Browsing by Author "Akande-Sholabi W"

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    Diabetes mortality and trends before 25 years of age: an analysis of the global burden of disease study 2019.
    (2019) Akande-Sholabi W
    Background Diabetes, particularly type 1 diabetes, at younger ages can be a largely preventable cause of death with the correct health care and services. We aimed to evaluate diabetes mortality and trends at ages younger than 25 years globally using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Methods We used estimates of GBD 2019 to calculate international diabetes mortality at ages younger than 25 years in 1990 and 2019. Data sources for causes of death were obtained from vital registration systems, verbal autopsies, and other surveillance systems for 1990–2019. We estimated death rates for each location using the GBD Cause of Death Ensemble model. We analysed the association of age-standardised death rates per 100 000 population with the Socio-demographic Index (SDI) and a measure of universal health coverage (UHC) and described the variability within SDI quintiles. We present estimates with their 95% uncertainty intervals. Findings In 2019, 16 300 (95% uncertainty interval 14 200 to 18 900) global deaths due to diabetes (type 1 and 2 combined) occurred in people younger than 25 years and 73·7% (68·3 to 77·4) were classified as due to type 1 diabetes. The age-standardised death rate was 0·50 (0·44 to 0·58) per 100 000 population, and 15 900 (97·5%) of these deaths occurred in low to high-middle SDI countries. The rate was 0·13 (0·12 to 0·14) per 100 000 population in the high SDI quintile, 0·60 (0·51 to 0·70) per 100 000 population in the low-middle SDI quintile, and 0·71 (0·60 to 0·86) per 100 000 population in the low SDI quintile. Within SDI quintiles, we observed large variability in rates across countries, in part explained by the extent of UHC (r²=0·62). From 1990 to 2019, age-standardised death rates decreased globally by 17·0% (–28·4 to –2·9) for all diabetes, and by 21·0% (–33·0 to –5·9) when considering only type 1 diabetes. However, the low SDI quintile had the lowest decline for both all diabetes (–13·6% [–28·4 to 3·4]) and for type 1 diabetes (–13·6% [–29·3 to 8·9]). Interpretation Decreasing diabetes mortality at ages younger than 25 years remains an important challenge, especially in low and low-middle SDI countries. Inadequate diagnosis and treatment of diabetes is likely to be major contributor to these early deaths, highlighting the urgent need to provide better access to insulin and basic diabetes education and care. This mortality metric, derived from readily available and frequently updated GBD data, can help to monitor preventable diabetes-related deaths over time globally, aligned with the UN’s Sustainable Development Targets, and serve as an indicator of the adequacy of basic diabetes care for type 1 and type 2 diabetes across nations.
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    Evaluation of physicians’ knowledge of deprescribing, deprescribing tools and assessment of factors affecting deprescribing process.
    (2023) Akande-Sholabi W
    Background Polypharmacy is a common global health concern in the older population. Deprescribing has been acknowledged as an important aspect of medication use review that helps to reduce polypharmacy, inappropriate medication uses and medication adverse events, thus ensuring medication optimization and improving health related quality of life. As physicians are primarily responsible for prescribing and monitoring of drug therapy, their perception of deprescribing and knowledge of available deprescribing tools is highly important. This study aimed to explore physicians’ knowledge of deprescribing, deprescribing tools and factors that may affect the deprescribing process. Methods This was a cross-sectional survey carried out among 70 physicians in selected units of a teaching hospital in Nigeria between May and June 2022. Social-demographic information, knowledge of deprescribing and deprescribing tools were obtained using a self-administered, semi-structured questionnaire, while barriers and enablers of medication deprescribing were assessed with modified Revised Patients’ Attitudes Towards Deprescribing (rPATD) Questionnaire. Descriptive and bivariate analyses were carried out using SPSS and α was set at p < 0.05. Results Most of the physicians (56; 80.0%) were aware of the term “deprescribing” and had good knowledge (53;75.7%) of the steps to deprescribing. However, (16; 22.9%) respondents knew of the deprescribing tools, of this, (5;31.3%) were aware of Beers criteria and STOPP/START criteria. Awareness of the term “deprescribing” was significantly associated with knowledge of deprescribing steps (p = 0.012), while knowledge of deprescribing tools was significantly associated with; awareness of the term “deprescribing” (p = 0.029), and daily encounters with older multimorbid patients (p = 0.031). Very important factor affecting physicians deprescribing decisions include benefit of the medication. The most common barrier is lack of information for a full clinical picture of the patient. Conclusion The physicians had good knowledge of the term “deprescribing” and the steps to deprescribing. Specific measures to target the barriers faced by the physicians in deprescribing medications and policies to implement physicians use of existing guidelines to facilitate their deprescribing decisions are essential.
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    Public health in practice
    (2020) Akande-Sholabi W