30% of diabetes mellitus, 70% of hypertension patients are uncontrolled

Expert assumes that generic drugs might have caused patients’ diseases to be poorly controlled but this is yet to be supported by evidence

by AZALEA AZUAR / pic by BLOOMBERG

THIRTY percent of diabetes mellitus patients and 70% of hypertension patients are uncontrolled over the past 15 years, according to the data from the National Heart Institute (IJN).

IJN clinical research director Datuk Dr Suhaimi Kadiman said the statistics do not necessarily mean that their patients are not compliant with their medicine but rather it shows how serious this problem is.

“When we have patients that are not properly in control of their diabetes mellitus and hypertension, this will translate into complications to the treatment modality.

“There are multiple factors that are affecting compliance and they are complex factors,” he said during the “Digital Health: How Tech Can Help Patients” forum today.

Such factors can be patient factors, socioeconomic factors and whether the medication is fully subsidised, partially subsidised or poorly funded from out of pocket.

Dr Suhaimi assumes that generic drugs might have caused patients’ diseases to be poorly controlled but this is yet to be supported by evidence.

“As far as IJN is concerned, from what I know, we provide original drugs for initiation and in fact, our cardiologist is extremely aggressive in managing the patients.

“But having said that, there are also multiple other factors that contribute towards quality control hypertension, this might be specific to the disease itself.”

Dr Suhaimi believes that awareness of keeping healthy should start from a young age (as early as their 20s) as it is still possible to induce hypertension although it is very rare.

On the other hand, IJN senior consultant cardiothoracic surgeon Prof Datuk Seri Dr Azhari Yakub explained how important it is for patients to be compliant with their health as it can enable them to save healthcare costs.

“If the patient is not compliant, it will lead to a 200% increase in hospitalisation and 300% increase in healthcare costs. So that is a huge saving on costs,” he said.

Dr Azhari explained that if a patient suffers from a stroke, the whole family has to take care of them and fork out their money.

Unfortunately, he observed that not many patients see the long-term effects of taking care of their health as there are no symptoms in the early stages of hypertension and diabetes.

Therefore, IJN plans to use human behaviour which is incentivising the patient so would encourage them to manage their diseases.

“When looking at what’s working in IJN, my experience as a clinician is this education and integral in individualisation and here we can leverage technology individualised information then empower how they feel.”

Previously one of the ideas was to use messages to remind them of their exercises and follow-ups but with technology, things have improved.

CaringUp CEO Pervai Gul added that there is no running across countries which are more likely to be compliant with their health.

However, he indicated that developed countries have less than 50% compliance while the data in developing countries are still very limited.

“We already have 6.4 million hypertension patients in Malaysia and more than two people here have diabetes so there’s a big gap in the middle of this prevention and treatment.

“We can’t prevent that anymore in the people who already have that, and nobody’s taking care of those people,” he said.

Therefore, Gul developed CaringUp which can be used by everybody who is suffering from chronic diseases while their family members can also monitor them through this app.

Such features include allowing the patients to key in their heart rate and blood pressure while their doctors and physicians have access to that too.

“The app is smart enough to trigger certain events or different measurements which are too high and the non-compliance is too high.

“That trigger can be to the family members and also their physicians who can intervene early to avoid any untoward incident,” he said.

The app is free to use but those who want to enjoy cash rewards can subscribe to it. Patients who are also concerned with their privacy should also be assured that CaringUp does not have access to their data and only those who have the consent such as other family members and doctors can access them.

Over the last three months, CaringUp has had a total of 30,000 users not only from Malaysia but also internationally.

“We have a lot of data in Indonesia and South-East Asian countries, these countries us, given the developed countries are using it and I think it goes back to the way we approach this problem.

“We involve the family in the care sector, the family is getting incentivised to take care of patients, family members who have chronic diseases, so that helps.”