Prescribing Pattern of Medicines for the Prevention of Diabetic Complications in District Hospitals

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Watcharawan Khobkun
Chulaporn Limwattananon
Supon Limwattananon


Introduction:Long-term complications of diabetes affect patients’ quality of life and health care costs. At present, medical evidence confirms effectiveness on prevention of vascular complications, both small and large blood vessels, of the use of angiotensin converting enzyme inhibitors (ACEIs) and angiotensin-2 receptor blockers (ARBs), statins and aspirin or clopidogrel. However, prescribing of these drugs was found to vary across hospitals. Materials and Method: Electronic prescribing and diagnosis data based on 18 standard files in 2011and 2012 from 46 district hospitals were analyzed for diabetic patients, using the SQL program. Semi-structured interview of nurse managers responsible for the hospital diabetes clinics was conducted. Results: Prescribing of drugs for diabetic complication prevention on average was: ACEIs/ARBs,38%; statins,40%; and aspirin orclopidogrel,38% and varied considerably across the study hospitals. The overall prescribing of ACEIs/ARBs and statins increased in 2012 despite hospital variations. Increased utilization was found in the hospitals that had internal medicine physicians, had a medical alert system for the drug requirement according to practice guidelines, and used the prescribing rate as hospital indicators for monitoring and evaluation. Conclusion: Thailand needs to assess the prescribing rate of drugs preventing diabetic complications. Increased utilization of these drugs should be advocated in all stakeholders.


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