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Dr. Kailash Tripathi talks about adherence to therapy for Diabetes control – Zee News

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Adherence to therapy for diabetes control

The degree to which a patient is committed to taking medication, adhering to a diet, making lifestyle changes, and aligning with accepted advice from a healthcare provider is known as adherence to therapy. When type 2 diabetes mellitus manifests, patients are initially urged to maintain a healthy diet and exercise routine. This is followed by early medication, which typically consists of one or more pills and may subsequently include injections.

Despite the advantages of therapy, studies have shown that less than 50% of patients meet the suggested blood glucose targets, which may be related to lower adherence to treatments. High blood sugar levels and chronic consequences thereby raise difficulties of life and premature death, as well as the price of healthcare services.1

Why may one fail to adhere to the treatment suggested?

The causes of nonadherence are complex and challenging to pinpoint. Age, knowledge of the condition, duration of treatment, the complexity of the dosing regimen, need to take multiple pills, psychological considerations, the safety of medicines, and cost are a few.

Adherence rates are usually reduced for patients with chronic conditions like diabetes than those with acute conditions; the decline in adherence is most rapid after the first six months of therapy. Such reduced adherence results in poor health outcomes and significantly impacts healthcare costs.2 Adherence to diet and exercise substantially improves health.3

The cost of medications can be a reason for a lack of adherence. According to a study, 34% of patients said that not taking their prescriptions as prescribed was due to the cost.3

The factors influencing adherence to exercise include overuse, injuries and lack of motivation, and whether the activity is routinely monitored. Regarding diet, patients expressed a dislike for foods included in meal plans.

Consequences of poor adherence

Skipping meals may increase the chances of binging on food that isn’t good for diabetes, and as a result, the patient starts to feel hungry and irritated, the mind becomes foggy and lacks clarity, and one could also gain weight. Not adhering to diet will also lead to medication imbalances causing gastrointestinal side effects.

Poor adherence to medications makes diabetes control difficult, which may increase the chances of complications like kidney damage, eye damage, amputation, heart disease, stroke, etc.4

Another long-term consequence of poor adherence is increased health-related expenses linked to type 2 diabetes. WHO emphasizes that “increasing the effectiveness of adherence interventions may have a far greater impact on the health of the population than any improvement in specific medical treatments”2

What to do if it is challenging to stick to the treatment or lifestyle changes suggested?

One has to discuss it very openly with the doctor. The doctor may help reduce the complexity of the medicines that are being taken, educate and persuade to stick to the treatment regimen, suggest alternate options, and prescribe cost-effective medicines. One can also use mobile apps, calendars and reminders that help to follow the treatment recommended.

References:

García-Pérez LE, Alvarez M, Dilla T, Gil-Guillén V, Orozco-Beltrán D. Adherence to therapies in patients with type 2 diabetes. Diabetes Ther. 2013 Dec;4(2):175-94. 
World Health Organization: Adherence to long-term therapies. Evidence for action. Geneva: World Health Organization; 2003
American Diabetes Association Standards of medical care in diabetes: 2013. Diabetes Care. 2013;36(Suppl 1):S11–S66.
Odegard PS, Gray SL. Barriers to medication adherence in poorly controlled diabetes mellitus. Diabetes Educ. 2008;34:692–697Tiv M, Viel J-F, Mauny F, et al. Medication adherence in type 2 diabetes: the ENTRED study 2007, a French population-based study. PLoS ONE. 2012;7:e32412.

 

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Some Ontario docs now offering RSV shot to infants with Quebec rollout set for Nov.

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Some Ontario doctors have started offering a free shot that can protect babies from respiratory syncytial virus while Quebec will begin its immunization program next month.

The new shot called Nirsevimab gives babies antibodies that provide passive immunity to RSV, a major cause of serious lower respiratory tract infections for infants and seniors, which can cause bronchiolitis or pneumonia.

Ontario’s ministry of health says the shot is already available at some doctor’s offices in Ontario with the province’s remaining supply set to arrive by the end of the month.

Quebec will begin administering the shots on Nov. 4 to babies born in hospitals and delivery centers.

Parents in Quebec with babies under six months or those who are older but more vulnerable to infection can also book immunization appointments online.

