Kebede Zelalem Bezie, Feyisa Desalegn
School of Pharmacy, College of Health Science, Mizan-Tepi University, Mizan-Teferi, Ethiopia.
Diabetes Metab Syndr Obes. 2020 Dec 8;13:4839-4847. doi: 10.2147/DMSO.S283993. eCollection 2020.
Diabetes mellitus (DM) is a chronic degenerative disease associated with a high risk of chronic complications and comorbidities. According t the World Health Organization, 16.7 million people worldwide die of cardiovascular diseases each year.
The aim of this study is to evaluate determinants of statin initiation among diabetic patients.
A hospital-based cross-sectional study was conducted to evaluate statin initiation and determinants in Gebre Tsadik Shewa General Hospital, Bonga, Ethiopia. This hospital covers a catchment population of about 1.4 million and offers diagnosis and treatment in outpatient and inpatient settings in different departments. Epi data 4.0.2.49 and STATA 14.2 were used for data entry and analysis. Before analysis, presence of co-linearity and model fitness were checked. Chi-square statistics were used to check adequacy of cells for binary logistic regression. Bivariate analysis was done and p <0.25 was included in a multivariate model. Finally p-value less than 0.05 was considered a significant predictor.
A total of 120 patients were included in this study, of which 77 (64.17%) were males. The mean age and standard deviation was 47.04 ± 12.13 years with 75% of patients ≥40 years. The mean duration of illness was 10.26 ± 0.6 years. Ninety-eight (81.67%) patients had varying comorbidities. Sixty-four (53.33%) patients developed complications. The majority of patients were evaluated by a general practitioner (GP). Fifty-one (42.5%) patients started statins. Of them, 31 (60.78%) started for secondary prevention. The majority of patients had atorvastatin with moderate dosage. Government insurance (p=0.029), polypharmacy (0.008), physician level of training (0.023) and previous counseling of patients about the importance of statins (p<001) were significantly associated with initiation of statins.
Only near to 40% of patients started statins. Physician reluctance and unavailability of drugs were the most common reasons not to initiate statins. The hospital tries to provide medication. Physicians should evaluate patients in need of cardio-protective drugs.
糖尿病（DM）是一种慢性退行性疾病，伴有慢性并发症和合并症的高风险。据世界卫生组织称，全球每年有1670万人死于心血管疾病。
本研究的目的是评估糖尿病患者开始使用他汀类药物的决定因素。
在埃塞俄比亚邦加的格布雷·察迪克·谢瓦综合医院进行了一项基于医院的横断面研究，以评估他汀类药物的起始使用情况及其决定因素。该医院覆盖约140万的服务人口，并在不同科室的门诊和住院环境中提供诊断和治疗。使用Epi data 4.0.2.49和STATA 14.2进行数据录入和分析。在分析之前，检查了共线性的存在和模型拟合情况。使用卡方统计量检查二元逻辑回归的单元格是否充足。进行了双变量分析，p<0.25的数据被纳入多变量模型。最后，p值小于0.05被认为是显著的预测因素。
本研究共纳入120例患者，其中77例（64.17%）为男性。平均年龄和标准差为47.04±12.13岁，75%的患者年龄≥40岁。平均病程为10.26±0.6年。98例（81.67%）患者有不同的合并症。64例（53.33%）患者出现并发症。大多数患者由全科医生（GP）进行评估。51例（42.5%）患者开始使用他汀类药物。其中，31例（60.78%）开始使用是为了二级预防。大多数患者使用中等剂量的阿托伐他汀。政府保险（p=0.029）、联合用药（0.008）、医生培训水平（0.023）以及之前对患者进行的他汀类药物重要性的咨询（p<0.001）与他汀类药物的起始使用显著相关。
只有近40%的患者开始使用他汀类药物。医生的不情愿和药物不可用是未开始使用他汀类药物的最常见原因。医院试图提供药物。医生应该对需要心脏保护药物的患者进行评估。
