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Effects of Anti-diabetic Agents on Major Depressive Disorder in Type 2 Diabetic Patients
Abstracts / Research in Social and Administrative Pharmacy 8 (2012) e1–e66 for community unwillingness to have type 2 diabetes screening and to create health promotion interventions for high-risk diabetes people. Methods: A participatory action research (PAR) was performed during November 2009 until June 2010 in Watsamakkee community, Maha Sarakham Province. PAR were divided into two phases Phase 1: focus group discussion to promote community participation in diabetes screening for people aged R35 years in the community and Phase 2: focus group to create and implement 1-month health promotion interventions for risk people by the community themselves. Four outcomes for risk people on diabetes were the better in 1) clinical outcomes 2) health behaviors 3) diabetes knowledge 4) health attitude. Outcomes on before and after activities were compared by using Wilcoxon Signed ranks tests. Results: After a focus group discussion with people in community, the causes of unwillingness to receive diabetes screening and resolution were found, Phase 1, we found 71 from 242 people (29.3%) came to screen and 33 (46.5%) were the risk diabetes persons. Phase 2, people proposed three health promotion activities that willing to participate, 1) home visits by community pharmacist, 2) providing posters of diabetes symptoms and giving symptom check every week by health volunteers, and 3) broadcasting diabetes songs via local radio every morning by community leaders. After 3 activities, the highrisk people showed the increasing scores on diabetes knowledge (1.851.28 score, p!0.001), more suitable behavior (p!0.05), decreased Fasting Blood Sugar from pre-test (4.8710.03 mg/dl, p¼0.009), decreased systolic blood pressure (7.5818.85mmHg, p¼0.028). Moreover, they were satisfied in health promotion activities, had more concern and good attitude on their health. Conclusion: When people have more participated in community health promotion intervention, they have more concern on their own health.
Effects of Anti-diabetic Agents on Major Depressive Disorder in Type 2 Diabetic Patients S. Watcharathanakij1, A. Jaturapatarawong2, 1Faculty of Pharmaceutical Sciences, Ubon Ratchathani University, Ubon Ratchathani, Thailand, 2Department of Pharmacy, Warinchamrab Hospital, Ubon Ratchathani, Thailand Objectives: To identify and measure the association between anti-diabetic agents and major depressive disorder (MDD) in patients with Type 2 diabetes mellitus (DM) who received ant-diabetic agents. Methods: This retrospective cohort study used validated electronic medical records from Warinchamrab hospital. Patients diagnosed with Type 2 DM from Jan 1, 2000 to Dec 31, 2010 were identified via ICD10 code E11X whereas MDD were F32X. Patients with MDD prior to DM diagnosis were excluded. Demographic data were also retrieved from hospital database. All patients were
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followed up at least 180 days and until either they were diagnosed with MDD or the end of study period (Dec 31, 2011). Patients were also identified whether they were treated with: (1) glibenclamide, (2) metformin, and (3) glipizide. Data were analyzed by descriptive statistics and Cox proportional hazard model. Results: Of 21785.49 person-years in 3,408 Type 2 diabetic patients, 35 patients were diagnosed with MDD. Average age diagnosed with Type 2 DM were 56.69 years old. Patients who received glibenclamide were less likely to be subsequently diagnosed with MDD than those who did not receive the drug (HR¼0.417, 95%CI ¼0.202-0.859, p¼0.018). Patient who took metformin were similarly to be diagnosed with MDD as those without metformin (HR¼2.339, 95%CI ¼ 0.883-6.195, p¼0.087). No significantly statistical association between glipizide use and MDD was observed (HR¼2.194, 95%CI ¼0.770-6.252, p¼0.141). Conclusions: Patients treated with glibenclamide were less likely to be subsequently diagnosed with MDD than those without glibenclamide. Other anti-diabetic agents showed no protective effect for MDD.
