ASSESSMENT OF ADHERENCE AND COST EFFECTIVENESS OF ANTILIPIDEMIC AND ANTIDIABETIC MEDICATIONS AT TERTIARY CARE HOSPITAL OF NAWABSHAH, PAKISTAN.

Abstract

Introduction: Appropriate utilization of medicines is very important due to its proven effectiveness in management of chronic disorders, but it always remains sub-optimal in health management. Objective: To find the antidiabetic and antilipidemic drug adherence and their effects on blood glucose and serum cholesterol level as well as cost of drugs. Methodology: Interventional study on three hundred cardiac and diabetic patients was performed at Peoples Medical College Hospital (P.M.C.H.) Nawabshah. Patients with age of 20-70 years and taking either antilipidemic or anti-diabetic were evaluated by using the questionnaire. Patients were counseled about the importance of appropriate medication and then effects were monitored after six months of counseling. Results: A total of 300 outpatients including one hundred patients of each disease (hyperlipidemia, diabetes mellitus (DM) and hyperlipidemia with DM). Male and female patients were 167 (55.7%) and 133 (44.3%) with age of 59.5 ± 9.6 years. Over all drug adherence was high 87 (29.0%), moderate 67 (22.3%) and low 146 (48.7%). Drug adherence was high 27 (27.0%), 30 (30.0%) and 30 (30.0%), moderate 24 (24.0%), 26 (26.0%) and 17 (17.0%) and low 49 (49.0%), 44 (44.0%) and 53 (53.0%) in hyperlipidemic, diabetic and hyperlipidemic with diabetic respectively. Before counseling serum cholesterol and fasting blood glucose (FBG) was normal in 79 (39.5%) and 88 (44.0%) patients that increased to 96 (61.1%) and 99 (61.5%) patients after counseling. Cost effective treatment was Niacin in hyperlipidemic, Glipizide in diabetic and Metformin with Atorvastatin in hyperlipidemic with diabetic patients respectively. Conclusion: Drug adherence was low that increased with proper counseling and affordable prescribing. Keywords: Antidiabetic, antilipidemic, adherence, glucose, cholesterol.