Abstract

LLINAS CASTRO, Rodolfo; ALVIS-ESTRADA, Luis  and  CASTILLO AVILA, Irma. Evaluation of the prescription of Metformin in patients with Type 2 Diabetes Mellitus in a Health Primary attention Institution in Cartagena de Indias, Colombia. Rev Clin Med Fam [online]. 2017, vol.10, n.1, pp.12-17. ISSN 2386-8201.

Objective: To evaluate the prescription of metformin (contraindication, dosage, adverse effects) for the treatment of type 2 diabetic patients, attending a low-complexity health institution in Cartagena de Indias, Colombia. Design: Descriptive study with a pharmacoepidemiological focus, specifically aimed at the field of studies on drug usage, and based on data collected from medical records of patients with type 2 diabetes. Setting: Performed in an institution of Primary Health Care in the city of Cartagena de Indias, Colombia. Participants: 331 type 2 diabetic patients, over 18 years old, who were enrolled in diabetes care program during 2013 and 2014 and who had been under supervision for at least six months. Main measurements: Appropriate prescription of metformin based on three conditions: 1) absence of contraindications for the use of the drug, 2) dose prescription according to the estimated glomerular filtration rate (GFR) and 3) prevention of gastrointestinal adverse effects. Results: 16.4 % (C.I. 95 % 12.5 % - 21.1 %) of the patients had some contraindication for the use of metformin. 27.4 % (C.I. 95 % 22.5 % - 32.9 %) were prescribed a dose inappropriate for the GFR. 54.4 % (C.I. 95 % 48.6 % - 60.1 %) were prescribed the drug inappropriately). Conclusion: Though Metformin is considered the initial first-line therapy for the management of patients with type 2 diabetes, in a high percentage of cases it is prescribed inappropriately, it is administered in spite of being contraindicated, and its dosage does not consider the GFR.

Keywords : Pharmacoepidemiology; Metformin; Dosage; Glomerular Filtration Rates.

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