Publication: Assessment of glycemic control protocol (STAR) through compliance analysis amongst malaysian ICU patients
Date
2020
Authors
Razak A.A.
Abu-Samah A.
Razak N.N.A.
Jamaludin U.
Suhaimi F.
Ralib A.
Nor M.B.M.
Pretty C.
Knopp J.L.
Chase J.G.
Journal Title
Journal ISSN
Volume Title
Publisher
Dove Medical Press Ltd
Abstract
Purpose: This paper presents an assessment of an automated and personalized stochastic targeted (STAR) glycemic control protocol compliance in Malaysian intensive care unit (ICU) patients to ensure an optimized usage. Patients and Methods: STAR proposes 1�3 hours treatment based on individual insulin sensitivity variation and history of blood glucose, insulin, and nutrition. A total of 136 patients recorded data from STAR pilot trial in Malaysia (2017�quarter of 2019*) were used in the study to identify the gap between chosen administered insulin and nutrition intervention as recommended by STAR, and the real intervention performed. Results: The results show the percentage of insulin compliance increased from 2017 to first quarter of 2019* and fluctuated in feed administrations. Overall compliance amounted to 98.8% and 97.7% for administered insulin and feed, respectively. There was higher average of 17 blood glucose measurements per day than in other centres that have been using STAR, but longer intervals were selected when recommended. Control safety and performance were similar for all periods showing no obvious correlation to compliance. Conclusion: The results indicate that STAR, an automated model-based protocol is positively accepted among the Malaysian ICU clinicians to automate glycemic control and the usage can be extended to other hospitals already. Performance could be improved with several propositions. � 2020 Abdul Razak et al.
Description
Blood; Glucose; Insulin; Intensive care units; Nutrition; Patient treatment; Sensitivity analysis; Stars; Stochastic systems; Automated modeling; Blood glucose; Blood glucose measurements; Compliance analysis; First quarter; Glycemic control; Insulin sensitivity; Malaysians; Compliance control; glucose; insulin; adult; aged; Article; automation; clinical effectiveness; clinical protocol; female; glucose blood level; glycemic control; hospital patient; human; insulin sensitivity; intensive care unit; major clinical study; Malaysian; male; nutrition; patient safety; personalized medicine; pilot study; prospective study; protocol compliance; retrospective study; stochastic model