title: Awareness, agreement, adoption and adherence to type 2 diabetes mellitus guidelines: a survey of Indonesian primary care physicians.
abstract: BACKGROUND
  To assess the degree of awareness, agreement, adoption and adherence of physicians in Indonesia to type 2 diabetes mellitus guidelines, and their association with characteristics of the responders.
  
  
  METHODS
  Questionnaire survey among General Practitioners (GPs) attending the Indonesian Association of Family Practitioners annual conference in November 2012. The proportion of GPs who were aware of, agreed with, adopted and adhered to the seven recommendations in the guidelines (screening for diabetes, diagnosis, lifestyle modification, use of sulfonylurea, target blood glucose, target blood pressure and use of statin) were calculated in the total number of responders.
  
  
  RESULTS
  Of the 399 GPs participating, 383 (89%) were aware of the existence of Indonesian type 2 diabetes guidelines. Awareness for each recommendation varied from 66 to 91%. The recommendation to use a random blood glucose test for diagnosing patients with classic diabetes symptoms had the least awareness (265/399, 66%) and least agreement (163/399, 41%). The recommendation on statin use was the least adopted (192/399, 48%), while the least adherence (7/399, 2%) was found for the recommendation on screening for diabetes for patients with risk factors. Years of practice experience and proportion of diabetes patients seen in their practice were independently related with adherence to statin prescription.
  
  
  CONCLUSIONS
  High awareness of the Indonesian type 2 diabetes guideline does not necessary lead to adoption or adherence to recommendations important for outcomes and quality of care. The awareness-to-adherence model helps in identifying barriers for the use of guidelines.
authors.affiliation: Community Medicine Department, Faculty of Medicine Universitas Indonesia, Jl, Pegangsaan Timur 16, Jakarta 10430, Indonesia. indah_widyahening@ui.ac.id.
authors.forename: Indah S
authors.initials: IS
authors.lastname: Widyahening
authors.forename: Yolanda
authors.initials: Y
authors.lastname: van der Graaf
authors.forename: Pradana
authors.initials: P
authors.lastname: Soewondo
authors.forename: Paul
authors.initials: P
authors.lastname: Glasziou
authors.forename: Geert J M G
authors.initials: GJ
authors.lastname: van der Heijden
mesh_terms: D000704:Analysis of Variance; D002983:Clinical Competence / Q000592:standards; D003226:Congresses as Topic; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000628:therapy*; D004059:Diffusion of Innovation; D005260:Female; D019983:Guideline Adherence / Q000592:standards / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007214:Indonesia; D008297:Male; D008403:Mass Screening / Q000592:standards; D058007:Physicians, Primary Care / Q000523:psychology* / Q000592:standards / Q000706:statistics & numerical data; D017064:Process Assessment, Health Care / Q000379:methods / Q000592:standards; D011364:Professional Practice / Q000706:statistics & numerical data; D011365:Professional Practice Location; D011795:Surveys and Questionnaires
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