Burger Johanita, Lubbe Martie, Serfontein Jan, Ellis Suria
North-West University, Medicine Usage in South Africa (MUSA).
North-West University, Faculty Natural Sciences, Statistical Consultation.
Afr Health Sci. 2017 Mar;17(1):88-98. doi: 10.4314/ahs.v17i1.12.
Prescribed Minimum Benefit Chronic Disease List (PMB CDL) conditions are a regulated list of conditions most common to South Africa.
To investigate the prevalence and association between PMB CDL conditions and age and gender among patients with concomitant hypertension, diabetes and dyslipidaemia.
The study population consisted of patients (n = 17 866) with a prescription containing at least one co-prescribed antilipemics, antihypertensive and antidiabetic (identified using the MIMS Desk Reference). ICD-10 codes on claims for PMB CDL conditions were counted.
39.5% of patients had a PMB CDL condition. Women had higher odds for hypothyroidism (OR 6.30, 95% CI; 5.52, 7.19, < 0.001) and lower odds for coronary artery disease (CAD) (OR 0.63, 95% CI; 0.55, 0.72, p < 0.001) than men. In combination with hypothyroidism the odds for CAD were reversed and strongly increased; 3.54 (95% CI; 2.38, 5.25, p < 0.001). The odds for females having cardiac failure (CF) was insignificant and low (OR 0.87, 95% CI; 0.75, 1.01, p = 0.063); however combined with hypothyroidism, the odds increased to 5.35 (95% CI; 3.52, 8.13, p < 0.001).
Hypothyroidism was an important discriminating factor for co-morbidity in women with concomitant hypertension, diabetes and dyslipidaemia, in particular with cardiovascular disease.
规定的最低福利慢性病列表(PMB CDL)中的疾病是南非最常见疾病的一个受监管列表。
调查患有高血压、糖尿病和血脂异常的患者中,PMB CDL疾病的患病率以及与年龄和性别的关联。
研究人群包括患者(n = 17866),其处方中至少含有一种联合开具的降脂药、抗高血压药和抗糖尿病药(使用《MIMS桌面参考》识别)。统计PMB CDL疾病索赔的ICD - 10编码。
39.5%的患者患有PMB CDL疾病。女性患甲状腺功能减退症的几率更高(比值比6.30,95%置信区间;5.52,7.19,p < 0.001),患冠状动脉疾病(CAD)的几率低于男性(比值比0.63,95%置信区间;0.55,0.72,p < 0.001)。与甲状腺功能减退症同时存在时,CAD的几率发生逆转且大幅增加;为3.54(95%置信区间;2.38,5.25,p < 0.001)。女性患心力衰竭(CF)的几率不显著且较低(比值比0.87,95%置信区间;0.75,1.01,p = 0.063);然而与甲状腺功能减退症同时存在时,几率增加到5.35(95%置信区间;3.52,8.13,p < 0.001)。
甲状腺功能减退症是患有高血压、糖尿病和血脂异常的女性共病的一个重要鉴别因素,尤其是与心血管疾病相关时。