A five-year evaluation of intervention in diabetes care in Trinidad and Tobago [see comments]
Diabet Med
; 16(11): 939-45, Nov. 1999.
Artigo
em Inglês
| MedCarib
| ID: med-723
Biblioteca responsável:
JM3.1
Localização: JM3.1
ABSTRACT
AIMS:
To evaluate an intervention to improve diabetes care in government-run health centres in Trinidad and Tobago over 5 years.METHODS:
A cross-sectional survey of 690 subjects with clinical diabetes attending nine health centres was carried out in 1993. The intervention was reports to the Ministry of Health, dissemination of management guidelines and annual training workshops for healthcare staff. Re-evaluation was through a survey of 1579 subjects with diabetes, attending 23 health centres in 1998.RESULTS:
Comparing 1993 with 1998, foot examinations in the previous year increased from 38 (6 percent) to 346 (22 percent) and fundoscopy from 6 (1 percent) to 139 (9 percent). For subjects attending for 1 year or less, 34/96 (35 percent) had dietary advice recorded in 1993 compared with 77/143 (54 percent) in 1998. Exercise advice was recorded for 3/96 (3 percent) in 1993 and 48/143 (34 percent) in 1998. In 1993, 329 (48 percent) were taking chlorpropamide but this fell to 57 (4 percent) in 1998. Glibenclamide use increased from 214 (31 percent) to 856 (54 percent) and gliclazide from 4 (1 percent) to 205 (13 percent). In 1993, 198/338 (56 percent) of hypertensive subjects were taking Brinerdin, this fell to 56/829 (7 percent) in 1998 while use of thiazide diuretics, methyldopa and angiotensin-converting enzyme (ACE) inhibitors increased. There were no changes in indicators of metabolic control, blood pressure control or body weight.CONCLUSIONS:
Use of audit data to inform health policy and practice, linked with educational interventions, may modify patterns of care in government-run primary care health centres in a middle-income country with a high prevalence of diabetes. (AU)
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Coleções:
Bases de dados internacionais
Contexto em Saúde:
ODS3 - Meta 3.8 Atingir a cobertura universal de saúde
Problema de saúde:
Arranjos de Entrega
Base de dados:
MedCarib
Assunto principal:
Diabetes Mellitus
Tipo de estudo:
Guia de prática clínica
/
Estudo observacional
/
Estudo de prevalência
/
Pesquisa qualitativa
/
Fatores de risco
Limite:
Feminino
/
Humanos
/
Masculino
País/Região como assunto:
Caribe Inglês
/
Trinidad e Tobago
Idioma:
Inglês
Revista:
Diabet Med
Ano de publicação:
1999
Tipo de documento:
Artigo