A cross-sectional analysis of the association between age and gender and  prescribed minimum benefit chronic disease list conditions among South Africans  with concomitant hypertension, diabetes and dyslipidaemia.

Johanita Burger, Martie Lubbe, Jan Serfontein, Suria Ellis

1. North-West University, Medicine Usage in South Africa (MUSA)
2. North-West University, Faculty Natural Sciences, Statistical Consultation

Abstract:
Background: Prescribed Minimum Benefit Chronic Disease List (PMB CDL) conditions are a regulated list of conditions most common to South Africa.

Objectives: To investigate the prevalence and association between PMB CDL conditions and age and gender among patients with concomitant hypertension, diabetes and dyslipidaemia.

Methods: The study population consisted of patients (n = 17 866) with a prescription containing at least one co-prescribed antilipemics, antihypertensive and antidiabetic (identified using the MIMS Desk Reference). ICD-10 codes on claims for PMB CDL conditions were counted.

Results: 39.5% of patients had a PMB CDL condition. Women had higher odds for hypothyroidism (OR 6.30, 95% CI; 5.52, 7.19, p< 0.001) and lower odds for coronary artery disease (CAD) (OR 0.63, 95% CI; 0.55, 0.72, p < 0.001) than men. In combination with hypothyroidism the odds for CAD were reversed and strongly increased; 3.54 (95% CI; 2.38, 5.25, p < 0.001). The odds for females having cardiac failure (CF) was insignificant and low (OR 0.87, 95% CI; 0.75, 1.01, p = 0.063); however combined with hypothyroidism, the odds increased to 5.35 (95% CI; 3.52, 8.13, p < 0.001).

Conclusion: Hypothyroidism was an important discriminating factor for co-morbidity in women with concomitant hypertension, diabetes and dyslipidaemia, in particular with cardiovascular disease.

Keywords:Concomitant hypertension, diabetes and dyslipidaemia, South Africa, prescribed minimum benefit chronic disease list (PMB CDL) conditions.