effective management of type 2 diabetes in primary care: qualitative systematic review. British journal of general practice, 66(643), e114-e127.
  • Seuring, T., Archangelidi, O., & Suhrcke, M. (2015). The economic costs of type 2 diabetes: a global systematic review. Pharmacoeconomics, 33, 811-831.
  • Shrivastav, M., Gibson Jr., W., Shrivastav, R., Elzea, K., Khambatta, C., Sonawane, R., ... & Vigersky, R. (2018). Type 2 diabetes management in primary care: the role of retrospective, professional continuous glucose monitoring. Diabetes spectrum, 31(3), 279-287.
  • Sim, R., Chong, C. W., Loganadan, N. K., Fong, A. Y., Navaravong, L., Hussein, Z., ... & Lee, S. W. H. (2022). Comparative effectiveness of cardiovascular, renal and safety outcomes of second‐line antidiabetic drugs use in people with type 2 diabetes: a systematic review and network meta‐analysis of randomised controlled trials. Diabetic medicine, 39(3), e14780.
  • Soumerai, S. B., McLaughlın, T. J., & Avorn, J. (2005). Improving drug prescribing in primary care: a critical analysis of the experimental literature. The milbank quarterly, 83(4).
  • Sugandh, F., Chandio, M., Raveena, F., Kumar, L., Karishma, F., Khuwaja, S., Memon, U. A., Bai, K., Kashif, M., Varrassi, G., Khatri, M., & Kumar, S. (2023). Advances in the management of diabetes mellitus: a focus on personalized medicine. Cureus, 15(8), e43697. https://doi.org/10.7759/cureus.43697.
  • Twigg, M. J., Desborough, J. A., Bhattacharya, D., & Wright, D. J. (2013). An audit of prescribing for type 2 diabetes in primary care: optimising the role of the community pharmacist in the primary healthcare team. Primary health care research & development, 14(3), 315-319.
  • Vos, T., Allen, C., Arora, M., Barber, R. M., Bhutta, Z. A., Brown, A., ... & Boufous, S. (2016). Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. The lancet, 388(10053), 1545-1602.
  • Wei, N. J., Wexler, D. J., Nathan, D. M., & Grant, R. W. (2013). Intensification of diabetes medication and risk for 30‐day readmission. Diabetic medicine, 30(2), e56-e62.
  • Welschen, L. M., Bloemendal, E., Nijpels, G., Dekker, J. M., Heine, R. J., Stalman, W. A., & Bouter, L. M. (2005). Self-monitoring of blood glucose in patients with type 2 diabetes who are not using insulin: a systematic review. Diabetes care, 28(6), 1510-1517.
  • WHO. (2023). Diabetes. https://www.who.int/news-room/fact-sheets/detail/diabetes. (Accessed on 10/2023).
  • Zelniker, T. A., Wiviott, S. D., Raz, I., Im, K., Goodrich, E. L., Bonaca, M. P., ... & Sabatine, M. S. (2019). SGLT2 inhibitors for primary and secondary prevention of cardiovascular and renal outcomes in type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcome trials. The lancet, 393(10166), 31-39.
  • Zhou, Q., & Liao, J. K. (2009). Statins and cardiovascular diseases: from cholesterol lowering to pleiotropy. Current pharmaceutical design, 15(5), 467–478. https://doi.org/10.2174/138161209787315684.
  • Zhou, B., Lu, Y., Hajifathalian, K., Bentham, J., Di Cesare, M., Danaei, G., ... & Gaciong, Z. (2016). Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4· 4 million participants. The lancet, 387(10027), 1513-1530.
There are 31 citations in total.

Details

Primary Language Turkish
Subjects Policy and Administration (Other)
Journal Section Research Article
Authors

Yasin Aras 0000-0002-5171-7779

Early Pub Date July 22, 2024
Publication Date November 30, 2024
Submission Date June 3, 2024
Acceptance Date July 22, 2024
Published in Issue Year 2024 Volume: 14 Issue: 28

Cite

APA Aras, Y. (2024). 1. BASAMAK SAĞLIK HİZMETLERİNDE İLAÇ KULLANIMININ HASTANE BAŞVURULARINA ETKİSİ: TİP 2 DİYABET ÖRNEĞİ. Dicle Üniversitesi İktisadi Ve İdari Bilimler Fakültesi Dergisi, 14(28), 882-894. https://doi.org/10.53092/duiibfd.1494771
AMA Aras Y. 1. BASAMAK SAĞLIK HİZMETLERİNDE İLAÇ KULLANIMININ HASTANE BAŞVURULARINA ETKİSİ: TİP 2 DİYABET ÖRNEĞİ. Dicle Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi. November 2024;14(28):882-894. doi:10.53092/duiibfd.1494771
Chicago Aras, Yasin. “1. BASAMAK SAĞLIK HİZMETLERİNDE İLAÇ KULLANIMININ HASTANE BAŞVURULARINA ETKİSİ: TİP 2 DİYABET ÖRNEĞİ”. Dicle Üniversitesi İktisadi Ve İdari Bilimler Fakültesi Dergisi 14, no. 28 (November 2024): 882-94. https://doi.org/10.53092/duiibfd.1494771.
EndNote Aras Y (November 1, 2024) 1. BASAMAK SAĞLIK HİZMETLERİNDE İLAÇ KULLANIMININ HASTANE BAŞVURULARINA ETKİSİ: TİP 2 DİYABET ÖRNEĞİ. Dicle Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi 14 28 882–894.
IEEE Y. Aras, “1. BASAMAK SAĞLIK HİZMETLERİNDE İLAÇ KULLANIMININ HASTANE BAŞVURULARINA ETKİSİ: TİP 2 DİYABET ÖRNEĞİ”, Dicle Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi, vol. 14, no. 28, pp. 882–894, 2024, doi: 10.53092/duiibfd.1494771.
ISNAD Aras, Yasin. “1. BASAMAK SAĞLIK HİZMETLERİNDE İLAÇ KULLANIMININ HASTANE BAŞVURULARINA ETKİSİ: TİP 2 DİYABET ÖRNEĞİ”. Dicle Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi 14/28 (November 2024), 882-894. https://doi.org/10.53092/duiibfd.1494771.
JAMA Aras Y. 1. BASAMAK SAĞLIK HİZMETLERİNDE İLAÇ KULLANIMININ HASTANE BAŞVURULARINA ETKİSİ: TİP 2 DİYABET ÖRNEĞİ. Dicle Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi. 2024;14:882–894.
MLA Aras, Yasin. “1. BASAMAK SAĞLIK HİZMETLERİNDE İLAÇ KULLANIMININ HASTANE BAŞVURULARINA ETKİSİ: TİP 2 DİYABET ÖRNEĞİ”. Dicle Üniversitesi İktisadi Ve İdari Bilimler Fakültesi Dergisi, vol. 14, no. 28, 2024, pp. 882-94, doi:10.53092/duiibfd.1494771.
Vancouver Aras Y. 1. BASAMAK SAĞLIK HİZMETLERİNDE İLAÇ KULLANIMININ HASTANE BAŞVURULARINA ETKİSİ: TİP 2 DİYABET ÖRNEĞİ. Dicle Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi. 2024;14(28):882-94.

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