Quality of diabetic care among patients with diabetes mellitus type 2 at Oshikuku hospital in Namibia
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Date
2022
Authors
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Journal ISSN
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Publisher
University of Namibia
Abstract
Introduction: Diabetes Mellitus Type 2 (T2DM) is a major public health problem worldwide, including in Namibia with an estimated prevalence of 5.4 %. The World Health Organisation (WHO) recommends quality care which includes promotion of blood glucose (BG) control, diet, physical activity, monitoring of blood pressure (BP), lipids, regular screening for T2DM complications, education on diabetes, and self-care practices. The study aim was to assess the quality of care offered to patients with T2DM, describe glycaemic control of patients and serve as a gap analysis to identify areas that need improvement. Methods: This cross-sectional study evaluated diabetes quality measures including glycaemic control, co-morbidity management, diabetes knowledge, and self-management activities amongst outpatients at Oshikuku District Hospital in Namibia. Data was collected from health record review and patient interviews using a standard questionnaire. Data was analysed using descriptive statistics. Diabetes control was defined as an A1C <8%. Predictors of diabetes and hypertension control were determined through binary and logistic regressions. The groups were assessed for any variable differences, using Pearson’s Chi-square test. The confidence level was set at 95% and the p-value at <0.05. A correlation analysis was done on knowledge and treatment outcomes. This research was approved by the Ministry of Health and Social Services.
Results: A total of 108 patients with T2DM were recruited, however only 84 had available A1Cs and were included in the analysis. All were Namibian. Most were female (63.1%) and married (81.0%). Few had tertiary level education (6.0%). Many were unemployed (59.5%), and pensioners (58.3%). Most (60.7%) had poor glycaemic control with an average A1C of 10.24%. Fewer than one-third of patients had annual monitoring for A1C (29.8%) and lipids (29.8%). Fewer than 25% were prescribed statins. Most (82%) had hypertension with few (16%) at goal. Foot (11.9%) and eye examinations (13.1%) were performed infrequently. Many (69%) had low diabetes knowledge. The only factor found to predict poor glycaemic control was a BMI greater than 25 (OR=1.2).
Conclusion: The quality of diabetic care at Oshikuku Hospital was below for all markers of quality including A1C testing and control, co-morbidity management, and self management. Hence there is need to develop interventions to improve the quality of care, which may ultimately improve treatment outcomes.
Description
A research thesis submitted in partial fulfilment of the requirements for the Degree of Master of Pharmacy (Clinical Pharmacy)
Keywords
Diabetes, Mellitus, Oshikuku hospital