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KIT - Royal Tropical Institute 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 Add to my selection
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Author(s) B.N. Miregwa
Institute KIT - Royal Tropical Institute
Department Development, Policy and Practice
Training Master of Public Health
Year 2012
Publisher KIT - Royal Tropical Institute [etc.]
Place Amsterdam
Pages xi, 61
Organization KIT - Royal Tropical Institute, VU - Vrije Universiteit Amsterdam
Subject Health and Nutrition
Keyword disease prevention and control, health services
Region East Africa
Country Kenya
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 .
Language English
Category Research
Document type Master's thesis
Rights © 2012 Miregwa
Link to this page http://www.search4dev.nl/record/428830