Length of Hospitalization and Polypharmacy in Diabetes Multimorbidity with Infectious Diseases
Keywords:
diabetes, HIV, malaria, multimorbidities, tuberculosis
Abstract
Patients with chronic condition have a higher risk of death and disability than others without chronic condition. Meanwhile, low to middle income countries facing challenges in reducing the burden of Non-Communicable Diseases (NCDs) and controlling infectious diseases such as Human Immunodeficiency Virus, Tuberculosis and Malaria. Patients with Diabetes are more often facing infection than people without diabetes. This research aimed to evaluate the length of hospitalization and polypharmacy in patients with multimorbidity of Diabetes with TB, HIV, and Malaria. Design of this research was a retrospective cohort study. All patients diagnosed with Diabetes since 2008 were grouped according to their illnesses to examine the impact of the diseases from the clinical perspective. Data were collected and extracted from the electronic medical records of PT. Freeport Indonesia since 2008. Determination of level of multimorbidities was performed by using principal component analysis, then the clinical impact of those multimorbidities analyzed using ANOVA tests. Multimorbidities have a significant effect on length of stay (p<0.05) and polypharmacy (p<0.05). The highest need for hospitalization and medication was in the Diabetes-Malaria-Tuberculosis group compared to the other multimorbidity groups. Multimorbidities have a significant impact on length of stay and polypharmacy.
References
Agur, K., McLean, G., Hunt, K., Guthrie, B. & Mercer, S. W. (2016). How does sex influence multimorbidity? secondary analysis of a large nationally representative dataset. Int. J. Environ. Res. Public Health. 13(391), 1-12.
Alebel, A., Wondemagegn, A. T., Tesema, C., Kibret, G. D., Wagnew, F., Petrucka, P., et al. (2019). Prevalence of diabetes mellitus among tuberculosis patients in Sub-Saharan Africa: a systematic review and meta-analysis of observational studies. BMC Infectious Diseases. 19(254), 1-10.
Baker, M. A., Harries, A. D., Jeon, C. Y., Hart, J. E., Kapur, A., Lonnroth, K., et al. (2011). The impact of diabetes on tuberculosis treatment outcomes: A systematic review. BMC Medicine. 9(81), 1-15.
Baluku, J. B., Nassozi, S., Gyagenda, B., Namanda, M., Biraro, I. A., Worodria, W. et al. (2019). Prevalence of malaria and tb coinfection at a national tuberculosis treatment centre in Uganda. Journal of Tropical Medicine. 3741294, 1-7.
Casqueiro, J., Casqueiro, J., & Alves, C. (2012). Infections in patients with diabetes mellitus : a review of pathogenesis. Indian Journal of Endocrinology and Metabolism. 16(1), 27-36.
Central Bureau of Statistics. (2018). Mimika in figures 2018. Central Bureau of Statistics Mimika Regency.
Comino, E. J., Harris, M. K., Islam, F. M. D., Tran, T.D., Jalaludin, B., Jorm, L., et al. (2015). Impact of diabetes on hospital admission and length of stay among a general population aged 45 year or more: a record linkage study. BMC Health Services Research. 15(12), 1-13.
Danquah, I., Bedu-Addo, G., & Mockenhaupt, F. P. (2010). Type 2 Diabetes Mellitus and increased risk for malaria infection. Emerging Infectious Diseases. 16(10), 1601-1604.
Faurholt-Jepsen, D., Range, N., Praygod, G., Kidola, J., Fourholt-Jepsen, M., Aabye, M. G., et al. (2012). The role of diabetes co-morbidity for tuberculosis treatment outcomes: a prospective cohort study from Mwanza, Tanzania. BMC Infectious Diseases. 12(165), 1-8.
Gennaro, F. D., Marotta, C., & Antunes, M. (2019). Diabetes in active tuberculosis in low-income countries: to test or to take care?. Lancet. 7.
Indonesian Ministry of Health. (2017) Indonesian health profile in 2016. Indonesian Ministry of Health.
Kalra, S., Kalra, B., Agrawal, N. & Unnikrishnan, A. G. (2011) Understanding diabetes in patients with HIV/AIDS. BMC. Diabetology & Metabolic Syndrome. 3(2), 1-7.
