PMID- 30705590
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220331
IS  - 1176-6336 (Print)
IS  - 1178-203X (Electronic)
IS  - 1176-6336 (Linking)
VI  - 15
DP  - 2019
TI  - Effectiveness and prescription pattern of lipid-lowering therapy and its 
      associated factors among patients with type 2 diabetes mellitus in Malaysian 
      primary care settings.
PG  - 137-145
LID - 10.2147/TCRM.S182716 [doi]
AB  - BACKGROUND: Cardiovascular diseases (CVDs) are the main complication leading to 
      morbidity and mortality among patients with type 2 diabetes mellitus (T2DM). 
      There is a large amount of evidence to support the use of lipid-lowering therapy 
      (LLT) for the prevention of CVD. This study aimed to assess the effectiveness and 
      prescription quality of LLT among T2DM patients and to identify its associated 
      factors. METHODS: A multicenter cross-sectional study included 816 T2DM patients 
      from four different primary care centers in Pahang, Malaysia. We involved 
      LLT-eligible T2DM patients as per the national clinical practice guidelines 
      (CPG). The assessment of therapy effectiveness focused on the attainment of 
      target lipid measures stated in the CPG. Evaluation of the prescription quality 
      was classified into appropriate, potentially inappropriate, and inappropriate, 
      based on the compliance with guidelines and existence of potential safety 
      concerns. Binomial logistic regression was employed to identify the predictors of 
      LLT effectiveness and prescription quality. RESULTS: The overall percentage of 
      T2DM patients receiving statin therapy was 87.6% (715/816). Statin therapy was 
      appropriately prescribed in 71.5% of the cases. About 17.5% of the LLT 
      prescriptions have at least one significant drug interaction with co-prescribed 
      medications. The achievement of the primary target of low-density lipoprotein 
      cholesterol (LDL-C) levels was observed in only 37% of T2DM patients. The LLT 
      indication and appropriateness of prescription were significantly associated with 
      the attainment of LDL-C treatment goals. Primary prevention, Malay race, and 
      hypertension were identified as predictors for appropriate prescribing of LLT 
      among T2DM subjects. CONCLUSION: There is a need to enhance the quality of LLT 
      prescribing in the primary care setting to cover all eligible high-risk patients 
      and ensure patient safety. Strategies to improve the achievement of LDL-C goals 
      among patients with T2DM, such as investigating the potential role of the 
      combination therapy and high-intensity statin therapy, are required.
FAU - Elnaem, Mohamed Hassan
AU  - Elnaem MH
AD  - Department of Pharmacy Practice, Faculty of Pharmacy, International Islamic 
      University Malaysia, Kuantan, Pahang, Malaysia, drmelnaem@gmail.com.
FAU - Mohamed, Mohamad Haniki Nik
AU  - Mohamed MHN
AD  - Department of Pharmacy Practice, Faculty of Pharmacy, International Islamic 
      University Malaysia, Kuantan, Pahang, Malaysia, drmelnaem@gmail.com.
FAU - Huri, Hasniza Zaman
AU  - Huri HZ
AD  - Department of Pharmacy, Faculty of Medicine, University of Malaya, Kuala Lumpur, 
      Malaysia.
FAU - Shah, Azarisman Shah Mohd
AU  - Shah ASM
AD  - Department of Internal Medicine, Faculty of Medicine, International Islamic 
      University Malaysia, Kuantan, Pahang, Malaysia.
LA  - eng
PT  - Journal Article
DEP - 20190118
PL  - New Zealand
TA  - Ther Clin Risk Manag
JT  - Therapeutics and clinical risk management
JID - 101253281
PMC - PMC6342220
OTO - NOTNLM
OT  - Malaysia
OT  - diabetes
OT  - dyslipidemia
OT  - primary care
OT  - statin therapy
COIS- Disclosure The authors report no conflicts of interest in this work.
EDAT- 2019/02/02 06:00
MHDA- 2019/02/02 06:01
PMCR- 2019/01/18
CRDT- 2019/02/02 06:00
PHST- 2019/02/02 06:00 [entrez]
PHST- 2019/02/02 06:00 [pubmed]
PHST- 2019/02/02 06:01 [medline]
PHST- 2019/01/18 00:00 [pmc-release]
AID - tcrm-15-137 [pii]
AID - 10.2147/TCRM.S182716 [doi]
PST - epublish
SO  - Ther Clin Risk Manag. 2019 Jan 18;15:137-145. doi: 10.2147/TCRM.S182716. 
      eCollection 2019.