QUALITY USE OF MEDICINES DOCX.

Running head: QUALITY USE OF MEDICINES
Quality use of medicines (QUM) in diabetes
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QUALITY USE OF MEDICINES1
Introduction
Chronic diseases constitute a significant reason for mortality and morbidity in most countries.
To reduce the burden of the most widespread chronic diseases such as diabetes, asthma,
cardiovascular diseases, and some mental health disorders, the availability of quality
medicines, superior in terms of appropriateness, safety and effectiveness are vital (Watts,
2017). Diabetes is one such significant long-term clinical condition affecting about 7.4% of
the total Australian population (Hasan et al., 2015). This paper focuses on a case study based
on diabetes and discusses the issues in the quality use of its medicines and the role of nursing
in overcoming these issues, including the required resources for the implementation,
associated benefits, and barriers.
Case scenario
X is a 58 years old male with type 2 diabetes mellitus. He was diagnosed with diabetes about
two years back. His medical history reveals obesity and excessive consumption of alcohol.
However, he quit drinking alcohol after his diagnosis of diabetes. Initially, his blood glucose
values of 6.5-7.0 mmol/L indicated borderline diabetes. He was also recommended to lose
weight of about 10 kg, but no significant action was taken. His family physician referred him
to a specialty diabetes clinic. He also demonstrates a family history of diabetes as both his
parents had diabetes. Nevertheless, he exhibits limited knowledge on the management of
diabetes.
The height of Mr. X is measured as 176 cm with a weight of about 110 kg. His observed
blood pressure is 168/100 mm Hg and a pulse rate of 86 beats/min. No evidence of peripheral
vascular disease or congestive heart failure was observed in the patient. No clinical record of
thyromegaly or retinopathy was observed. Laboratory urine tests showed a trace amount of
protein, with 1.2 mg/dl of serum creatinine and 14 mg/dl of blood urea nitrogen. The levels of
electrolytes and thyroid-stimulating hormones were normal. The patient also underwent a 24-
hour urine collection, which reveals 250mg/day of urine albumin excretion rate.
His medication dose includes Gliclazide. Gliclazide was preferred over Metformin for the
patient X as his medical history displays obesity with heavy alcohol consumption. As a result,
Metformin would put him into cardiovascular risks. Thus, Metformin was not prescribed as a
first-line drug, and instead, the doctor prescribed Gliclazide which is known for its quick
glycemic response and cardiovascular neutrality. (Chang et al., 2015).
Issues in the quality use of medicine (QUM)
With the growing incidence of diabetes mellitus worldwide, the quality of medicine and
services involved in its treatment and monitoring is not guaranteed. As in the case described
above, patient X does not comply with his proposed diabetes management program properly
which results in the progression of the disease. Non-compliance with his prescribed dose of
gliclazide can result in fluctuations in his glycemic levels and lead to events of
hypoglycemia. It is thus, essential to analyze the quality of antidiabetic medicines and the
available supplies of self-monitoring of blood glucose (SMBG) and describe their potential
impacts on the patients and the community to innovate suitable strategies for overcoming
these issues (Saraswati et al., 2019). The various issues involved in the quality use of
medicine for the patient X described above include equity of access, specifically in terms of
affordability, safety, appropriateness and efficacy of the drug and judiciousness in its use.