Examining determinants of control of metabolic syndrome among older adults with NCDs receiving service at NCD Plus clinics: multilevel analysis
1
Issued Date
2024-09-27
Resource Type
eISSN
14726963
Scopus ID
2-s2.0-85205335255
Pubmed ID
39334103
Journal Title
BMC health services research
Volume
24
Issue
1
Rights Holder(s)
SCOPUS
Bibliographic Citation
BMC health services research Vol.24 No.1 (2024) , 1118
Suggested Citation
Suapumee N., Seeherunwong A., Wanitkun N., Chansatitporn N. Examining determinants of control of metabolic syndrome among older adults with NCDs receiving service at NCD Plus clinics: multilevel analysis. BMC health services research Vol.24 No.1 (2024) , 1118. doi:10.1186/s12913-024-11562-3 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/101523
Title
Examining determinants of control of metabolic syndrome among older adults with NCDs receiving service at NCD Plus clinics: multilevel analysis
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Abstract
BACKGROUND: Metabolic syndrome (MetS) in older adults with hypertension, diabetes, and hyperlipidemia increases the risks of cardiovascular diseases by 2.5 times and type 2 diabetes by five times. This study aimed to explain the multilevel relationships between health service system factors and individual-level factors influencing the control of MetS among older adults with NCDs receiving health care services at the NCD Plus clinics of hospitals in 1 year. METHODS: This cross-sectional analytical study employed a systematic sampling method to have two groups of samples from 4 regions of Thailand: (1) 600 older adults having at least one diagnosis of NCDs receiving services at NCD Plus clinics and (2) 12 nurses in charge of the NCD Plus clinics at the hospitals providing services to these patient samples. Data were analyzed using multilevel logistic regression analysis. RESULTS: 24% of older adults with NCDs can control MetS within one year. The MetS escalation from the initial assessment to 1-year follow-up varied according to the level of the hospitals. The transition from MetS to non-MetS status was rare in older adults with NCDs. Among health service system factors, complete screening for MetS influenced 1-year MetS control (95% CI [1.06, 2.92]). Older adults who were female and who had polypharmacy had a 66% (95% CI [0.22, 0.53]) and a 54% (95% CI [0.29 - 0.71]) reduction chance in MetS control. Older adults, who were ≥ 80 years old, labor-employed, healthy dietary patterns, and medication adherence increased chances of controlling MetS by 2.38 times (95% CI [1.12, 5.05]), 2.14 times (95% CI [1.03, 4.42]), 1.61 times (95% CI [1.06-2.46]), and 3.18 times (95% CI [1.51, 6.70]), respectively. CONCLUSIONS: NCDs Plus clinics that provide complete screening for MetS significantly enhance their effectiveness in reducing the proportion of older adults with MetS. In addition, the service should pay attention to older adults who are female, are retired, and take multiple medications to achieve MetS control better. The insights gained from such an analysis could be instrumental in pinpointing the resources necessary to bolster the efficacy of NCD Plus clinics.