Adherence to Guidelines and Its Effect on Glycemic Control During the Management of Type 2 Diabetes in Turkey: The ADMIRE Study

Adherence to the National Guidelines for Follow-Up Protocol in Subjects with Type 2 Diabetes Mellitus in Greece: The GLANCE Study

“…Physican adherence was highest for the laboratory evaluation domain (48%), followed by the complete medical history domain (46%) and then the physical examination domain (31%). Slightly higher physician adherence rates were reported in the ADMIRE (Adherence of physicians to guidelines for the management of type 2 diabetes) study [18,24], which had a similar design as the GLANCE study and evaluated physician adherence to the Turkish diabetes guidelines PFP in 1790 patients [18,25]. The Turkish and Greek PFP have several items in common, and the former separates the items into the same three domains as examined in the GLANCE study [20].…”

“…The Turkish and Greek PFP have several items in common, and the former separates the items into the same three domains as examined in the GLANCE study [20]. In ADMIRE, the mean overall adherence score for the 12 months prior to study enrolment was 70%, with the scores (on 10-point scales) being 8.8 for the 5-item medical history domain, 6.3 for the 3-item laboratory evaluation domain, and 5.9 for the 10-item physical examination domain [18]. The difference in the adherence scores between the two studies may be partly due to all 62 items of the HDA PFP being considered in the GLANCE study, whereas only 18 of the 39 items of the Turkish guidelines were evaluated in the ADMIRE study [18,24,25].…”

“…In ADMIRE, the mean overall adherence score for the 12 months prior to study enrolment was 70%, with the scores (on 10-point scales) being 8.8 for the 5-item medical history domain, 6.3 for the 3-item laboratory evaluation domain, and 5.9 for the 10-item physical examination domain [18]. The difference in the adherence scores between the two studies may be partly due to all 62 items of the HDA PFP being considered in the GLANCE study, whereas only 18 of the 39 items of the Turkish guidelines were evaluated in the ADMIRE study [18,24,25]. Additionally, the higher physician adherence rate in ADMIRE could, at least partly, be attributed some items of the PFP examined possibly being among those more commonly performed by physicians.…”

“…In general, the achievement of therapeutic targets in T2DM is not optimal [11,12]; this also holds true for Greece [13][14][15][16], where the achievement rates of glycated haemoglobin (HbA 1c ) and BP targets have been reported to be 53 and 27%, respectively [15]. Achievement of therapeutic targets may be linked to adherence to diabetes standards of medical care recommendations [17][18][19]. In Greece, the Hellenic Diabetes Association (HDA) issues and regularly updates practice guidelines for the management and care of persons with diabetes [20], which are aligned with the guidelines of the American Diabetes Association (ADA) and European Association for the Study of Diabetes (EASD) [21][22][23].…”

Cost Effectiveness of Insulin Glargine versus Neutral Protamin Hagedorn Insulin in the Treatment of Type 2 Diabetes Patients in Turkey

“…11 Indeed, the adherence of Turkish clinicians to the SEMT guidelines has been found inadequate, with negative impact on glycaemic control. 12 Delays in the progression of treatment in the management of T2DM can result in extended periods of poor glycaemic control, which ultimately increase the risk of micro-and macro-vascular complications. 13,14 Despite the efficacy of insulin therapy, concerns regarding the administration of injections, hypoglycaemia and weight gain 15 fuel physician and patient reluctance to initiate insulin therapy.…”