Awareness, agreement, adoption and adherence to type 2 diabetes mellitus guidelines: a survey of Indonesian primary care physicians

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• 作者：Indah S Widyahening (1) (2)
  Yolanda van der Graaf (2)
  Pradana Soewondo (3)
  Paul Glasziou (4)
  Geert JMG van der Heijden (5)
  
  1. Community Medicine Department ; Faculty of Medicine Universitas Indonesia ; Pegangsaan Timur 16 ; Jakarta ; 10430 ; Indonesia
  2. Julius Center for Health Sciences and Primary Care ; University Medical Center Utrecht ; Heidelberglaan 100 ; 3584 CX ; Utrecht ; The Netherlands
  3. Internal Medicine Department ; Faculty of Medicine Universitas Indonesia 鈥?Cipto Mangunkusumo Hospital ; Jl. Diponegoro 71 ; Jakarta ; 10430 ; Indonesia
  4. Centre for Research in Evidence-Based Practice (CREBP) Faculty of Health Sciences ; Bond University ; Gold Coast ; Queensland ; 4229 ; Australia
  5. Department Social Dentistry ; Academic Center for Dentistry Amsterdam (ACTA) ; Gustav Mahlerlaan 3004 ; 1081 LA ; Amsterdam ; The Netherlands
  
• 关键词：Awareness ; Adoption ; Adherence ; Diabetes ; Guidelines ; General practitioners
• 刊名：BMC Family Practice
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：15
• 期：1
• 全文大小：230 KB
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  IDF Diabetes Atlas. International Diabetes Federation, Brussels, Belgium
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  4. Soewondo, P, Soegondo, S, Suastika, K, Pranoto, A, Soeatmadji, D, Tjokroprawiro, A (2010) The DiabCare Asia 2008 study 鈥?Outcomes on control and complications of type 2 diabetic patients in Indonesia. Med J Indones 19: pp. 235-244 CrossRef
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  5. Nathan, DM, Buse, JB, Davidson, MB, Heine, RJ, Holman, RR, Sherwin, R, Zinman, B (2009) Medical management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy: a consensus statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care 32: pp. 193-203 5" target="_blank" title="It opens in new window">CrossRef
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  13. Pathman, DE, Konrad, T, Freed, GL, Freeman, VA, Koch, GG (1996) The awareness-to-adherence model of the steps to clinical guideline compliance; The case of pediatric vaccine recommendations. Med Care 34: pp. 873-889 5650-199609000-00002" target="_blank" title="It opens in new window">CrossRef
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  18. Widyahening, IS, Soewondo, P (2012) Capacity for management of diabetes mellitus in primary health centres in Indonesia. J Indon Med Assoc 62: pp. 439-443
  19. Nunes, V, Neilson, J, O鈥橣lynn, N, Calvert, N, Kuntze, S, Smithson, H, Benson, J, Blair, J, Bowser, A, Clyne, W, Crome, P, Haddad, P, Hemingway, S, Horne, R, Johnson, S, Kelly, S, Packham, B, Patel, M, Steel, J (2009) Clinical Guidelines and Evidence Review for Medicines Adherence: Involving Patients in Decisions About Prescribed Medicines and Supporting Adherence. National Collaborating Centre for Primary Care and Royal College of General Practitioners, London
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  21. The pre-publication history for this paper can be accessed here: 5/72/prepub" class="a-plus-plus">http://www.biomedcentral.com/1471-2296/15/72/prepub
  
• 刊物主题：General Practice / Family Medicine; Primary Care Medicine;
• 出版者：BioMed Central
• ISSN：1471-2296

文摘

Background To assess the degree of awareness, agreement, adoption and adherence of physicians in Indonesia to type 2 diabetes mellitus guidelines, and their association with characteristics of the responders. Methods Questionnaire survey among General Practitioners (GPs) attending the Indonesian Association of Family Practitioners annual conference in November 2012. The proportion of GPs who were aware of, agreed with, adopted and adhered to the seven recommendations in the guidelines (screening for diabetes, diagnosis, lifestyle modification, use of sulfonylurea, target blood glucose, target blood pressure and use of statin) were calculated in the total number of responders. Results Of the 399 GPs participating, 383 (89%) were aware of the existence of Indonesian type 2 diabetes guidelines. Awareness for each recommendation varied from 66 to 91%. The recommendation to use a random blood glucose test for diagnosing patients with classic diabetes symptoms had the least awareness (265/399, 66%) and least agreement (163/399, 41%). The recommendation on statin use was the least adopted (192/399, 48%), while the least adherence (7/399, 2%) was found for the recommendation on screening for diabetes for patients with risk factors. Years of practice experience and proportion of diabetes patients seen in their practice were independently related with adherence to statin prescription. Conclusions High awareness of the Indonesian type 2 diabetes guideline does not necessary lead to adoption or adherence to recommendations important for outcomes and quality of care. The awareness-to-adherence model helps in identifying barriers for the use of guidelines.