ORIGINAL: Health Resource Utilization among Patients with Type 2 Diabetes Mellitus In Nigeria: An Analysis from the International Diabetes Management Practice Study (IDMPS)

West Afr J Med. November 2023; 40(11): 1145-1154 PMID: 38085916

Abstract

Purpose: To assess the data on health resource utilization collected from patients with T2DM in Nigeria, within the seventh wave (2016) of the International Diabetes Management Practices Study (IDMPS).

Methods: In this cross-sectional study, adults (≥25 years) with T2DM, who had requisite diabetes treatment data and were attended by participating physicians during the two-week recruitment period, were included.

Results: Thirty-one participating physicians enrolled 304 eligible patients (mostly 40-60 years of age) with the duration of T2DM ranging from 1 to 31 years (median: 7). Only 34.2% (102/298) patients possessed health insurance and 46.8% (138/295) co-paid for medications outside the insurance. About 70.1% of patients had T2DM-related complications; 19.7% of patients were hospitalized in the past 12 months due to these complications. Altogether, 275 patients with T2DM received oral glucose-lowering drugs, with (88/275) or without (187/275) insulin. The cost of medications/strips was the reason reported for not achieving glycemic targets in ~60.0% (50/84) insulin users and 54.3% (114/210) patients self-monitoring blood glucose, respectively. Specialists in diabetes care attended to a lower number of patients/day than non-specialists (31.61±30.74 vs. 49.25±49.64). Most of the specialists (14/22; 63.6%) reported insulin use in 20%-40% patients; while non-specialists (6/9; 66.6%) reported insulin use in <20% patients.

Conclusion: In Nigeria, low insurance coverage and high out-of pocket payments for healthcare limit access to healthcare. Physicians are overburdened and medical resources trained in diabetes care seem insufficient. These findings highlight the need to formulate effective healthcare strategies for patients with T2DM.