Discharge pharmacotherapy for Type 2 diabetic inpatients at two hospitals of different tiers in Zhejiang Province, China
Objects To look into the discharge pharmacotherapy for type 2 diabetics admitted to two general hospitals of different ranks and inspect current real-world management of discharge pharmacology and its related factors. Methods Type 2 diabetics admitted to a tertiary general hospital (Ningbo Medical T...
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| creator | Yu, Xiaofang Zhang, Long Yu, Rongbin Yang, Jiao Zhang, Saifei |
| description | Objects
To look into the discharge pharmacotherapy for type 2 diabetics admitted to two general hospitals of different ranks and inspect current real-world management of discharge pharmacology and its related factors.
Methods
Type 2 diabetics admitted to a tertiary general hospital (Ningbo Medical Treatment Centre Lihuili Hospital, LHLH) or a secondary general hospital (Simen Hospital, SMH) for intensification of their anti-diabetics were included for retrospective analysis. Patients' demographics, clinical characteristics, admission diabetes therapy and discharge diabetes pharmacology were analyzed and compared among patients in each hospital as well as between two hospitals.
Results
391 patients from LHLH and 164 patients from SMH were included for analyzing. Compared with patients from LHLH, patients from SMH were older, more illiterate and had higher HbA1c concentrations. While there was a nearly equal split of oral anti-diabetes drugs (OADs)-only and Insulin treatment in LHLH's discharge pharmacotherapy, insulin treatment dominated SMH's. Basal-and-bolus insulin assumed the majority of SMH's insulin regimens but only accounted for less than 20% of LHLH's. The principal discrepancy in OADs-only treatment existed in the utilization of newer classes of OADs. Cost and body mass index (BMI) were the main differentiating factors among OADs-only treatments while duration, BMI and HbA1c differ among insulin treatments at LHLH. Clinical characteristics didn't significantly differ among OADs-only treatments and HbA1c was the only differentiating factor among insulin treatments at SMH. Overall, hospital, duration, HbA1c, and vascular diseases were main factors that affect discharge pharmacology.
Conclusions
Great disparities exist in the discharge pharmacotherapy at two hospitals. Diabetes management is mostly glucose-oriented at SMH while multifactorial considerations were reflected in LHLH's discharge pharmacotherapy. Besides differences in patients' demographics, medication availability and diagnosis of early-stage vascular complications, lack of practical algorithm for discharge management in T2DM may be the underlying deficiency and a key part for future improvement. |
| doi_str_mv | 10.1371/journal.pone.0230123 |
| format | Article |
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To look into the discharge pharmacotherapy for type 2 diabetics admitted to two general hospitals of different ranks and inspect current real-world management of discharge pharmacology and its related factors.
Methods
Type 2 diabetics admitted to a tertiary general hospital (Ningbo Medical Treatment Centre Lihuili Hospital, LHLH) or a secondary general hospital (Simen Hospital, SMH) for intensification of their anti-diabetics were included for retrospective analysis. Patients' demographics, clinical characteristics, admission diabetes therapy and discharge diabetes pharmacology were analyzed and compared among patients in each hospital as well as between two hospitals.
Results
391 patients from LHLH and 164 patients from SMH were included for analyzing. Compared with patients from LHLH, patients from SMH were older, more illiterate and had higher HbA1c concentrations. While there was a nearly equal split of oral anti-diabetes drugs (OADs)-only and Insulin treatment in LHLH's discharge pharmacotherapy, insulin treatment dominated SMH's. Basal-and-bolus insulin assumed the majority of SMH's insulin regimens but only accounted for less than 20% of LHLH's. The principal discrepancy in OADs-only treatment existed in the utilization of newer classes of OADs. Cost and body mass index (BMI) were the main differentiating factors among OADs-only treatments while duration, BMI and HbA1c differ among insulin treatments at LHLH. Clinical characteristics didn't significantly differ among OADs-only treatments and HbA1c was the only differentiating factor among insulin treatments at SMH. Overall, hospital, duration, HbA1c, and vascular diseases were main factors that affect discharge pharmacology.
