Research Articles

Poor control and management of type 2 diabetes mellitus at an under-resourced South African Hospital: is it a case of clinical inertia?

Romona Devi Govender, Prem Gathiram, Miljenko Panajatovic
South African Family Practice | Vol 59, No 5 : September/October| a4634 | DOI: https://doi.org/10.4102/safp.v59i5.4634 | ©
Submitted: 24 January 2017 | Published: 31 October 2017

About the author(s)

Romona Devi Govender, University of KwaZulu-Natal, South Africa
Prem Gathiram, University of KwaZulu-Natal, South Africa
Miljenko Panajatovic, Port Shepstone Regional Hospital, South Africa

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Abstract

Evidence shows that even with the implementation of evidence-based medicine, the attainment of optimal glycaemic control is difficult and challenging for both patients and healthcare providers. This study was a one-year retrospective chart review with data collected during the period October 2010 to December 2010 of patients with Type 2 diabetes mellitus (T2DM) who attended the outpatients’ department at the Port Shepstone Regional Hospital (PSRH), South Africa (SA). The total study population was 360 patients with 51% Black African, 32% Indian, 16% White and 1% Coloured. Of the 111 patients’ charts only 78 had two consecutive HbA1c levels recorded. Of the 78/111 patients, only 10 patients had the target HbA1c level of < 7% at visit 1. By visit two, 15.4% (n = 12) had achieved the target HbA1c level. Over the one-year chart review only 3/111 (2.7%) maintained their HbA1c level of < 7% and 5/111 patients whose treatment was revised according to the 2009 SEMDSA guidelines reached HbA1c < 7% by visit 2 whilst 4/111 patients, whose treatment schedule was not modified according to the 2009 SEMDSA guidelines, also reached HbA1c < 7% at visit 2. However, this one-year chart review showed that glycaemia was poorly managed at this hospital, which may be explained by clinical inertia.

(Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp)

S Afr Fam Pract 2017; DOI: 10.1080/20786190.2017.1307909

Keywords

Type 2 diabetes mellitus control and management; clinical inertia; glycated haemoglobin

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