MATERIALS AND METHODS: This is a cross-sectional, retrospective study design. All patients who received vildagliptin in the Pharmacy Integrated Health System (PHIS) registry database from 2016 to 2021 were included as study samples. The exclusion criteria were being less than 18 years old and having type 1 diabetes mellitus. Patients' medical records were retrieved after sampling, and data were collected. One medical record was missing, thus SPSS analysis were performed on 144 vildagliptin users.
RESULTS: In total, 84 females (58.3%) and 60 males (41.7%) with a mean age of 62.1 (±10.1) years were analysed in this study. Mean HbA1c pre-therapy was 8.5 ± 2.1%; while posttherapy 6 months demonstrated a mean HbA1c of 7.9 ± 1.8%. Use of vildagliptin alone or as an adjunct was associated with a mean reduction of 0.6% in HbA1c (p = 0.01). Factors influencing this HbA1c reduction were advancing age, specifically individuals aged 62 years and older (p = 0.02), patients who are already receiving insulin therapy (p=0.00) and those who express a willingness to commence insulin treatment during the counselling session prior to initiating the treatment plan (p = 0.00). Reasons for vildagliptin initiation documented by prescribers were non-insulin acceptance (n = 59, 40.97%), frequent hypoglycaemia (n = 6, 4.1%) and non-compliance with medications (n = 23, 15.9%). There was no association between demographic, medical background and reason for starting vildagliptin variables and HbA1c reduction (p < 0.001).
CONCLUSION: This study showed that initiating vildagliptin alone or as an adjunct therapy significantly reduced HbA1c and is beneficial for uncontrolled diabetes patients. While advancing age, concurrent administration of insulin and the patients' willingness to accept insulin treatment prior to the commencement of therapy were the factors that influenced HbA1c reduction among patients receiving vildagliptin therapy, we recommend primary care providers prioritise all of the significant variables discovered before initiating vildagliptin for their patients.
METHODS: This observational study analysed secondary data from the self-reported HAT within MySejahtera. It included all patients who were diagnosed with COVID-19 through molecular assays such as RT-PCR or RTK-Ag on 1-21 February 2021, aged >18 years and residing in Selangor. Patients who had documented their symptoms at least once in the HAT during the prescribed 10-day isolation period were classified as HAT users.
RESULTS: A total of 4438 patients were included, of whom 39.4% were HAT users, while 60.6% were non-HAT users. Logistic regression analysis revealed three significant factors associated with low utilisation of the HAT: absence of medical condition (odds ratio [OR]: 9.4; 95% confidence interval [CI]: 7.49-12.01), advanced age (OR: 1.35; 95% CI: 1.20-1.52) and non-Malaysian citizenship (OR: 3.4; 95% CI: 2.50-4.72).
CONCLUSION: The utilisation of the HAT is low, which is associated with advanced age (>65 years), absence of medical conditions and foreign nationality. It is imperative to develop inventive strategies tailored to address the unique needs of these particular demographics.