Conclusions
Great disparities exist in the discharge pharmacotherapy at two hospitals. Diabetes management is mostly glucose-oriented at SMH while multifactorial considerations were reflected in LHLH's discharge pharmacotherapy. Besides differences in patients' demographics, medication availability and diagnosis of early-stage vascular complications, lack of practical algorithm for discharge management in T2DM may be the underlying deficiency and a key part for future improvement.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0230123</identifier><identifier>PMID: 32267843</identifier><language>eng</language><publisher>SAN FRANCISCO: Public Library Science</publisher><subject>Algorithms ; Alliances ; Analysis ; Biology and Life Sciences ; Body mass ; Body mass index ; Body size ; Cardiovascular disease ; China ; Complications ; Demography ; Diabetes ; Diabetes mellitus ; Diabetes therapy ; Diabetics ; Diseases ; Drug therapy ; Endocrinology ; Ethics ; Glucose ; Glycosylated hemoglobin ; Health services ; Hemoglobin ; Hospital patients ; Hospitals ; Hyperglycemia ; Hypoglycemic agents ; Insulin ; Management ; Medical records ; Medical referrals ; Medical treatment ; Medicine and Health Sciences ; Multidisciplinary Sciences ; Patients ; Pharmacology ; Rankings ; Science & Technology ; Science & Technology - Other Topics ; Type 2 diabetes ; Urban areas ; Vascular diseases</subject><ispartof>PloS one, 2020-04, Vol.15 (4), p.e0230123-e0230123, Article 0230123</ispartof><rights>COPYRIGHT 2020 Public Library of Science</rights><rights>2020 Yu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 Yu et al 2020 Yu et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>0</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000535967600006</woscitedreferencesoriginalsourcerecordid><cites>FETCH-LOGICAL-c641t-b7936c3e668ad7b39079d433f77b63332a9298b8aab103f9b03b364cf471ac743</cites><orcidid>0000-0002-1812-9174 ; 0000-0003-3019-5091</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7141672/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7141672/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,865,886,2103,2115,2929,23871,27929,27930,28253,53796,53798</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32267843$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Fawzy, Manal S.</contributor><creatorcontrib>Yu, Xiaofang</creatorcontrib><creatorcontrib>Zhang, Long</creatorcontrib><creatorcontrib>Yu, Rongbin</creatorcontrib><creatorcontrib>Yang, Jiao</creatorcontrib><creatorcontrib>Zhang, Saifei</creatorcontrib><title>Discharge pharmacotherapy for Type 2 diabetic inpatients at two hospitals of different tiers in Zhejiang Province, China</title><title>PloS one</title><addtitle>PLOS ONE</addtitle><addtitle>PLoS One</addtitle><description>Objects
To look into the discharge pharmacotherapy for type 2 diabetics admitted to two general hospitals of different ranks and inspect current real-world management of discharge pharmacology and its related factors.
Methods
Type 2 diabetics admitted to a tertiary general hospital (Ningbo Medical Treatment Centre Lihuili Hospital, LHLH) or a secondary general hospital (Simen Hospital, SMH) for intensification of their anti-diabetics were included for retrospective analysis. Patients' demographics, clinical characteristics, admission diabetes therapy and discharge diabetes pharmacology were analyzed and compared among patients in each hospital as well as between two hospitals.
Results
391 patients from LHLH and 164 patients from SMH were included for analyzing. Compared with patients from LHLH, patients from SMH were older, more illiterate and had higher HbA1c concentrations. While there was a nearly equal split of oral anti-diabetes drugs (OADs)-only and Insulin treatment in LHLH's discharge pharmacotherapy, insulin treatment dominated SMH's. Basal-and-bolus insulin assumed the majority of SMH's insulin regimens but only accounted for less than 20% of LHLH's. The principal discrepancy in OADs-only treatment existed in the utilization of newer classes of OADs. Cost and body mass index (BMI) were the main differentiating factors among OADs-only treatments while duration, BMI and HbA1c differ among insulin treatments at LHLH. Clinical characteristics didn't significantly differ among OADs-only treatments and HbA1c was the only differentiating factor among insulin treatments at SMH. Overall, hospital, duration, HbA1c, and vascular diseases were main factors that affect discharge pharmacology.
