Evaluation of general practitioners’ routine assessment of patients with diabetes in Tshwane, South Africa

Abstract

Background: Diabetes mellitus is a composite disease that, if not well managed and controlled, may lead to severe complications. To avoid or delay these debilitating complications, it is necessary for the practitioner to implement adequate management of the disease by using currently available clinical guidelines. The authors wished to establish the use of existing diabetes management guidelines by general practitioners (GPs) in the City of Tshwane (Pretoria) Metropolitan Municipality of South Africa.
Method: A cross-sectional and descriptive study was conducted. A total of 50 randomly selected general practitioners participated in the survey.
Results: A large majority of the participants (92%) was aware of the existence of the latest guidelines for the management of diabetes in South Africa. The assessments performed by most GPs were body mass index and lipid profile, as reported by 96% of the respondents, followed by foot examination, microalbumin (88%) and glycated haemoglobin (84%) measurements. The practice of eye specialist referrals was found adequate in 22% of the participants. Fifty-four per cent reported that they did not undertake any continuing professional development activity regarding diabetes in the preceding year.
Conclusion: Although the GPs surveyed in the Tshwane district were aware of the existence of guidelines for the assessment of patients with diabetes, their implementation was not satisfactory. Training institutions play a pivotal role in guiding future practitioners to improve such implementation. Also, the improvement of the quality of primary health care systems is of great importance.

Keywords: diabetes mellitus, guidelines, annual physical assessment, Tshwane, South Africa