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Andersen TH, Marcussen TM, Nørgaard O. Information needs for GPs on type 2 diabetes in Western countries: a systematic review. Br J Gen Pract 2024:BJGP.2023.0531. [PMID: 38429111 DOI: 10.3399/bjgp.2023.0531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 02/26/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Most people with type 2 diabetes receive treatment in primary care by GPs who are not specialised in diabetes. Thus, it is important to uncover the most essential information needs regarding type 2 diabetes in general practice. AIM To identify information needs related to type 2 diabetes for GPs. DESIGN AND SETTING Systematic review focused on literature relating to Western countries. METHOD MEDLINE, Embase, PsycInfo and CINAHL were searched from inception to January 2024. Two researchers conducted the selection process, and citation searches were performed to identify any relevant articles missed by the database search. Quality appraisal was conducted with the Mixed Methods Appraisal Tool. Meaning units were coded individually, grouped into categories, and then studies were summarised within the context of these categories using narrative synthesis. An evidence map was created to highlight research gaps. RESULTS Thirty-nine included studies revealed eight main categories and 36 subcategories of information needs. Categories were organised into a comprehensive hierarchical model of information needs, suggesting 'Knowledge of guidelines' and 'Reasons for referral' as general information needs alongside more specific needs on 'Medication', 'Management', 'Complications', 'Diagnosis', 'Risk factors', and 'Screening for diabetes'. The evidence map provides readers with the opportunity to explore the characteristics of the included studies in detail. CONCLUSION This systematic review provides GPs, policymakers, and researchers with a hierarchical model of information and educational needs for GPs, and an evidence map showing gaps in the current literature. Information needs about clinical guidelines and reasons for referral to specialised care overlapped with needs for more specific information.
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Affiliation(s)
- Tue Helms Andersen
- Danish Diabetes Knowledge Center, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Thomas Møller Marcussen
- Danish Diabetes Knowledge Center, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Ole Nørgaard
- Danish Diabetes Knowledge Center, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark
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Haghighinejad H, Malekpour F, Jooya P. Evaluation of the knowledge and practice of family physicians in the management of diabetes mellitus type 2 in Iran. BMC PRIMARY CARE 2023; 24:222. [PMID: 37891459 PMCID: PMC10612364 DOI: 10.1186/s12875-023-02183-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 10/13/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND The increasing prevalence and occurrence of type 2 diabetes has made it a widespread epidemic. Being the first line of care, family doctors can play an essential role in this field. The knowledge of these doctors about how to deal with the prevention, diagnosis, and correct treatment of patients is fundamental in reducing the burden of this disease in the community. In this study, we decided to evaluate the knowledge and practice of family doctors in Shiraz-Iran and its related factors in managing Diabetes. METHOD This analytical cross-sectional study was conducted among family doctors of two primary healthcare centers, Shahadai Wal-Fajr Health Center and the Enghlab Health Center in Shiraz, Iran, from March 2021 to August 2021. A researcher-designed diabetes questionnaire consisting of 21 items and a data collection form including demographic information and other related factors was used in this study. An interviewer asked the questions from participants at their workplace and completed the questionnaires. The data were analyzed by SPSS-20 software. A linear regression test was used to investigate the factors affecting the questionnaire score. A one-way ANOVA test was used to compare questionnaire scores among multiple groups. RESULTS On average, the participants obtained 62.5% of the total score. The average scores for each question in the screening, the diagnosis, and the treatment sections were 0.5 ± 0.28, 0.65 ± 0.2, and 0.66 ± 0.17, respectively. Physicians' knowledge about the blood sugar threshold for diagnosing Diabetes was suboptimal, and 81.9, 47, 43 correctly mentioned the FBS, 2hrpp BS, and HbA1c threshold, respectively. Although 95% knew the first line medication but 33.6% prescribed 2nd or 3rd medication for DM treatment. Only 43% knew the goal of therapy. Sixty-three doctors (42%) have not registered any referrals for newly diagnosed uncomplicated diabetic patients, and 37.6% referred these new DM cases to an internist or endocrinologist at the first visit. Microvascular complication screening, such as testing for microalbuminuria and ophthalmologist consultation reported by 32. 89% and 8% of physicians, respectively. Years since graduation was the determining factor of the knowledge level of doctors in this study. Regarding the preferred education method, most participants selected the workshop method as the preferred training method. Virtual education was ranked as the second preferred educational method. CONCLUSION The knowledge and practice of general family doctors were lower than the optimal level in diabetes screening, diagnosis, and treatment. In the treatment of patients, the knowledge of most of the physicians was appropriate in the early stages of treatment, such as determining the time to start the medication and the first line of treatment, but in the follow-up and more advanced treatment, the knowledge and performance of the doctors were less than expected. They prefer to refer patients to higher levels in the healthcare system. Recently graduated physicians had better knowledge and approach to DM management. Therefore, effective periodic training should be conducted as soon as possible to address this pitfall and improve the quality of care. Workshops and virtual education were the most preferred education methods from the participants' points of view. So, it is suggested that these methods be used as the first training methods. Implementing the specialty training program for family medicine (which has been started in our country for a few years) is the best final solution. In addition, A clinical guideline should be designed for family physicians highlighting these physicians' roles in the management of Diabetes.
