Abdul Razak, Athirah and Abu-Samah, Asma and Abdul Razak, Normy Norfiza and Jamaludin, Ummu Kulthum and Suhaimi, Fatanah M. and Md Ralib, Azrina and Mat Nor, Mohd Basri and Pretty, Christopher G. and Knopp, Jennifer Launa and Chase, Geoffrey
(2020)
Assessment of glycemic control protocol (STAR)
through compliance analysis amongst Malaysian
ICU patients.
Medical Devices: Evidence and Research, 13 (1).
pp. 139-149.
ISSN 11791470
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.
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