Kalra, S., Khandelwal, D., Singla, R., Aggarwal, S., & Dutta, D. (2017). Malaria and Diabetes. Recent advances in endocrinology. 67(5), 810–813.
Kumar, N. P., Moideen, K., Viswanathan, V., Shruthi, B. S., Sivakumar, S., Menon, P.A., et al. (2018). Elevated levels of matrix metalloproteinases reflect severity and extent of disease in tuberculosis-diabetes co-morbidity and are predominantly reversed following standard anti-tuberculosis or metformin treatment. BMC Infectious Diseases. 18(345), 1-10.
Lynch, C. P., Gebregziabher, M., Axon, R. N., Hunt, K. E., Payne, E. & Egede, L. E. (2014). Geographic and racial/ethnic variations in patterns of multimorbidity burden in patient with type 2 diabetes. J Gen Intern Med. 30(1), 25–32.
Majumdar, A., Welkinson, E., Rinu, P. K., Maung, T. M., Bachani, D., Punia, J. S., et al. (2019). Tuberculosis-diabetes screening: how well are we doing?: a mixed-methods study from North India. PHA. 9(1), 3-10.
Mimika Regency Health Office. (2017). Mimika Regency Health Profile 2016. Mimika Regency Health Office.
Monroe, A. K., Glesby, M. J. & Brown, T, T. (2015). Diagnosing and managing diabetes in HIV-infected patients: current concepts. Clinical Infectious Diseases. 60(3), 453–462.
Murphy, C. S. & Mckay, G. A. (2013). HIV and diabetes. Diabetes Manage. 3(6), 495–503.
Nascimento, C. V. & Soares, S. M. (2019). Co-management of tuberculosis and diabetes: an integrative review. Rev Panam Salud Publica. 43, 1-9.
Paengsai, N., Jouedain, G., Chaiwarith, R., Tantraworasin, A., Bowonwatanuwong, C., Bhakeecheep, S. et al. (2018) Incidence and clinical outcomes of diabetes mellitus in HIV-infected adults in Thailand: a retrospective cohort study. BMC Public Health. 18(1079), 1-10.
Pati, S., Swain, S., Metsemakers, J., Knottneur, J. A. & Akker, M. V. D. (2017). Pattern and severity of multimorbidity among patients attending primary care settings in Odisha, India. PloS ONE. 1-19.
Pizzol, D., Gennaro, F., Chhaganlal, K. D., Fabrizio, C., Monno, L., Putoto, G., et al. (2016). Tuberculosis and diabetes: current state and future perspectives. Tropical Medicine and International Health. 21(6), 694-702.
Puth, M. T., Weckbecker, K., Schmid, M. & Munster, E. (2017). Prevalence of multimorbidity in Germany: impact of age and educational level in a cross-sectional study on 19,294 adults. BMC Public Health. 17(826), 1-7.
Restrepo, B. I. (2016) Diabetes and tuberculosis. Microbiology spectrum. 4(6).
Rodriguez-Fernandez, R., Ng, N., Susilo, D., Prawira, J., Bangs, M. J. & Amiya, R. M. (2016). The double burden of disease among mining workers in Papua, Indonesia: at the crossroads between old and new health paradigms. BMC Public Health. 16(951), 1-7.
Ronald, L. A., FitzGerald, J. M., Benedetti, A., Boivin, J., Schwartzman, K., Bartlett-Esquilant, G. et al. (2016). Predictors of hospitalization of tuberculosis patients in Montreal, Canada: a retrospective cohort study. BMC Infectious Disease. 16(679), 1-11.
Saracino. A., Nacarapa, E. A., Massinga, E. A., Martinelli, D., Scacchetti, M., Oliveira, C., et al. (2012). Prevalence and clinical features of HIV and malaria co-infection in hospitalized adults in Beira, Mozambique. Malaria Journal. 11(241), 1-8.
Schmittdiel, J. A., Raebel, M. A., Dyer, W., Xu, S., Goodrich, G.K., Schroeder, E. B., et al. (2014). Prescription medication burden in patients with newly-diagnosed diabetes: a surveillance, prevention, and management of diabetes mellitus (SUPREME-DM) study. J Am Pharm Assoc. 54(4), 374–382.
