Evaluation of general practitioners' routine assessment of patients with diabetes in Tshwane, South Africa

Leslie, Kayode G; Nkombua, Lushiku

doi:10.1080/20786204.2012.10874178

Cited by 4 publications

(5 citation statements)

References 7 publications

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“…It's therefore logical to infer that patients managed by these PCPs are at high risk of progression of DM complications with resultant disability and/or death. In contrast to our observations, over 80% of PCPs routinely conducted periodic screening for diabetes complications in Sri Lanka and South Africa [10,21]. Inadequate knowledge of diabetes clinical practice guidelines (CPG) and lack of equipments may explain the observed low quality of diabetes care practices among our respondents.…”

Section: Knowledge Of Diagnostic Criteria For Diabetes and Prediabetescontrasting

confidence: 96%

“…Inadequate knowledge of diabetes clinical practice guidelines (CPG) and lack of equipments may explain the observed low quality of diabetes care practices among our respondents. A positive correlation between knowledge of diabetes CPG and better diabetes care practices among GPs has been demonstrated [12,21]. Only 20.3% of our respondents were aware of any diabetes CPG, compared to Australia and South Africa where knowledge of diabetes CPG were reported in 95.6 and 92% of general physicians respectively [14,21].…”

Section: Knowledge Of Diagnostic Criteria For Diabetes and Prediabetesmentioning

confidence: 74%

“…A positive correlation between knowledge of diabetes CPG and better diabetes care practices among GPs has been demonstrated [12,21]. Only 20.3% of our respondents were aware of any diabetes CPG, compared to Australia and South Africa where knowledge of diabetes CPG were reported in 95.6 and 92% of general physicians respectively [14,21]. It is noteworthy that absence of local diabetes management protocol was identified by our respondents as the commonest challenge they faced in the care of PLWD in their practice.…”

Section: Knowledge Of Diagnostic Criteria For Diabetes and Prediabetesmentioning

confidence: 99%

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Diabetes care knowledge and practice among primary care physicians in Southeast Nigeria: a cross-sectional study

2020

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Background: Due to the perennial shortage of diabetes specialists, primary care physicians (PCPs) constitute the largest diabetes care manpower in Nigeria. However, the competence of the PCPs to undertake this task is not known. This study was aimed at evaluating diabetes care knowledge and practice among PCPs in Southeastern part of Nigeria. Methods: This was a cross-sectional study among PCPs in Southeastern Nigeria. Diabetes care knowledge and practices were evaluated using a structured self administered questionnaire. Results: A total of 64 PCPs with mean duration of practice of 17.3 ± 11.6 years completed the study. 65.6% were in private practice and 50% attended to between 11 and 20 persons living with diabetes (PLWD) weekly. Majority (78.1%) had not participated in any diabetes training since graduation from medical school and 79.9% were not aware of any diabetes clinical practice guideline. The PCPs had adequate knowledge of classical symptoms of diabetes. However, they had very poor knowledge of glycemic thresholds for diagnosis of diabetes which was 26.6, 45.3 and 10.9% for fasting blood glucose (FBG), random blood glucose (RBG) and glycated hemoglobin (A1c) respectively. We observed serious gaps in diabetes care practice such that only 18.8% of the respondents performed foot examination on newly diagnosed PLWD while 28.1 and 39.1% provided counseling on foot care and hypoglycemia respectively. Annual comprehensive foot examination was conducted by only 12.5%, none of the physicians ever screened for microalbuminuria and only 21.9% conducted annual dilated eye examination. Majority (57.8%) rated their confidence in prescribing insulin as "low" and only 23.4% had ever prescribed outpatient insulin for type 2 diabetes in their practice. Glycemic monitoring was largely limited to FBG and only 17.2% monitored A1c. Duration of practice more than 10 years (OR 10.1; P 0.034) and non participation in diabetes training (OR 6.5; P 0.027) were significant predictors of poor diabetes care knowledge. Conclusion: Diabetes care knowledge and practice were poor among PCPs in Southeast Nigeria. There is an urgent need to improve their capacity to provide diabetes care through periodic training.

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Section: Knowledge Of Diagnostic Criteria For Diabetes and Prediabetescontrasting

confidence: 96%

Section: Knowledge Of Diagnostic Criteria For Diabetes and Prediabetesmentioning

confidence: 74%

Section: Knowledge Of Diagnostic Criteria For Diabetes and Prediabetesmentioning

confidence: 99%

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Diabetes care knowledge and practice among primary care physicians in Southeast Nigeria: a cross-sectional study

2020

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“…22,23 Evidence shows that knowledge is associated with better attitudes and practices of foot care, and should consequently bring clinical benefit – although this is not always the case, as the quality of care offered at primary healthcare (PHC) level in our settings is often unsatisfactory. 24,25 More studies need to be performed to evaluate whether clinical benefit may arise from education-targeted community programmes in comparison with the usual care provided. 25 Awareness of good foot care is essential amongst T2DM patients and health care providers to reduce the incidence of foot disease, and this would involve:…”

Section: Introductionmentioning

confidence: 99%

Awareness of diabetic foot disease amongst patients with type 2 diabetes mellitus attending the chronic outpatients department at a regional hospital in Durban, South Africa

Goie

Naidoo

2016

Afr. j. prim. health care fam. med.

