A patient-based study on the adherence of physicians to guidelines for the management of type 2 diabetes in Turkey.
OBJECTIVE
To evaluate physicians' adherence to guidelines by Diabetes Study Group of The Society of Endocrinology and Metabolism of Turkey (SEMT).


METHODS
The medical records of 1790 patients with type 2 diabetes (mean age, 58.7 ± 10.9 years; diabetes duration, 7.7 ± 7.5 years) followed by 180 physicians during last 12 months were reviewed. Adherence to SEMT guidelines was analysed under medical history, physical examination and laboratory evaluations subheadings, each scored on a 10-point scale. Effects of patients' age, gender, diabetes duration, body mass index, chronic complications, physicians' specialty and institution on guideline adherence were evaluated.


RESULTS
Follow-up procedures were >75% compliant for 52% of patients. Full adherence to medical history, physical examination and laboratory aspects of SEMT guidelines were met in 68.6%, 8.3% and 19.2% of patients, respectively. Older patients and males fared better for laboratory evaluations. All aspects of guideline adherence were poor in patients with short duration of diabetes and in the absence of chronic complications. State institutions and family practitioners had lower adherence scores for physical examination and laboratory evaluation.


CONCLUSIONS
Overall guideline adherence of physicians was suboptimal. Educational programs emphasizing the preventive aspect of diabetes management, targeted towards family practitioners and state institutions, may improve guideline adherence and patient outcome.
Division of Endocrinology & Metabolism, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, 34093 Istanbul, Turkey. satmandiabet@gmail.com
Ilhan
I
Satman
Sazi
S
Imamoglu
Candeger
C
Yilmaz
D000328:Adult; D001291:Attitude of Health Personnel; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control*; D019468:Disease Management; D005194:Family Practice; D005260:Female; D005500:Follow-Up Studies; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D010808:Physical Examination / Q000706:statistics & numerical data; D010820:Physicians / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014421:Turkey / Q000453:epidemiology