Sharma, A., Muir, R., Johnston, R., Carter, E., Bowden, G. & Wilson-Macdonald, J. (2013). Diabetes is predictive of longer hospital stay and increased rate of complications in spinal surgery in the UK. Ann R Coll Surg Engl. 95, 275–279.
Siddiqui, A. N., Khayyam, K. U. & Sharma, M. (2016). Effect of diabetes mellitus on tuberculosis treatment outcome and adverse reactions in patients receiving directly observed treatment strategy in India: a prospective study. Hindawi. 7273935, 1-11.
Silva, D. R., Muñoz-torrico, M., Duarte, R., Galvão, T., Bonini, E. H., Arbex, F. F. et al. (2018). Risk factors for tuberculosis: diabetes, smoking, alcohol use, and the use of other drugs. J Bras Pneumol. 44(2), 145-152.
Sundstrup, E., Jakobsen, M. D., Mortensen, O. S. & Andersen, L. L. (2017). Joint association of multimorbidity and work ability with risk of long-term sickness absence: a prospective cohort study with register follow-up. Scand J Work Environ Health. 43(2), 146-154.
Tripathy, J. P. (2018). Burden and risk factors of diabetes and hyperglycemia in India: findings from the Global Burden of Disease Study 2016. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy 11, 381-387.
Udoh, B. E., Iwalokun, B. A., Etukumana, E. & Amoo, J. (2019). Asymptomatic falciparum malaria and its effects on type 2 diabetes mellitus patients in Lagos, Nigeria. Saudi J Med Med Sci. 8, 32-40.
Valent, F., Tonutti, L. & Grimaldi, F. (2017). Does diabetes mellitus comorbidity affect in-hospital mortality and length of stay? analysis of administrative data in an Italian Academic Hospital. Acta Diabetol.
Wallace, E., Salisbury, C., Guthrie, B., Lewis, C., Fahey, T. & Smith, S. M. (2015). Managing patients with multimorbidity in prymary care. BMJ. 1-6.
WHO. (2017). Primary health care systems (PRIMASYS): a case study from Indonesia. World Health Organization.
Wiwanitkit, V. (2007). Primary care for diabetes in HIV-infected patients. OJHAS. 6(2), 1-5.
Wyss, K., Wångdahl, A., Vesterlund, M., Hammar, U., Dashti, S., Naucler, P. et al. (2017). Obesity and diabetes as risk factors for severe plasmodium falciparum malaria: results from a Swedish nationwide study. Clinical Infectious Diseases. 65(6), 949–958.
Alebel, A., Wondemagegn, A. T., Tesema, C., Kibret, G. D., Wagnew, F., Petrucka, P., et al. (2019). Prevalence of diabetes mellitus among tuberculosis patients in Sub-Saharan Africa: a systematic review and meta-analysis of observational studies. BMC Infectious Diseases. 19(254), 1-10.
Baker, M. A., Harries, A. D., Jeon, C. Y., Hart, J. E., Kapur, A., Lonnroth, K., et al. (2011). The impact of diabetes on tuberculosis treatment outcomes: A systematic review. BMC Medicine. 9(81), 1-15.
Baluku, J. B., Nassozi, S., Gyagenda, B., Namanda, M., Biraro, I. A., Worodria, W. et al. (2019). Prevalence of malaria and tb coinfection at a national tuberculosis treatment centre in Uganda. Journal of Tropical Medicine. 3741294, 1-7.
Casqueiro, J., Casqueiro, J., & Alves, C. (2012). Infections in patients with diabetes mellitus : a review of pathogenesis. Indian Journal of Endocrinology and Metabolism. 16(1), 27-36.
Central Bureau of Statistics. (2018). Mimika in figures 2018. Central Bureau of Statistics Mimika Regency.
Comino, E. J., Harris, M. K., Islam, F. M. D., Tran, T.D., Jalaludin, B., Jorm, L., et al. (2015). Impact of diabetes on hospital admission and length of stay among a general population aged 45 year or more: a record linkage study. BMC Health Services Research. 15(12), 1-13.
