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Treatment intensification and therapeutic inertia of antihypertensive therapy among patients with type 2 diabetes and hypertension with uncontrolled blood pressure.
Wan, Kim Sui; Moy, Foong Ming; Mohd Yusoff, Muhammad Fadhli; Mustapha, Feisul; Ismail, Mastura; Mat Rifin, Halizah; Yoga Ratnam, Kishwen Kanna; Ismail, Hasimah; Chong, Kah Kian; Ahmad, Noor Ani; Hairi, Noran Naqiah.
Afiliación
  • Wan KS; Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, 40170, Shah Alam, Selangor, Malaysia. kimsui@moh.gov.my.
  • Moy FM; Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, 50603, Federal Territory of Kuala Lumpur, Malaysia. kimsui@moh.gov.my.
  • Mohd Yusoff MF; Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, 50603, Federal Territory of Kuala Lumpur, Malaysia.
  • Mustapha F; Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, 40170, Shah Alam, Selangor, Malaysia.
  • Ismail M; Disease Control Division, Federal Government Administration Centre, Ministry of Health, 62590, Putrajaya, Malaysia.
  • Mat Rifin H; Perak State Health Department, Ministry of Health Malaysia, 30000, Ipoh, Perak, Malaysia.
  • Yoga Ratnam KK; Family Health Development Division, Federal Government Administration Centre, Ministry of Health Malaysia, 62590, Putrajaya, Malaysia.
  • Ismail H; Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, 40170, Shah Alam, Selangor, Malaysia.
  • Chong KK; Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, 40170, Shah Alam, Selangor, Malaysia.
  • Ahmad NA; Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, 40170, Shah Alam, Selangor, Malaysia.
  • Hairi NN; Medical Department, Hospital Port Dickson, Negeri Sembilan, 71050, Port Dickson, Malaysia.
Sci Rep ; 14(1): 12625, 2024 06 01.
Article en En | MEDLINE | ID: mdl-38824234
ABSTRACT
Treatment intensification is essential to ensure guideline targets are attained in diabetes patients. The failure to intensify treatment when the targets are not achieved is therapeutic inertia. This study aimed to determine the proportions and factors associated with treatment intensification and therapeutic inertia of antihypertensive therapy in type 2 diabetes patients with uncontrolled hypertension in Malaysia. A retrospective cohort analysis was conducted utilising registry data. Diabetes hypertensive patients with uncontrolled baseline systolic or diastolic blood pressure were included. Treatment intensification was the increase in the number of antihypertensive agents from the index treatment. Therapeutic inertia was the absence of treatment intensification when the second blood pressure reading was still uncontrolled. About 6956 patients were followed up over 2.5 ± 1.1 person-years. Treatment intensification was observed in 29.8% of patients, while 38.6% had therapeutic inertia. Chinese, Indian, and 'others' ethnic groups, retinopathy, more antihypertensive agents, and higher systolic blood pressure were associated with therapeutic inertia. Underweight, overweight patients and those with dyslipidaemia had lower risks for therapeutic inertia. The results indicate suboptimal quality of care in public health clinics in Malaysia. Further studies are needed to determine the underlying causes to formulate precise interventions to tackle the problem in Malaysia.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Presión Sanguínea / Diabetes Mellitus Tipo 2 / Hipertensión / Antihipertensivos Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Sci Rep Año: 2024 Tipo del documento: Article País de afiliación: Malasia Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Presión Sanguínea / Diabetes Mellitus Tipo 2 / Hipertensión / Antihipertensivos Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Sci Rep Año: 2024 Tipo del documento: Article País de afiliación: Malasia Pais de publicación: Reino Unido