The injection will be available in Nunavut and Yukon this fall and winter, though administration start dates have not yet been announced.

This report by The Canadian Press was first published Oct. 21, 2024.

-With files from Nicole Ireland

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

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Polio is rising in Pakistan ahead of a new vaccination campaign

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ISLAMABAD (AP) — Polio cases are rising ahead of a new vaccination campaign in Pakistan, where violence targeting health workers and the police protecting them has hampered years of efforts toward making the country polio-free.

Since January, health officials have confirmed 39 new polio cases in Pakistan, compared to only six last year, said Anwarul Haq of the National Emergency Operation Center for Polio Eradication.

The new nationwide drive starts Oct. 28 with the aim to vaccinate at least 32 million children. “The whole purpose of these campaigns is to achieve the target of making Pakistan a polio-free state,” he said.

Pakistan regularly launches campaigns against polio despite attacks on the workers and police assigned to the inoculation drives. Militants falsely claim the vaccination campaigns are a Western conspiracy to sterilize children.

Most of the new polio cases were reported in the southwestern Balochistan and southern Sindh province, following by Khyber Pakhtunkhwa province and eastern Punjab province.

The locations are worrying authorities since previous cases were from the restive northwest bordering Afghanistan, where the Taliban government in September suddenly stopped a door-to-door vaccination campaign.

Afghanistan and Pakistan are the two countries in which the spread of the potentially fatal, paralyzing disease has never been stopped. Authorities in Pakistan have said that the Taliban’s decision will have major repercussions beyond the Afghan border, as people from both sides frequently travel to each other’s country.

The World Health Organization has confirmed 18 polio cases in Afghanistan this year, all but two in the south of the country. That’s up from six cases in 2023. Afghanistan used a house-to-house vaccination strategy this June for the first time in five years, a tactic that helped to reach the majority of children targeted, according to WHO.

Health officials in Pakistan say they want the both sides to conduct anti-polio drives simultaneously.

The Canadian Press. All rights reserved.

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White House says health insurance needs to fully cover condoms, other over-the-counter birth control

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WASHINGTON (AP) — Millions of people with private health insurance would be able to pick up over-the-counter methods like condoms, the “morning after” pill and birth control pills for free under a new rule the White House proposed on Monday.

Right now, health insurers must cover the cost of prescribed contraception, including prescription birth control or even condoms that doctors have issued a prescription for. But the new rule would expand that coverage, allowing millions of people on private health insurance to pick up free condoms, birth control pills, or “morning after” pills from local storefronts without a prescription.

The proposal comes days before Election Day, as Vice President Kamala Harris affixes her presidential campaign to a promise of expanding women’s health care access in the wake of the U.S. Supreme Court’s decision to undo nationwide abortion rights two years ago. Harris has sought to craft a distinct contrast from her Republican challenger, Donald Trump, who appointed some of the judges who issued that ruling.

“The proposed rule we announce today would expand access to birth control at no additional cost for millions of consumers,” Health and Human Services Secretary Xavier Becerra said in a statement. “Bottom line: women should have control over their personal health care decisions. And issuers and providers have an obligation to comply with the law.”

The emergency contraceptives that people on private insurance would be able to access without costs include levonorgestrel, a pill that needs to be taken immediately after sex to prevent pregnancy and is more commonly known by the brand name “Plan B.”

Without a doctor’s prescription, women may pay as much as $50 for a pack of the pills. And women who delay buying the medication in order to get a doctor’s prescription could jeopardize the pill’s effectiveness, since it is most likely to prevent a pregnancy within 72 hours after sex.

If implemented, the new rule would also require insurers to fully bear the cost of the once-a-day Opill, a new over-the-counter birth control pill that the U.S. Food and Drug Administration approved last year. A one-month supply of the pills costs $20.

Federal mandates for private health insurance to cover contraceptive care were first introduced with the Affordable Care Act, which required plans to pick up the cost of FDA-approved birth control that had been prescribed by a doctor as a preventative service.

The proposed rule would not impact those on Medicaid, the insurance program for the poorest Americans. States are largely left to design their own rules around Medicaid coverage for contraception, and few cover over-the-counter methods like Plan B or condoms.

The Canadian Press. All rights reserved.

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