Danquah, I., Bedu-Addo, G., & Mockenhaupt, F. P. (2010). Type 2 Diabetes Mellitus and increased risk for malaria infection. Emerging Infectious Diseases. 16(10), 1601-1604.
Faurholt-Jepsen, D., Range, N., Praygod, G., Kidola, J., Fourholt-Jepsen, M., Aabye, M. G., et al. (2012). The role of diabetes co-morbidity for tuberculosis treatment outcomes: a prospective cohort study from Mwanza, Tanzania. BMC Infectious Diseases. 12(165), 1-8.
Gennaro, F. D., Marotta, C., & Antunes, M. (2019). Diabetes in active tuberculosis in low-income countries: to test or to take care?. Lancet. 7.
Indonesian Ministry of Health. (2017) Indonesian health profile in 2016. Indonesian Ministry of Health.
Kalra, S., Kalra, B., Agrawal, N. & Unnikrishnan, A. G. (2011) Understanding diabetes in patients with HIV/AIDS. BMC. Diabetology & Metabolic Syndrome. 3(2), 1-7.
Kalra, S., Khandelwal, D., Singla, R., Aggarwal, S., & Dutta, D. (2017). Malaria and Diabetes. Recent advances in endocrinology. 67(5), 810–813.
Kumar, N. P., Moideen, K., Viswanathan, V., Shruthi, B. S., Sivakumar, S., Menon, P.A., et al. (2018). Elevated levels of matrix metalloproteinases reflect severity and extent of disease in tuberculosis-diabetes co-morbidity and are predominantly reversed following standard anti-tuberculosis or metformin treatment. BMC Infectious Diseases. 18(345), 1-10.
Lynch, C. P., Gebregziabher, M., Axon, R. N., Hunt, K. E., Payne, E. & Egede, L. E. (2014). Geographic and racial/ethnic variations in patterns of multimorbidity burden in patient with type 2 diabetes. J Gen Intern Med. 30(1), 25–32.
Majumdar, A., Welkinson, E., Rinu, P. K., Maung, T. M., Bachani, D., Punia, J. S., et al. (2019). Tuberculosis-diabetes screening: how well are we doing?: a mixed-methods study from North India. PHA. 9(1), 3-10.
Mimika Regency Health Office. (2017). Mimika Regency Health Profile 2016. Mimika Regency Health Office.
Monroe, A. K., Glesby, M. J. & Brown, T, T. (2015). Diagnosing and managing diabetes in HIV-infected patients: current concepts. Clinical Infectious Diseases. 60(3), 453–462.
Murphy, C. S. & Mckay, G. A. (2013). HIV and diabetes. Diabetes Manage. 3(6), 495–503.
Nascimento, C. V. & Soares, S. M. (2019). Co-management of tuberculosis and diabetes: an integrative review. Rev Panam Salud Publica. 43, 1-9.
Paengsai, N., Jouedain, G., Chaiwarith, R., Tantraworasin, A., Bowonwatanuwong, C., Bhakeecheep, S. et al. (2018) Incidence and clinical outcomes of diabetes mellitus in HIV-infected adults in Thailand: a retrospective cohort study. BMC Public Health. 18(1079), 1-10.
Pati, S., Swain, S., Metsemakers, J., Knottneur, J. A. & Akker, M. V. D. (2017). Pattern and severity of multimorbidity among patients attending primary care settings in Odisha, India. PloS ONE. 1-19.
Pizzol, D., Gennaro, F., Chhaganlal, K. D., Fabrizio, C., Monno, L., Putoto, G., et al. (2016). Tuberculosis and diabetes: current state and future perspectives. Tropical Medicine and International Health. 21(6), 694-702.
Puth, M. T., Weckbecker, K., Schmid, M. & Munster, E. (2017). Prevalence of multimorbidity in Germany: impact of age and educational level in a cross-sectional study on 19,294 adults. BMC Public Health. 17(826), 1-7.
Restrepo, B. I. (2016) Diabetes and tuberculosis. Microbiology spectrum. 4(6).