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Affiliation(s)
- Hourvash Haghighinejad
- Department of Family Medicine, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Fatemeh Malekpour
- Department of Family Medicine, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parisa Jooya
- Department of Family Medicine, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
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Alharbi NS, Alanazi MA. Perceptions of health care professionals towards clinical practice guidelines: The case of Diabetes Mellitus in Saudi Arabia. Prim Care Diabetes 2020; 14:605-609. [PMID: 32057724 DOI: 10.1016/j.pcd.2020.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 01/24/2020] [Accepted: 02/03/2020] [Indexed: 01/25/2023]
Abstract
BACKGROUND Clinical practice guidelines are developed by healthcare policy makers and disseminated to practitioners in order to minimize practice variations and to improve the quality of care. Problems arise when there is a sole reliance on passive dissemination strategies such as mailing or publishing the guidelines, as these approaches do not usually lead to the adoption. OBJECTIVE This study aims to explore the perspectives of the health care professionals toward the Saudi National Diabetes Guidelines in terms of awareness, adherence and their preferred dissemination and implementation strategies of the guideline. METHOD A cross-sectional survey was conducted among physicians and nurses working in twenty primary health care centers in the city of Riyadh between February and March 2019. RESULTS Nearly half of the total 179 respondents reported that they were unaware of the guidelines (49.1%), and 92% of the remaining 91 participants who were aware of the guideline reported that they had first heard about it through their official mail. The mean scores ranked according to the most preferred methods for disseminating and implementing the diabetes guidelines were as follows: via reminder systems 4.35±0.74, financial incentives 4.33±0.65, and audit and feedback 4.27±0.58. On the other hand, the least favorable strategies were traditional education 3.79±0.96 and the distribution of the guideline by mail 3.13±0.95. CONCLUSION The level of awareness of the diabetes guidelines among the primary health care professionals was suboptimal. This was more likely due to the Ministry of Health's reliance on passive implementation strategies. In order to have the guidelines translated into clinical practice, active and targeted implementation strategies such as reminder systems, audit and feedback must be considered by the Saudi health policy makers.
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Affiliation(s)
- Nouf Sahal Alharbi
- Department of Health Sciences, Collage of Applied Studies and Community Service, King Saud University, Riyadh, Saudi Arabia
| | - Musaad Alnashmi Alanazi
- Department of hospital and health administration, Collage of Business Administration, King Saud University, Saudi Arabia.
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Abstract
BACKGROUND Diabetes mellitus is a major global threat to public health. Reducing the daily obstacles of coping with the disease for patients with diabetes may improve management. PURPOSE The aim of this study was to investigate daily obstacles to coping with Type 2 diabetes mellitus (T2DM) and related factors. METHODS A descriptive and cross-sectional design was used. Data were collected from 186 patients with T2DM who were hospitalized in an endocrinology clinic in Turkey. The Hospital Anxiety and Depression Scale and the Diabetes Obstacles Questionnaire were used to collect data. Multiple linear regression analysis was performed to explore the predictors of obstacles to coping in patients with T2DM. RESULTS The highest mean score was achieved on the obstacles to coping with diabetes (2.57 ± 3.78) among the subscales of the Diabetes Obstacles Questionnaire. After regression analysis, level of treatment compliance was identified as the most significant predictor (β = .289, p < .001). Anxiety, depression, smoking status, and highest level of education were also identified as significant predictors. CONCLUSIONS On the basis of these results, nurses should plan and implement interventions to improve treatment compliance and assist patients to overcome obstacles to disease management. Moreover, patient anxiety, depression, and lifestyle behaviors should be addressed.
