Barriers associated with poor control in Spanish diabetic patients. A consensus study.
Int J Clin Pract
; 67(9): 888-94, 2013 Sep.
Article
en En
| MEDLINE
| ID: mdl-23758484
ABSTRACT
BACKGROUND:
Delphi technique allows developing a multidisciplinary consensus to establish solutions.AIM:
To identify barriers and solutions to improve control in patients with Type-2 Diabetes Mellitus (DM2).METHODS:
An observational study using the 2-round Delphi technique (June-August 2011). A panel of 108 experts in DM2 from medical and nursing fields (primary care providers and specialists) from different regions completed via email a questionnaire with 41 Likert statements and 9 scores for each one. Level of agreement was assessed using measures of central tendency and dispersion. We analysed commonalities/differences between the two groups (Kappa index and McNemar chi-square).RESULTS:
Response rate 65%. Degree of agreement 63.4% (95% CI 48.7-78.1%) in medicine, and 78.1% (95% CI 65.4-90.8) in nursing (p > 0.05). Overall level of agreement Kappa = 0.43, (χ(2) = 2.5 p > 0.05). Regarding non-compliance with therapy, it improves with the information to the partner/family/caregiver, patient education degree in diabetes, patient motivation and ability to share and agree on decisions with the patient. Clinical inertia improves with motivation degree of healthcare professionals and the calculation of cardiovascular risk; and gets worse with the shortage of time in consultation, absence of data in medical record, border high limits measurements accepted as normal readings, lack of a treatment goals, lack of teamwork (Physician/Nurse), scarcity of resources and lack of alarm systems in the electronic medical record on goals to achieve.CONCLUSION:
The participants achieved an agreement in interventions in non-therapeutic compliance and clinical inertia to improve DM2 control.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Práctica Profesional
/
Diabetes Mellitus Tipo 2
/
Cumplimiento de la Medicación
Tipo de estudio:
Guideline
/
Observational_studies
/
Prognostic_studies
/
Qualitative_research
/
Risk_factors_studies
Límite:
Humans
País/Región como asunto:
Europa
Idioma:
En
Revista:
Int J Clin Pract
Asunto de la revista:
MEDICINA
Año:
2013
Tipo del documento:
Article
País de afiliación:
España