A Retrospective Combination Health Outcomes Study among Diabetic Patients with Chronic Kidney Disease: A Multi-Level Study
Issued Date
2022-04-15
Resource Type
eISSN
27740226
Scopus ID
2-s2.0-85128863442
Journal Title
Trends in Sciences
Volume
19
Issue
8
Rights Holder(s)
SCOPUS
Bibliographic Citation
Trends in Sciences Vol.19 No.8 (2022)
Suggested Citation
Nichachotesalid P., Watthayu N., Sindhu S., Viwatwongkasem C. A Retrospective Combination Health Outcomes Study among Diabetic Patients with Chronic Kidney Disease: A Multi-Level Study. Trends in Sciences Vol.19 No.8 (2022). doi:10.48048/tis.2022.3223 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/86521
Title
A Retrospective Combination Health Outcomes Study among Diabetic Patients with Chronic Kidney Disease: A Multi-Level Study
Author's Affiliation
Other Contributor(s)
Abstract
Diabetes is the prominent cause of the progression of chronic kidney diseases (CKD) worldwide. Effective implementation of healthcare services and healthcare delivery system to control glycemic level and slow annually declining eGFR remain a challenge in many countries including Thailand. The aims of this study were to investigate the association between individual and health service delivery factors on the combination health outcomes. This multi-level study applied case-control method was conducted. The 397 participants were recruited from 11 hospitals during December 2018 to May 2019 in Thailand. The samples were categorized into 4-group combination health outcome. Data analysis was performed by descriptive analysis and multi-level multinomial logistic regression analysis. The multinomial logistic regression in bivariate analysis showed that diabetes self-care activities score were more likely to control glycemic and CKD progression compared with those with a low-level of DSCA (OR 3.47; 95 % CI: 1.19-10.15). The rational drug uses (RDU) as the health service-level factors increased combination health outcomes 2 times (OR 2.41; 95 % CI: 1.05-5.53). The multi-level analysis found that performing with high-level of DSCA (OR 5.36; 95 % CI:1.99-14.46) and rational drug uses of metformin and NSAIDs (OR 2.33; 95 % CI: 1.25-4.36) increased probability to achieve combination health outcomes. Findings highlight the importance of diabetes self-care activities and health service delivery system to optimize the combination health outcomes among diabetic patients with CKD.