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Chikani U, Bisi-Onyemaechi A, Ogugua C, Ugege O, Mbanefo N, Chime P. Childhood diabetes in a developing country; How much knowledge can the clinical medical students offer? NIGERIAN JOURNAL OF MEDICINE 2020. [DOI: 10.4103/njm.njm_130_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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Radwan M, Akbari Sari A, Rashidian A, Takian A, Abou-Dagga S, Elsous A. Attitudes of Palestinian Health-Care Professionals in Gaza to Clinical Practice Guideline for Diagnosis and Treatment of Diabetes Mellitus. Front Endocrinol (Lausanne) 2017; 8:288. [PMID: 29163359 PMCID: PMC5671658 DOI: 10.3389/fendo.2017.00288] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Accepted: 10/11/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Despite the huge numbers of the internationally produced and implemented Clinical Practice Guidelines (CPGs), the compliance with them is still low in health care. This study aimed at assessing the attitudes of Palestinian health-care professionals toward the most perceived factors influencing the adherence to the CPG for Diabetes Mellitus in the Primary Health-care centers of the Ministry of Health (PHC-MoH) and the Primary Health-care centers of the United Nations Relief and Works Agency for Palestine Refugees (PHC-UNRWA) using a validated questionnaire. METHODS A cross-sectional design was employed with a census sample of all Palestinian family doctors and nurses (n = 323). The Cabana theoretical framework was used to develop a study questionnaire. A cross cultural adaptation framework was followed to develop the Arabic version questionnaire. The psychometric properties of Arabic version were finally assessed. RESULTS The Arabic version questionnaire showed a good construct validity and internal consistency reliability. The overall adherence level to the diabetic guideline was disappointingly suboptimal 51.5% (47.3% in the PHC-MoH and 55.5% in the PHC-UNRWA) P = 0.000. The most frequently perceived barriers in the PHC-MoH were lack of incentives, lack of resources, and lack of guideline trustworthiness, whereas the lack of time and the lack of guideline trustworthiness were the most prominent barriers in the PHC-UNRWA. In spite of the lack of trustworthiness of the diabetic guideline, most respondents in both settings had a positive attitude toward guidelines in general, but this attitude was not a predictor of guideline adherence. CONCLUSION The good validity and reliability of our questionnaire can provide support for the accuracy of our findings. Multifaceted implementation strategies targeting the main barriers elicited from this study are required for addressing the lack of incentives, organizational resources, lack of confidence in the guideline, and time constraints.