Conclusions
Great disparities exist in the discharge pharmacotherapy at two hospitals. Diabetes management is mostly glucose-oriented at SMH while multifactorial considerations were reflected in LHLH's discharge pharmacotherapy. Besides differences in patients' demographics, medication availability and diagnosis of early-stage vascular complications, lack of practical algorithm for discharge management in T2DM may be the underlying deficiency and a key part for future improvement.</description><subject>Algorithms</subject><subject>Alliances</subject><subject>Analysis</subject><subject>Biology and Life Sciences</subject><subject>Body mass</subject><subject>Body mass index</subject><subject>Body size</subject><subject>Cardiovascular disease</subject><subject>China</subject><subject>Complications</subject><subject>Demography</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetes therapy</subject><subject>Diabetics</subject><subject>Diseases</subject><subject>Drug therapy</subject><subject>Endocrinology</subject><subject>Ethics</subject><subject>Glucose</subject><subject>Glycosylated hemoglobin</subject><subject>Health services</subject><subject>Hemoglobin</subject><subject>Hospital patients</subject><subject>Hospitals</subject><subject>Hyperglycemia</subject><subject>Hypoglycemic agents</subject><subject>Insulin</subject><subject>Management</subject><subject>Medical records</subject><subject>Medical referrals</subject><subject>Medical treatment</subject><subject>Medicine and Health Sciences</subject><subject>Multidisciplinary Sciences</subject><subject>Patients</subject><subject>Pharmacology</subject><subject>Rankings</subject><subject>Science & Technology</subject><subject>Science & Technology - Other Topics</subject><subject>Type 2 diabetes</subject><subject>Urban areas</subject><subject>Vascular diseases</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>AOWDO</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk11v0zAUhiMEYmPwDxBYQkIgaPFHZic3SFP5qjRpCAYX3FiOYzeu0jjYzrb-e07WrlrRLiZf2LKf97XP8TlZ9pzgKWGCfFj6IXSqnfa-M1NMGSaUPcgOScnohFPMHt5aH2RPYlxifMwKzh9nB4xSLoqcHWZXn1zUjQoLg3qYVkr71Jig-jWyPqDzdW8QRbVTlUlOI9f1KjnTpYhUQunSo8bH3iXVRuQtcNaaAMcIoBABR38as3SqW6DvwV-4Tpv3aNa4Tj3NHllQmWfb-Sj79eXz-ezb5PTs63x2cjrRPCdpUomScc0M54WqRcVKLMo6Z8wKUXHGGFUlLYuqUKoimNmywqxiPNc2F0RpkbOj7OXGt299lNukRUlZITjLKRVAzDdE7dVS9sGtVFhLr5y83vBhIVWA4FsjC3gKrRW3rCK5qk2VC6yNEIYckxznFXh93N42VCtTa0hFUO2e6f5J5xq58BdSkJxwQcHgzdYg-L-DiUmu4INM26rO-OH63QXGEOqIvvoPvTu6LbVQEIDrrId79WgqTzgpoQpEMXpN76Bg1GblNFSYdbC_J3i7JwAmmau0UEOMcv7zx_3Zs9_77OtbbGNUm5ro2yE538V9MN-AOvgYg7G7JBMsxwa5yYYcG0RuGwRkL25_0E500xEAFBvg0lTeRg3Frs0Ow2MPHZdccFhhPoPKH18280OXQPru_lL2D08RK_o</recordid><startdate>20200408</startdate><enddate>20200408</enddate><creator>Yu, Xiaofang</creator><creator>Zhang, Long</creator><creator>Yu, Rongbin</creator><creator>Yang, Jiao</creator><creator>Zhang, Saifei</creator><general>Public Library Science</general><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>AOWDO</scope><scope>BLEPL</scope><scope>DTL</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-1812-9174</orcidid><orcidid>https://orcid.org/0000-0003-3019-5091</orcidid></search><sort><creationdate>20200408</creationdate><title>Discharge pharmacotherapy for Type 2 diabetic inpatients at two hospitals of different tiers in Zhejiang Province, China</title><author>Yu, Xiaofang ; Zhang, Long ; Yu, Rongbin ; Yang, Jiao ; Zhang, Saifei</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c641t-b7936c3e668ad7b39079d433f77b63332a9298b8aab103f9b03b364cf471ac743</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Algorithms</topic><topic>Alliances</topic><topic>Analysis</topic><topic>Biology and Life Sciences</topic><topic>Body mass</topic><topic>Body mass index</topic><topic>Body size</topic><topic>Cardiovascular disease</topic><topic>China</topic><topic>Complications</topic><topic>Demography</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Diabetes therapy</topic><topic>Diabetics</topic><topic>Diseases</topic><topic>Drug therapy</topic><topic>Endocrinology</topic><topic>Ethics</topic><topic>Glucose</topic><topic>Glycosylated hemoglobin</topic><topic>Health services</topic><topic>Hemoglobin</topic><topic>Hospital patients</topic><topic>Hospitals</topic><topic>Hyperglycemia</topic><topic>Hypoglycemic agents</topic><topic>Insulin</topic><topic>Management</topic><topic>Medical records</topic><topic>Medical referrals</topic><topic>Medical treatment</topic><topic>Medicine and Health Sciences</topic><topic>Multidisciplinary Sciences</topic><topic>Patients</topic><topic>Pharmacology</topic><topic>Rankings</topic><topic>Science & Technology</topic><topic>Science & Technology - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yu, Xiaofang</au><au>Zhang, Long</au><au>Yu, Rongbin</au><au>Yang, Jiao</au><au>Zhang, Saifei</au><au>Fawzy, Manal S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Discharge pharmacotherapy for Type 2 diabetic inpatients at two hospitals of different tiers in Zhejiang Province, China</atitle><jtitle>PloS one</jtitle><stitle>PLOS ONE</stitle><addtitle>PLoS One</addtitle><date>2020-04-08</date><risdate>2020</risdate><volume>15</volume><issue>4</issue><spage>e0230123</spage><epage>e0230123</epage><pages>e0230123-e0230123</pages><artnum>0230123</artnum><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Objects
To look into the discharge pharmacotherapy for type 2 diabetics admitted to two general hospitals of different ranks and inspect current real-world management of discharge pharmacology and its related factors.