Role and Model of Pharmacy School in Integrating the Health Promotion Concept into the PharmD Program: Experience from Mahasarakham University Faculty of Pharmacy S. Chaiyasong, J. Kanjanasilp, Faculty of Pharmacy, Mahasarakham University, Thailand Objectives: Evidence suggests that healthcare expenditure is increasing every year and health promotion is needed. Therefore, Thai Health Promotion Foundation supported a health promotion project in health professional schools to promote healthy people via graduated professionals. Since 2004, Mahasarakham University Faculty of Pharmacy (MSUPD) has conducted ‘Health Promotion Project’ under Pharmacy Network for Health Promotion (PNHP) to emphasize the concept of health promotion and quality use of medicines in PharmD students. This paper describes role and model of pharmacy school in promoting community health and lessons learned from the project. Methods: This paper reviewed available documents and data related to the project. Results: The concept was incorporated into all main activities and both faculties and students of MSUPD via teaching, academic services, research and student activities. With good cooperation from all boundary partners, leadership of faculty administrators and unity of all staff, it seems to be a successful story that MSUPD has integrated the concept into PharmD curriculum and routine teaching activities. Alumni pharmacists illustrated that the project facilitated them to have concept on health promotion and work with proactive healthcare to reduce and prevent health risks behaviors.
Effects of Anti-diabetic Agents on Major Depressive Disorder in Type 2 Diabetic Patients S. Watcharathanakij1, A. Jaturapatarawong2, 1Faculty of Pharmaceutical Sciences, Ubon Ratchathani University, Ubon Ratchathani, Thailand, 2Department of Pharmacy, Warinchamrab Hospital, Ubon Ratchathani, Thailand Objectives: To identify and measure the association between anti-diabetic agents and major depressive disorder (MDD) in patients with Type 2 diabetes mellitus (DM) who received ant-diabetic agents. Methods: This retrospective cohort study used validated electronic medical records from Warinchamrab hospital. Patients diagnosed with Type 2 DM from Jan 1, 2000 to Dec 31, 2010 were identified via ICD10 code E11X whereas MDD were F32X. Patients with MDD prior to DM diagnosis were excluded. Demographic data were also retrieved from hospital database. All patients were
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followed up at least 180 days and until either they were diagnosed with MDD or the end of study period (Dec 31, 2011). Patients were also identified whether they were treated with: (1) glibenclamide, (2) metformin, and (3) glipizide. Data were analyzed by descriptive statistics and Cox proportional hazard model. Results: Of 21785.49 person-years in 3,408 Type 2 diabetic patients, 35 patients were diagnosed with MDD. Average age diagnosed with Type 2 DM were 56.69 years old. Patients who received glibenclamide were less likely to be subsequently diagnosed with MDD than those who did not receive the drug (HR¼0.417, 95%CI ¼0.202-0.859, p¼0.018). Patient who took metformin were similarly to be diagnosed with MDD as those without metformin (HR¼2.339, 95%CI ¼ 0.883-6.195, p¼0.087). No significantly statistical association between glipizide use and MDD was observed (HR¼2.194, 95%CI ¼0.770-6.252, p¼0.141). Conclusions: Patients treated with glibenclamide were less likely to be subsequently diagnosed with MDD than those without glibenclamide. Other anti-diabetic agents showed no protective effect for MDD.
Role and Model of Pharmacy School in Integrating the Health Promotion Concept into the PharmD Program: Experience from Mahasarakham University Faculty of Pharmacy S. Chaiyasong, J. Kanjanasilp, Faculty of Pharmacy, Mahasarakham University, Thailand Objectives: Evidence suggests that healthcare expenditure is increasing every year and health promotion is needed. Therefore, Thai Health Promotion Foundation supported a health promotion project in health professional schools to promote healthy people via graduated professionals. Since 2004, Mahasarakham University Faculty of Pharmacy (MSUPD) has conducted ‘Health Promotion Project’ under Pharmacy Network for Health Promotion (PNHP) to emphasize the concept of health promotion and quality use of medicines in PharmD students. This paper describes role and model of pharmacy school in promoting community health and lessons learned from the project. Methods: This paper reviewed available documents and data related to the project. Results: The concept was incorporated into all main activities and both faculties and students of MSUPD via teaching, academic services, research and student activities. With good cooperation from all boundary partners, leadership of faculty administrators and unity of all staff, it seems to be a successful story that MSUPD has integrated the concept into PharmD curriculum and routine teaching activities. Alumni pharmacists illustrated that the project facilitated them to have concept on health promotion and work with proactive healthcare to reduce and prevent health risks behaviors.