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Affiliation(s)
- Mahmoud Radwan
- Department of Health Management and Economics, School of Public Health, International Campus, Tehran University of Medical Sciences (IC-TUMS), Tehran, Iran
- International Cooperation Directorate, Palestinian Ministry of Health, Gaza City, Palestine
- *Correspondence: Mahmoud Radwan,
| | - Ali Akbari Sari
- Department of Health Management and Economics, School of Public Health, International Campus, Tehran University of Medical Sciences (IC-TUMS), Tehran, Iran
| | - Arash Rashidian
- Department of Health Management and Economics, School of Public Health, International Campus, Tehran University of Medical Sciences (IC-TUMS), Tehran, Iran
| | - Amirhossein Takian
- Department of Health Management and Economics, School of Public Health, International Campus, Tehran University of Medical Sciences (IC-TUMS), Tehran, Iran
- Health Equity Research Center (HERC), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Sanaa Abou-Dagga
- Department of Research Affairs and Graduates Studies, Islamic University of Gaza, Gaza City, Palestine
| | - Aymen Elsous
- Department of Health Management and Economics, School of Public Health, International Campus, Tehran University of Medical Sciences (IC-TUMS), Tehran, Iran
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Khotimah PH, Sugiyama Y, Yoshikawa M, Hamasaki A, Okamoto K, Kuroda T. Revealing oral medication patterns from reconstructed long-term medication history of type 2 diabetes. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2016; 2016:5599-5603. [PMID: 28269524 DOI: 10.1109/embc.2016.7591996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
With the growing attention to evidence-based medical guideline development, longitudinal analysis of Electronic Medical Records (EMR) has become a good tool for providing insight into and new knowledge on the existing therapy. For chronic diseases, longitudinal analysis of medication history plays a key role in reaching this goal. However, raw medication data in EMR are not suitable for longitudinal analysis for several reasons. First, many prescriptions have a short duration. Second, the prescription duration may have a gap or overlap with other prescription durations. Additionally, for diabetes cases, physicians must wait for a certain period to observe the effectiveness of the medication. However, the existing methods do not address these conditions. To tackle these issues, we propose a set of rules for medication episode reconstruction. We then apply the rules for longitudinal analysis on anonymous Type 2 diabetes patients' EMR provided by Kyoto University Hospital. The EMR span from 2000 to 2015. Two of our significant results are as follows: (1) our proposed medication episode reconstruction method is able to compress the search space into 23.83% compared to the raw data, and (2) the preliminary results show the benefits of the method in revealing the existing medication patterns over the years and unfamiliar therapy transition.
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Yacoub TG. Combining Clinical Judgment With Guidelines for the Management of Type 2 Diabetes: Overall Standards of Comprehensive Care. Postgrad Med 2015; 126:85-94. [DOI: 10.3810/pgm.2014.05.2758] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Abstract
Abstract
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Management of primary immune thrombocytopenia, 2012: a survey of oklahoma hematologists-oncologists. Am J Med Sci 2014; 347:190-4. [PMID: 23462246 DOI: 10.1097/maj.0b013e31827f4dd1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Management options for patients with primary immune thrombocytopenia (ITP) have increased, and treatment of patients with ITP has changed during the past 10 years. METHODS To document current practice and to determine how current practice is related to recommendations of 2 recent practice guidelines for ITP, an International Consensus report and an American Society of Hematology (ASH) guideline, the authors surveyed practicing hematologists-oncologists in Oklahoma. Surveys were specific for children or adults. Each survey had 3 questions describing patients with a new diagnosis and patients who had not achieved remission with initial treatment. Questions were adapted from the clinical scenarios of the ASH guideline. RESULTS Twelve (92%) Oklahoma pediatric hematologists-oncologists responded; 82 (81%) Oklahoma adult hematologists-oncologists responded. For a child with a new diagnosis of ITP, a platelet count of 8000/µL and minor bleeding, 5 (42%) hematologists-oncologists selected observation without drug treatment (recommended by both guidelines). For an adult with a platelet count of 9000/µL who had failed to respond to initial treatment with corticosteroids and IVIg, 32 (39%) selected splenectomy (recommended by the ASH guideline); 30 (37%) selected rituximab and 13 (16%) selected thrombopoietin-receptor agonists (both recommended by the International Consensus report). Hematologists-oncologists who had more years in practice were more likely to select splenectomy (P = 0.047). CONCLUSIONS In a time of changing management for patients with ITP, these data document reported current management in Oklahoma and provide a basis for serial comparisons across time and for comparisons with other regions and comparison of management with patient outcomes.
