124 32nd World Congress of Internal Medicine (October 24-28, 2014) WCIM 2014
PS 0288 Nutrition
Prevalence of Lifestyle Risk Factors among Diabetic Pa- tients at Kenyatta National Hospital (Nairobi, Kenya)
Njeri Rahab MBUGUA1, Elizabeth Ann BUKUSI2, Dismas Ongore ONGORE3 Kenya Medical Research Institute, Kenya1, Nairobi University, Kenya2, Kenyatta National Hospital, Kenya3 Background: Modifi cation of lifestyle risk factors like exercise, diet, alcoholism and smoking is important in management of diabetes (5,6). Urbanisation in Kenya is likely to affect adherence to lifestyle changes. No studies have looked at lifestyle adherence among diabetes patients in Kenya.
Methods: This descriptive cross sectional survey assessed the prevalence of lifestyle risk factors among Kenyatta National Hospital diabetic clinic patients and how this relates to diabetes control. A structured questionnaire was used to collect socio de- mographic as well as biophysical and biochemical data (weight, height, blood pressure
& random blood sugar) from each patient.
Results: Majority of the respondents (85%) consume less than the WHO recommend- ed fi ve servings of fruits and vegetables per day and a signifi cant number (42%) is not involved in any type of moderate intensity physical exercise. Forty seven percent of those who exercise do so for less than 5 days in a week. The prevalence of alco- hol consumption (6.4%) and smoking (3%) is low. Moderate physical activity and consumption of fruits and vegetables was associated with better blood sugar control while gender, level of education and working statu’s were found to be important fac- tors in lifestyle practices.
Conclusions: Lifestyle modifi cation needs to be emphasized in diabetes management.
There is need for a population-based studyon the prevalence of lifestyle risk factors for diabetes and other non-communicable diseases.
PS 0289 Geriatrics
A Comparative Analysis of the 8-Item Morisky Med- ication Adherence Scale Before and After a Pharma- ceutical Care Program among Chronically Hypertensive Elderly Patients
Peter QUILALA1, Yssa AGAPITA1, Janel BERBERABE1, Kristine CRUZ1, Dominique DELA CRUZ1, Janielle Kristine GO1, Katlyn HUNG1, Edelyn IGNO1, Patrick JUACALLA1, Marrione LANZONA1, Ryan LAO1, Donna LEDESMA1, Lichelle LIM1, Thomas MIGUEL1, Angel PANALIGAN1, Jefferson TAN1, Quennie YU1
University of Santo Tomas, Philippines1
Background: Problems with non-adherence to treatments is one of the risk factors that highly contribute to a total reduction in the control of blood pressure. Adher- ence to prescribed medication regimens is diffi cult for all patients and particularly chal-lenging for the elderly.
Methods: Data were collected from chronically hypertensive geriatric respondents of St. John’s Home for the Elders Quiapo, Manila, Philippines between September 7, 2013 and December 8, 2013. The geriatric patients were subjected to the MMAS-8 and measurement of blood pressure before and few weeks after the pharmaceutical intervention. The data also include their age, gender, height, weight, and visual acuity.
Data from the MMAS-8 were analyzed and scores of more than 2 were recorded as low adherence, 1 or 2 as medium adherence and a score of 0 as high adherence.
Results: 83.33% of the patients were adherent (MMAS-8 = 0) and 16.67% were non-adherent (MMAS-8 >2). One out of three (33.33%) patients with uncontrolled BP did not adhere to antihypertensive treatment, while 88.89% of patients with con- trolled BP were adherent.
Conclusion: The effect of the intervention to BP control and medication adherence was found to be inconclusive since a very small population was involved in the study.
The medication adherence rate was found to be high among patients after an inter- vention. A poor adherence rate was found to affect blood pressure control. The effect of the intervention programs is necessary to improve adherence and, in turn, to im- prove blood pressure control.