Methods
Type 2 diabetics admitted to a tertiary general hospital (Ningbo Medical Treatment Centre Lihuili Hospital, LHLH) or a secondary general hospital (Simen Hospital, SMH) for intensification of their anti-diabetics were included for retrospective analysis. Patients' demographics, clinical characteristics, admission diabetes therapy and discharge diabetes pharmacology were analyzed and compared among patients in each hospital as well as between two hospitals.
Results
391 patients from LHLH and 164 patients from SMH were included for analyzing. Compared with patients from LHLH, patients from SMH were older, more illiterate and had higher HbA1c concentrations. While there was a nearly equal split of oral anti-diabetes drugs (OADs)-only and Insulin treatment in LHLH's discharge pharmacotherapy, insulin treatment dominated SMH's. Basal-and-bolus insulin assumed the majority of SMH's insulin regimens but only accounted for less than 20% of LHLH's. The principal discrepancy in OADs-only treatment existed in the utilization of newer classes of OADs. Cost and body mass index (BMI) were the main differentiating factors among OADs-only treatments while duration, BMI and HbA1c differ among insulin treatments at LHLH. Clinical characteristics didn't significantly differ among OADs-only treatments and HbA1c was the only differentiating factor among insulin treatments at SMH. Overall, hospital, duration, HbA1c, and vascular diseases were main factors that affect discharge pharmacology.
Conclusions
Great disparities exist in the discharge pharmacotherapy at two hospitals. Diabetes management is mostly glucose-oriented at SMH while multifactorial considerations were reflected in LHLH's discharge pharmacotherapy. Besides differences in patients' demographics, medication availability and diagnosis of early-stage vascular complications, lack of practical algorithm for discharge management in T2DM may be the underlying deficiency and a key part for future improvement.</abstract><cop>SAN FRANCISCO</cop><pub>Public Library Science</pub><pmid>32267843</pmid><doi>10.1371/journal.pone.0230123</doi><tpages>15</tpages><orcidid>https://orcid.org/0000-0002-1812-9174</orcidid><orcidid>https://orcid.org/0000-0003-3019-5091</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | PloS one, 2020-04, Vol.15 (4), p.e0230123-e0230123, Article 0230123 |
| issn | 1932-6203 1932-6203 |
| language | eng |
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| source | DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS) Journals Open Access; Web of Science - Science Citation Index Expanded - 2020<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" />; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Algorithms Alliances Analysis Biology and Life Sciences Body mass Body mass index Body size Cardiovascular disease China Complications Demography Diabetes Diabetes mellitus Diabetes therapy Diabetics Diseases Drug therapy Endocrinology Ethics Glucose Glycosylated hemoglobin Health services Hemoglobin Hospital patients Hospitals Hyperglycemia Hypoglycemic agents Insulin Management Medical records Medical referrals Medical treatment Medicine and Health Sciences Multidisciplinary Sciences Patients Pharmacology Rankings Science & Technology Science & Technology - Other Topics Type 2 diabetes Urban areas Vascular diseases |
| title | Discharge pharmacotherapy for Type 2 diabetic inpatients at two hospitals of different tiers in Zhejiang Province, China |
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