Structured self monitoring of blood glucose in Iranian people with type 2 diabetes; A cost consequence analysis 英文参考文献.docVIP

Aghilietal.DARUJournalofPharmaceuticalSciences2012,20:32 /content/20/1/32 RESEARCH ARTICLE OpenAccess Structuredselfmonitoringofbloodglucosein Iranianpeoplewithtype2diabetes;Acost consequenceanalysis RokhsarehAghili1,MohammadEKhamseh1,MojtabaMalek1,ShahinYarahmadi2andAmirFarshchi3* Abstract Background:Self-MonitoringofBloodGlucose(SMBG)isconsideredasakeyfactorinmanagementofpeoplewith diabeteswhichisagrowingandcostdemandinghealthproblem.Thepurposeofthisstudywastoinvestigatethe effectofcomprehensivepatientmanagementusingstructuredSMBGonmetaboliccontrolaswellasitscost consequenceanalysis. Methods:Sixtysubjectswererecruitedinanobservationalstudyforaperiodof6months.Theywereprovided withtheACCU-CHEK360°Viewtooltofillinthevaluesofthe7-pointbloodglucoseprofilesinthreeconsecutive daysduringthestudyonamonthlybasis.ChangesinmetaboliccontrolwereassessedbyHbA1candlipidprofile measurementatthebeginningandattheendofthestudy.Inaddition,costconsequenceanalysiswasdone consideringdifferentlevelofhealthcareprofessionalswithorwithoutinsurancecoverage.TheAverageCost EffectivenessRatio(ACER)aswellasCostsavinganalysiswerecalculatedandcompared. Results:TheanalysisshowedsignificantreductioninHbA1cduringthe6-monthperiodinallsubjects(P=0.000). Furthermore,apositiveeffectwasobservedonlipidprofile.Thecostofendocrinologist’svisitinprivatesectorwas estimatedtobe265.76USDwhilethisfigurewas149.15USDforgeneralpractitionerinpublicsectorwithinsurance coverage.Totalcomplicationsandmortalitycostsavingwas154.8USD.ThelowestACERwascalculatedfor interventionwithgeneralpractitionerinpublicsectorwithinsurancecoverage. Conclusion:StructuredSMBGresultsinsignificantimprovementofglycemicstatus.Moreover,itismorecost savinginpublicsectorwithinsurancecoverage.Itseemsthatgeneralpractitionervisitswithinsurancecoverageis themostaffordableoptionforpeoplewithtype2diabetes. Keywords:Structuredself-monitoringofbloodglucose,Diabetes,Costanalysis Introduction There are many risk factors for development of dia- Diabetesisac