Rodriguez-Fernandez, R., Ng, N., Susilo, D., Prawira, J., Bangs, M. J. & Amiya, R. M. (2016). The double burden of disease among mining workers in Papua, Indonesia: at the crossroads between old and new health paradigms. BMC Public Health. 16(951), 1-7.
Ronald, L. A., FitzGerald, J. M., Benedetti, A., Boivin, J., Schwartzman, K., Bartlett-Esquilant, G. et al. (2016). Predictors of hospitalization of tuberculosis patients in Montreal, Canada: a retrospective cohort study. BMC Infectious Disease. 16(679), 1-11.
Saracino. A., Nacarapa, E. A., Massinga, E. A., Martinelli, D., Scacchetti, M., Oliveira, C., et al. (2012). Prevalence and clinical features of HIV and malaria co-infection in hospitalized adults in Beira, Mozambique. Malaria Journal. 11(241), 1-8.
Schmittdiel, J. A., Raebel, M. A., Dyer, W., Xu, S., Goodrich, G.K., Schroeder, E. B., et al. (2014). Prescription medication burden in patients with newly-diagnosed diabetes: a surveillance, prevention, and management of diabetes mellitus (SUPREME-DM) study. J Am Pharm Assoc. 54(4), 374–382.
Sharma, A., Muir, R., Johnston, R., Carter, E., Bowden, G. & Wilson-Macdonald, J. (2013). Diabetes is predictive of longer hospital stay and increased rate of complications in spinal surgery in the UK. Ann R Coll Surg Engl. 95, 275–279.
Siddiqui, A. N., Khayyam, K. U. & Sharma, M. (2016). Effect of diabetes mellitus on tuberculosis treatment outcome and adverse reactions in patients receiving directly observed treatment strategy in India: a prospective study. Hindawi. 7273935, 1-11.
Silva, D. R., Muñoz-torrico, M., Duarte, R., Galvão, T., Bonini, E. H., Arbex, F. F. et al. (2018). Risk factors for tuberculosis: diabetes, smoking, alcohol use, and the use of other drugs. J Bras Pneumol. 44(2), 145-152.
Sundstrup, E., Jakobsen, M. D., Mortensen, O. S. & Andersen, L. L. (2017). Joint association of multimorbidity and work ability with risk of long-term sickness absence: a prospective cohort study with register follow-up. Scand J Work Environ Health. 43(2), 146-154.
Tripathy, J. P. (2018). Burden and risk factors of diabetes and hyperglycemia in India: findings from the Global Burden of Disease Study 2016. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy 11, 381-387.
Udoh, B. E., Iwalokun, B. A., Etukumana, E. & Amoo, J. (2019). Asymptomatic falciparum malaria and its effects on type 2 diabetes mellitus patients in Lagos, Nigeria. Saudi J Med Med Sci. 8, 32-40.
Valent, F., Tonutti, L. & Grimaldi, F. (2017). Does diabetes mellitus comorbidity affect in-hospital mortality and length of stay? analysis of administrative data in an Italian Academic Hospital. Acta Diabetol.
Wallace, E., Salisbury, C., Guthrie, B., Lewis, C., Fahey, T. & Smith, S. M. (2015). Managing patients with multimorbidity in prymary care. BMJ. 1-6.
WHO. (2017). Primary health care systems (PRIMASYS): a case study from Indonesia. World Health Organization.
Wiwanitkit, V. (2007). Primary care for diabetes in HIV-infected patients. OJHAS. 6(2), 1-5.
Wyss, K., Wångdahl, A., Vesterlund, M., Hammar, U., Dashti, S., Naucler, P. et al. (2017). Obesity and diabetes as risk factors for severe plasmodium falciparum malaria: results from a Swedish nationwide study. Clinical Infectious Diseases. 65(6), 949–958.
Published
2022-06-28
How to Cite
Ahmad, T., Saktiningsih, H., Permana, F., Sebong, P., Subronto, Y., & Ahmad, R. (2022). Length of Hospitalization and Polypharmacy in Diabetes Multimorbidity with Infectious Diseases. Indonesian Journal of Global Health Research, 4(2), 399-410. https://doi.org/10.37287/ijghr.v4i2.1195
Section
Articles
