The effect of drugs stock out on discontinuity of antiretroviral therapy and type 2 diabetes mellitus treatment at the Coast Provincial General Hospital in Kenya
Document type: mthesis
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Abstract:
BACKGROUND: Drugs stock out may cause unwanted treatment interruption. This study will quantify the problem of discontinuities of antiretroviral therapy (ART) and type 2 diabetes mellitus (T2DM) treatment due to drug stock outs in Kenya. METHODS: A retrospective cohort study of subjects starting ART and T2DM treatment at the Coast Provincial General hospital between 6th September, 2010 and 6th January, 2012 was carried out. Follow up ended on 6th June, 2012. The primary outcome was first discontinuation of treatment (regimen switch, temporary or complete discontinuation). Incidence rates (IR) and 95% confidence intervals (CIs) were estimated and relative risks (RRs) were calculated to compare the two cohorts. Kaplan-Meier survival plots were created to depict time until discontinuation.
FINDINGS: Overall, 57% of the 167 T2DM patients and 48% of the 342 ART patients experienced at least one treatment discontinuity. Overall rates of discontinuation were 2.66 (95%CI 2.24-3.74) and 1.65 (95%CI 1.41-1.92) per 1000 patient-days for T2DM and ART cohorts respectively, yielding a RR of 1.61 (95%CI 1.25-2.08).The RR of discontinuity due to drug stock out for T2DM vs. ART was 8.92 (95% CI; 4.33-19.9). The median time to discontinue treatment due to drug stock outs was similar for both cohorts: 72 days for T2DM (Interquartile range (IQR): 42-161) and 86 days (IQR: 32-177) for ART (p= 0.803). CONCLUSION: Patients on T2DM treatment were at a higher risk of discontinuation than those on ART. Drug stocks affected more patients on T2DM treatment than on ART. Policy interventions are needed to avoid unnecessary treatment interruptions due to drug stock outs
.
Authors:
Miregwa, B.N.
Country:
Kenya
Category:
Research
Department:
Development, Policy and Practice
Institute:
KIT - Royal Tropical Institute
Keywords:
disease prevention and control
,
health services
Language:
eng
Organization:
KIT - Royal Tropical Institute
Organization:
VU - Vrije Universiteit Amsterdam
PAGE:
xi, 61
Place:
Amsterdam
Publisher:
KIT - Royal Tropical Institute [etc.]
Year:
2012
Region:
East Africa
Right:
© 2012 Miregwa
Subject:
Health and Nutrition
Title:
The effect of drugs stock out on discontinuity of antiretroviral therapy and type 2 diabetes mellitus treatment at the Coast Provincial General Hospital in Kenya
Training:
Master of Public Health