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Leslie KG, Nkombua L. Evaluation of general practitioners' routine assessment of patients with diabetes in Tshwane, South Africa. S Afr Fam Pract (2004) 2012. [DOI: 10.1080/20786204.2012.10874178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- KG Leslie
- Private Practitioner, City of Tshwane (Pretoria)
| | - L Nkombua
- University of Pretoria (Mpumalanga Campus)
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Aakre KM, Thue G, Subramaniam-Haavik S, Cooper J, Bukve T, Morris HA, Müller M, Lovrencic MV, Plum I, Kallion K, Aab A, Kutt M, Gillery P, Schneider N, Horvath AR, Onody R, Oosterhuis W, Ricos C, Perich C, Nordin G, Sandberg S. Diagnosing microalbuminuria and consequences for the drug treatment of patients with type 2 diabetes: a European survey in primary care. Diabetes Res Clin Pract 2010; 89:103-9. [PMID: 20409604 DOI: 10.1016/j.diabres.2010.03.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2009] [Revised: 01/26/2010] [Accepted: 03/29/2010] [Indexed: 11/30/2022]
Abstract
AIMS To assess general practitioners (GPs) knowledge of guideline recommendations on diagnosing microalbuminuria (MA) and to evaluate how this diagnosis influences drug treatment of diabetes patients. METHODS A postal case-history based questionnaire describing a male patient (previously not tested for MA) with type 2 diabetes who had several risk markers for cardiovascular disease. RESULTS 2078GPs from nine European countries were included, with response rates varying from 7% to 43%. Almost all GPs recommended annual testing for MA. Forty-five to 77% (depending on country) of GPs required more than one positive test to diagnose MA. The absolute increase in the percentages of GPs who would supplement the patient's drug treatment if MA developed was: for anginotensin converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) 23-50% (depending on country), for statins 0-19%, for acetylsalicylic acid 2-13%, and for hypoglycemic agents (tablets and insulin) 0-33%. The proportion of GPs recommending all four possible treatment modalities was low. CONCLUSIONS Guidelines for diagnosing MA were partly followed. ACEIs and ARBs were recommended when MA was present, but the recommended multifactorial treatment of cardiovascular risk markers was not implemented.
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Affiliation(s)
- Kristin M Aakre
- Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway.
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Rätsep A, Kalda R, Lember M. Meeting targets in type 2 diabetes care contributing to good glycaemic control. A cross-sectional study from a primary care setting in Estonia. Eur J Gen Pract 2010; 16:85-91. [PMID: 20429704 DOI: 10.3109/13814788.2010.481017] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Anneli Rätsep
- Department of Family Medicine, University of Tartu, Estonia.
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Aakre KM, Thue G, Subramaniam-Haavik S, Bukve T, Morris H, Müller M, Lovrencic MV, Plum I, Kallion K, Aab A, Kutt M, Gillery P, Schneider N, Horvath AR, Onody R, Oosterhuis W, Ricos C, Perich C, Nordin G, Sandberg S. Postanalytical External Quality Assessment of Urine Albumin in Primary Health Care: An International Survey. Clin Chem 2008; 54:1630-6. [DOI: 10.1373/clinchem.2007.100917] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
background: Microalbuminuria (MA) is recognized as an important risk factor for cardiovascular and renal complications in diabetes. We sought to evaluate how screening for MA is conducted and how urine albumin (UA) results are interpreted in primary care internationally.
methods: General practitioners (GPs) received a case history–based questionnaire depicting a male type 2 diabetes patient in whom UA testing had not been performed. Questions were related to type of urine sample used for UA testing, need for a repeat test, whether UA testing was performed in the office laboratory, and what changes in UA results were considered clinically important [critical difference (CD)]. Participants received national benchmarking feedback reports.
results: We included 2078 GPs from 9 European countries. Spot urine samples were used most commonly for first time office-based testing, whereas timed collections were used to a larger extent for hospital-based repeat tests. Repeat tests were requested by 45%–77% of GPs if the first test was positive. Four different measurement units were used by 70% of participants in estimating clinically important changes in albumin values. Stated CDs varied considerably among GPs, with similar variations in each country. A median CD of 33% was considered clinically important for both improvement and deterioration in MA, corresponding to an achievable analytical imprecision of 14%, when UA is reported as an albumin/creatinine ratio.
conclusions: Guidelines on diagnosing MA are followed only partially, and should be made more practicable, addressing issues such as type of samples, measurement units, and repeat tests.
