Quality of diabetes care in a university health center in Lebanon.
OBJECTIVE
To assess the quality of care provided to diabetic patients by family physicians in a university health clinic, using measures of glycemic and cardiovascular risk control as well as documentation of and adherence to World Health Organization (WHO) guidelines for diabetes primary care.


METHODS
Chart review of the previous year's medical notes for all identified diabetics in the practice over 2.5 years.


RESULTS
Two-hundred and four diabetic patients were identified, with an estimated prevalence of 4.1%. The majority was type II diabetics, on oral hypoglycemic agents. Glycosylated hemoglobin was documented in 39.7% of patients, fasting plasma glucose in 99%, cholesterol in 93.1%, triglycerides in 91.2% and blood pressure in 85.8%; optimal control of these indicators was noted in 28.4%, 17.8%, 34%, 29.6% and 55.4% respectively. Fifty percent of the diabetics were referred for retinal checks. Physicians documented the presence of nephropathy in 46.8% and neuropathy in 59.6%; however, they documented patient instruction on foot care, diet, exercise and diabetes self-care poorly.


CONCLUSIONS
There is a need for interventions to improve management and documentation in diabetes care in order to achieve early detection and prevention of complications. Developing a protocol for the clinic based on standard guidelines, and the use of flow sheets may be helpful in improving these intermediate indicators of quality of care.
Akel
M
M
Department of Family Medicine, American University of Beirut--Medical Center, Lebanon. ma00aub.edu.lb.
Hamadeh
G
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000097:blood / Q000628:therapy*; D005260:Female; D019983:Guideline Adherence / Q000592:standards / Q000706:statistics & numerical data; D006279:Health Maintenance Organizations / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D007861:Lebanon; D008297:Male; D008875:Middle Aged; D011787:Quality of Health Care / Q000592:standards* / Q000706:statistics & numerical data; D012307:Risk Factors; D013333:Student Health Services / Q000592:standards* / Q000706:statistics & numerical data; D014481:United States / Q000208:ethnology; D014944:World Health Organization
D001786:Blood Glucose