PS 0290 Geriatrics
Spirituality in Successful Aging: Data from the Singa- pore Successful Aging Study
Rajeev KUMAR1
Australian National University, Australia1
Background: Successful aging (SA) was fi rst defi ned by Rowe and Kahn as avoidance of disease and disability, maintenance of physical and cognitive function and engage- ment in social and productive activities. More recently, spirituality has been recognized as an important contributor to SA. Unlike religiosity, spirituality has a more experien- tial and existential focus upon an individual’s internalized faith, value and beliefs and their infl uence upon daily behaviour. Most of the existing studies on spirituality and SA have been performed outside Asia. The aim of this study was to examine the role of spirituality in SA in a multiethnic community in Singapore. We hypothesised that spirituality is positively correlated with attributes of SA (resilience, better cognitive functions, optimism, mastery, satisfaction with life, and self-rated SA).
Methods: Singapore Successful Aging Study (SSOSA) was a sub-study added to the second wave of a large population-based study of aging and health (Singapore Longitudinal Aging Studies-SLAS). Cross-sectional survey of 489 community living Singaporeans aged 65 years and older. We collected data on sociodemographic char- acteristics, and measures of the SA attributes using standardized culturally appropriate instruments.
Results: Our sample comprised Chinese (85%), Malay (10%), and Indians (5%). On hierarchical multiple linear regression analysis, spirituality was signifi cantly correlated with female gender, ethnicity (Malays and Indians), resilience, optimism, and better cognitive status after controlling for age, marital status, education, income, depres- sion, and chronic medical conditions.
Conclusions: Spirituality is one of the major determinants in the attributes of SA- optimism, resilience, and better cognitive function. More importantly, gender and ethnicity play a key role in the expression of these attributes.
PS 0291 Geriatrics
Post-Operative Blood Loss in Hip-Fracture Patients in a Regional Australian Orthogeriatric Unit
Vinesh APPADURAI1, Joyita BHATTACHARYA1, Someswara ATTOTI1 Sunshine Coast Hospital and Health Service, Australia1, University of Queensland, Australia2 Background: Blood loss post hip fracture surgery in an elderly population is an independent risk factor for morbidity and mortality. There is limited data available addressing the haemoglobin drops post hip fracture procedures. To determine the haemoglobin drop in elderly patients undergoing hip fracture procedures in a regional Australian orthogeriatric unit.
Methods: A retrospective cohort analysis over a 3 month period in an established orthogeriatric service was performed that reviewed pre-operative, post-operative and nadir haemoglobin levels in consecutive elderly patients admitted to the unit. Data on commencement of VTE prophylaxis and wound complications, such as ooze and hae- matoma formation, were also collected.
Results: Of 50 patients analysed, 78% (39/50) were female and the mean age of patients was 84.1 years (60-98 years). 46% (23/50) were on antiplatelets or antico- agulants prior to surgery. Of the hip fractures 42% were Subcapital fractures, 12%
subtrochanteric fractures, 46% intertrochanteric fractures and 4% were peripros- thetic fractures. The mean haemoglobin pre-operatively was 124.42 g/L (88-167g/L), the fi rst day post-operatively 98.14 g/L (68-137g/L) and the mean nadir haemoglobin value was 89.86 g/L (68-120g/L). The average day of VTE prophylaxis commencement was 1.65 (1-5 days). The average day with a nadir haemoglobin value was 2.48 (1-7 days). 24% (12/50) patients experienced wound ooze and 2% (1/50) experienced wound haematoma. Of the patients only 22% had any documentation of amount of intraoperative blood loss.
Conclusions: Haemoglobin levels continue to fall for several days post-operatively and documentation of blood loss intraoperatively may not be a reliable indicator of the gross volume of blood loss. Regular monitoring of haemoglobin levels in this group of patients for days post-operatively is important to avoid complications of anaemia.
The incidence of wound ooze and haematoma was low in the analysed population.