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BackgroundDiabetic foot disease (DFD) is a major challenge for the healthcare system, with enormous economic consequences for people living with diabetes, their families, and society, affecting both quality of life and quality of care. The study aim was to assess the level of awareness of DFD amongst patients with type 2 diabetes mellitus (T2DM).MethodsAn observational descriptive cross-sectional study was conducted at the chronic outpatients department of a regional hospital in Durban, South Africa.ResultsTwo hundred participants with T2DM participated in the study. Ninety-one per cent of participants were either overweight or obese. Ninety-two per cent of participants had concomitant hypertension (57.5%), dyslipidaemia (26.7%) and eye disease (7.2%). Seventy-six per cent reported altered sensation in their lower limbs, and 90% reported having no previous DFD education. Only 22.2% of participants reported having examined their feet, but only when they experienced a problem. Participants achieved mediocre scores for knowledge (mean 4.45, standard deviation (s.d.) 2.201, confidence interval (CI) 4.2–4.7) and practice (mean 11.09, s.d. 2.233, CI 10.8–11.5) on diabetic foot care (DFC). Those who had a higher level of education and who were less than 65 years old had a significantly better score for previous foot care education (p <0.05).ConclusionThe study demonstrated that awareness of DFD was suboptimal, based on current DFC guidelines. To minimise the burden of DFD, improved screening and prevention programmes as well as patient education should be provided to T2DM patients, whilst maintaining an aggressive approach to risk factor modifications, footwear and identifying the at-risk foot.

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“…Therefore, a copy of the diabetes guidelines must be made available to every health staff member dealing with diabetes patients and not simply to physicians. The guidelines may directly or indirectly influence the care given by physicians to patients with diabetes (13). A number of studies have shown that the presence of guidelines is not a factor in determining physicians' knowledge and behaviour in the followup and treatment of diabetes patients and very few physicians report using them (4,6,14).…”

Section: Discussionmentioning

confidence: 99%

Compliance with and knowledge about Diabetes guidelines among physicians and nurses in Palestine

Sharif

Samara²,

Titi³

et al. 2015

East Mediterr Health J

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Guidelines for the care of patients with diabetes mellitus are believed to improve clinical practice and patient care. This study aimed to analyse the pattern of diabetes care by physicians and nurses in primary care clinics in Palestine and their self-reported compliance with the local Palestinian guidelines. Questionnaires were used to collect data from 401 participants in 3 governorates in the West Bank. In total, 46.0% of participants knew about the existence of the Palestinian guidelines and about 60% believed these were partially used; 32.7% had received training on implementation of the guidelines. Multivariate analysis showed that training on the guidelines was the only factor significantly associated with self-reported compliance with guideline use. Respondents reported high commitment to the use of the guidelines, but their attitudes and behaviour varied with time constraints, availability of the guidelines, availability of laboratory tests and training on how to apply the guidelines. ‫فلسطني‬ Connaissances et respect des recommandations sur le diabète chez des médecins et des infirmières en PalestineRÉSUMÉ Les recommandations pour les soins aux patients atteints de diabète sont réputées améliorer la pratique clinique et les soins aux patients. La présente étude visait à analyser la tendance des soins aux diabétiques dispensés par des médecins et des infirmières en établissements de soins de santé primaires en Palestine ainsi que le respect autodéclaré des recommandations locales palestiniennes. Des questionnaires ont été utilisés pour recueillir les données de 401 participants dans trois gouvernorats de la Cisjordanie. Au total, 46,0 % des participants connaissaient l'existence des recommandations palestiniennes et 60 % pensaient qu'elles étaient appliquées en partie ; 32,7 % avaient reçu une formation sur leur mise en oeuvre. Une analyse multivariée a démontré qu'une formation aux recommandations était le seul facteur significativement associé au respect autodéclaré de l'application des recommandations. Les répondants ont déclaré des niveaux d'engagement élevés concernant l'utilisation de ces recommandations, mais leurs attitudes et leur comportement variaient en fonction des contraintes de temps, de la disponibilité des recommandations, de la disponibilité des analyses de laboratoires et de la formation sur l'application des recommandations.

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Evaluation of general practitioners' routine assessment of patients with diabetes in Tshwane, South Africa

Cited by 4 publications

References 7 publications

Diabetes care knowledge and practice among primary care physicians in Southeast Nigeria: a cross-sectional study

Diabetes care knowledge and practice among primary care physicians in Southeast Nigeria: a cross-sectional study

Awareness of diabetic foot disease amongst patients with type 2 diabetes mellitus attending the chronic outpatients department at a regional hospital in Durban, South Africa

Compliance with and knowledge about Diabetes guidelines among physicians and nurses in Palestine

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