(1) Objective: To assess the reliability and validity of the simplified Chinese version of the brief Diabetes Quality of Life (DQoL) questionnaire in measuring health-related quality of life (HRQoL) in Chinese type 2 diabetes (T2D) patients. (2) Methods: A cross-sectional validation study including 277 patients was conducted at a tertiary hospital in Shanghai, China during April–May, 2018. The English brief DQoL was forward and back-translated into simplified Chinese. The expert interview, exploratory factor analysis (EFA), and Spearman correlation with the 5-level version of EuroQoL-5 (EQ-5D-5L) were employed to establish its validity. The internal reliability was assessed by Cronbach’s alpha. Participants were also stratified into subgroups to evaluate if the Chinese brief DQoL had more test effectiveness in a specific subpopulation. (3) Results: No items were removed from the original English brief DQoL based on the results of factor analysis and expert interview. The Spearman coefficient revealed a low-moderate inverse correlation between DQoL and EQ-5D-5L index and visual analogue scale (VAS), respectively (ρ1 = −0.364, p < 0.0001; ρ2 = −0.514, p < 0.0001). The Cronbach’s alpha coefficient of the final scale was 0.731. (4) Conclusions: The simplified Chinese version of the brief DQoL questionnaire showed reasonable reliability and validity, suggesting its potential appropriateness for evaluating quality of life in Chinese T2D patients. More future efforts should be made to generalize the application of the findings.
Background: Evidence is lacking on risk factors for frailty and prefrailty and their relationship with self-management behaviors in patients ≥40 years of age with type 2 diabetes. Methods: Participants were selected as a cross-sectional cohort at five communities in Shanghai, China during January–March 2021. The modified FRAIL scale and the Summary of Diabetes Self-Care Activities (SDSCA) measure were used. Results: Of the 558 participants, 10.2% were classified as frailty and 34.1% as prefrailty. The prevalence of frailty was higher in males than in females (p = 0.009), whereas females were associated with higher odds of prefrailty (aOR 1.67, 95% CI [1.08–2.60]). Multimorbidity, ≥3 chronic diseases, and hospitalization in the past year were considered risk factors for both frailty and prefrailty. Each point earned on SDSCA and physical activity were associated with lower odds of frailty (aOR 0.95, 95% CI [0.92–0.98]) and prefrailty (aOR 0.52, 95% CI [0.31–0.85]), respectively. Frail participants performed significantly worse self-care practice than prefrail and non-frail ones, especially on diet, physical activity, and medication adherence (p < 0.001). Conclusions: Frail patients ≥40 years of age with type 2 diabetes reported poorer self-care performance. Further interventional studies are warranted to clarify their causal relationship.
Objectives To describe the development of pharmaceutical retail market and community pharmacists in mainland China and identify challenges from both government and business perspectives. Design A retrospective cross-sectional study. Setting Community pharmacies providing primary care in mainland China. Participants Community pharmacies and community pharmacists in all 31 provincial units in mainland China registered in the National Medical Products Administration during 2014–2020. Number of community pharmacies ranged from 433 529 (2014) to 553 892 (2020). Number of community pharmacists ranged from 129 895 (2014) to 541 264 (2020). Primary and secondary outcome measures Changes in pharmaceutical retail market and accessibility of community pharmacists over the study period. We also examined the qualification of pharmacists and regional differences. Results During 2014–2020, the total number of retail companies and pharmacies increased by 47.6% and 27.4%, respectively. The national retail chain rate boosted from 39.4% to 56.5%, and average number of stores per company increased from 40.2 to 49.7. The number of community pharmacists rose by 316.7%. Regarding accessibility, number of pharmacy stores per 10 000 inhabitants increased from 3.2 to 3.9; the average number of pharmacists per store and per 10 000 residents rose from 0.30 to 0.98 and from 0.95 to 3.83. However, the proportion holding a postgraduate or bachelor’s degree dropped to one-third. Pharmacy resources were unevenly distributed across the country. Correlations were observed between economic indicators and number of pharmacy stores and pharmacists (p<0.05). Conclusions In general, the accessibility and centralisation of retail pharmacies in China have shown a steady growth with a sign of regional disparities. The availability of community pharmacists has increased significantly, although with an unreasonable composition of academic qualifications and a shortage of personnel. Further efforts are necessary to provide sufficient pharmacy resources for community settings and resolve regional disparities.
17 October 2024 in British Journal of Clinical Pharmacology
Diabetic diarrhea is one of the chronic complications of diabetes mellitus, which belongs to one kind of gastrointestinal autonomic neuropathy, and can seriously affect the quality of life of patients. In recent years, Traditional Chinese medicine has achieved more satisfactory efficacy in the treatment of diabetic diarrhea. In addition to the treatment of Chinese herbal medicine, acupuncture, acupoint plasters and other Chinese medicine special therapies can significantly improve the clinical symptoms of diabetic diarrhea patients and improve the quality of life. This article mainly summarizes the treatment of Chinese medicine, in order to provide new ideas for the treatment of such diseases.
Background: Atherosclerotic cardiovascular disease (ASCVD) imposes a substantial clinical and economic burden in China. Despite maximally tolerated statin therapy, many patients fail to achieve recommended low-density lipoprotein cholesterol (LDL-C) targets. Inclisiran, a novel small interfering ribonucleic acid (siRNA) therapy, provides sustained LDL-C reduction, but its economic value under the Chinese healthcare system remains uncertain. Objective: To evaluate the cost-effectiveness of inclisiran when added to standard lipid-lowering therapy for patients with ASCVD in China. Methods: A Markov cohort multistate-transition model was developed from the perspective of the Chinese healthcare system, using a one-year cycle length and a lifetime horizon. Clinical inputs, costs, and utilities were derived from published literature and clinical trials. Both costs and outcomes were discounted at 4.5% annually. The primary result of the economic evaluation was the incremental cost-effectiveness ratio (ICER), with inclisiran considered cost-effective if the ICER was below the willingness-to-pay (WTP) threshold of CNY 191,498 per quality-adjusted life year (QALY), equivalent to two times China’s per capita gross domestic product in 2024. One-way and probabilistic sensitivity analyses were conducted to assess model uncertainty. Results: Compared with statin therapy alone, inclisiran added to statin therapy yielded an additional 0.41 QALYs and incurred incremental costs of CNY 58,321.35, resulting in an ICER of CNY 143,044.57/QALY, which is well below the WTP threshold. One-way sensitivity analyses showed that the mortality reduction effect, discount rate, and inclisiran price were the main drivers of model outcomes; however, inclisiran remained cost-effective across all tested scenarios. Probabilistic sensitivity analysis showed a 95.1% probability that inclisiran is cost-effective at the current price. Conclusions: At its current negotiated price of CNY 2,790 per dose, inclisiran added to standard therapy is cost-effective for patients with ASCVD in China.
About Me
Clinical Pharmacy; Clinical Drug Evaluation;
Pharmaceutical Affairs; Pharmaceutical Administration and Regulation.
Clinical Pharmacy; Clinical Drug Evaluation;
Pharmaceutical Affairs; Pharmaceutical Administration and Regulation.