期刊
DIABETIC MEDICINE
卷 38, 期 9, 页码 -出版社
WILEY
DOI: 10.1111/dme.14530
关键词
epidemiology; health care delivery
资金
- Indian Council of Medical Research, New Delhi [5/4/5--11/Diab/16-NCD-II]
The study found that the quality of care for known diabetes patients in Delhi is poor, with inadequate glycemic control, lipid control, and blood pressure management. There is a significant gap between practice recommendations and the delivery of diabetes care in Delhi.
Aims To evaluate the quality of care in known diabetes patients of Delhi. Methods A cross-sectional survey was conducted using a two-stage cluster design. In all, 30 of 150 wards were chosen in Stage 1 (using a random computer-generated seed value and then selecting wards at a predefined sampling interval; Probability Proportionate to Size-Systematic) and one colony from each ward was selected randomly in Stage 2. The selected areas were surveyed house-to-house in one-of-four random directions to recruit a minimum of 25 subjects (known diabetes >= 1 year; 35-65 years of age) per area. Data were collected by interview, blood sampling and from medical records by specifically trained research staff. Results A total of 843 subjects (of 1315 eligible) were enrolled from 11,490 houses. For the intermediate outcome measures, an estimated 33.5% (95% CI 27.3-40.2) had an HbA(1c) value >10%, 67.2% (95% CI 62.8-71.4) had an LDL cholesterol level >100 mg/dl and 57.3% (95% CI 50.4-63.9) had BP levels >140/90 mmHg. For the processes of care in the last 1 year, 25.6% (95% CI 19.7-32.6) of the patients had an HbA(1c) (A1c) estimation and 2.4% (95% CI 1.1-4.9) had a dilated eye examination and 4.1% (95% CI 2.6-6.2) had foot examination. Diabetes self-management education was provided to only 11.3% (95% CI 8.6-14.7) while nutrition counselling was provided to 56.0% (95% CI 51.7-60.2). Conclusions The glycaemic control, lipid control and BP management of known diabetes patients in Delhi are unacceptably poor and a wide gap exists between practice recommendations and delivery of diabetes care in Delhi.
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