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Affiliation(s)
- Kristin M Aakre
- Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway
| | - Geir Thue
- The Norwegian Quality Improvement of Primary Care Laboratories (NOKLUS), Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway
| | - Sumathi Subramaniam-Haavik
- The Norwegian Quality Improvement of Primary Care Laboratories (NOKLUS), Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway
| | - Tone Bukve
- The Norwegian Quality Improvement of Primary Care Laboratories (NOKLUS), Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway
| | - Howard Morris
- Hanson Institute, Institute of Medical and Veterinary Science, Adelaide, Australia
| | - Mathias Müller
- Institute of Laboratory Diagnostics, Kaiser Franz Joseph Hospital, Vienna, Austria
| | - Marijana V Lovrencic
- Laboratory of Medical Biochemistry, Vuk Vrhovac University Clinic, Zagreb, Croatia
| | - Inger Plum
- Danish Institute for External Quality Assurance for Laboratories in Health Care (DEKS), Herlev University Hospital, Herlev, Denmark
| | - Kaja Kallion
- Department of Children’s Hospital, United Laboratories, Clinicum of the University of Tartu, Tartu, Estonia
| | - Alar Aab
- Department of Clinical Chemistry, United Laboratories, Clinicum of the University of Tartu, Tartu, Estonia
| | - Marge Kutt
- East Tallinn Central Hospital, Tallinn, Estonia
| | - Philippe Gillery
- Laboratoire de Biologie et de Recherche Pédiatriques, American Memorial Hospital, CHU de Reims, Reims, France
| | - Nathalie Schneider
- Laboratoire de Biologie et de Recherche Pédiatriques, American Memorial Hospital, CHU de Reims, Reims, France
| | - Andrea R Horvath
- Laboratory Department of Clinical Chemistry, University of Szeged, Szeged, Hungary
| | - Rita Onody
- Laboratory Department of Clinical Chemistry, University of Szeged, Szeged, Hungary
| | - Wytze Oosterhuis
- Department of Clinical Chemistry, St. Elisabeth Hospital, Tilburg, the Netherlands
| | - Carmen Ricos
- Laboratori Clínic Bon Pastor Barcelona, Barcelona, Spain
| | - Carmen Perich
- Analytical Quality Commission of the Spanish Society of Clinical Biochemistry and Molecular Pathology (SEQC), Barcelona, Spain
| | - Gunnar Nordin
- External quality assurance in laboratory medicine in Sweden (Equalis), Uppsala, Sweden
| | - Sverre Sandberg
- Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway
- The Norwegian Quality Improvement of Primary Care Laboratories (NOKLUS), Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway
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Prince EA, Murphy TP, Dhangana R, Soares GM, Ahn SH, Dubel GJ. Evaluation and Management of Patients with Peripheral Artery Disease by Interventional Radiologists: Current Practices. J Vasc Interv Radiol 2008; 19:639-44. [DOI: 10.1016/j.jvir.2008.02.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2007] [Revised: 01/31/2008] [Accepted: 02/04/2008] [Indexed: 01/14/2023] Open
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Kalda R, Rätsep A, Lember M. Predictors of quality of life of patients with type 2 diabetes. Patient Prefer Adherence 2008; 2:21-6. [PMID: 19920940 PMCID: PMC2770386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Researchers have shown that patients with type 2 diabetes have a lower quality of life than the general population and also somewhat lower than patients with other chronic diseases. Thus one of the most important outcomes of treatment is optimizing the quality of life of the patient. This study examines the factors that most strongly influence the quality of life of patients with type 2 diabetes. METHODS 200 patients with type 2 diabetes were studied in Estonia in 2004-2005. A patient blood sample, taken during a visit to the family doctor, was collected. The family doctor also provided data on each patient's body mass index (BMI), blood pressure, and medications for treatment of type 2 diabetes. Patients completed a SF-36 during a doctor visit, and also a special questionnaire which we provided to study their awareness about diabetes type 2. RESULTS The mean age of the respondents was 64.7 (+/-11.1) years and the mean duration of the diabetes was 7.5 (+/-1.8) years. Logistic regression analysis showed that quality of life was most significantly affected by awareness of the complications and risk-factors of diabetes, and by the age, duration of the disease, and BMI of the patient. Patients who were less aware had a significantly higher quality of life score (p < 0.001 in all cases). The age and BMI of the patients as well as the duration of the diabetes all lowered the score of the quality of life. CONCLUSIONS The results suggest that the main challenges for physicians in management of diabetes type 2 are modifying patient BMI and patient awareness.
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Affiliation(s)
- Ruth Kalda
- Department of Family Medicine, University of Tartu
| | | | - Margus Lember
- Department of Internal Medicine, University of Tartu
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