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South African Medical Journal

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Physician education programme improves quality of diabetes care

D.G. van Zyl, P Rheeder

Abstract


Background. Diabetes mellitus is a common chronic disease needing long-term glycaemic control to prevent complications. Guidelines are available for achievement of optimal glycaemic control, but these are seldom properly instituted.
Objectives. To determine if a physician education programme and a structured consultation schedule would improve the quality of diabetes patient care in a diabetes clinic.
Setting. Two tertiary care diabetes clinics at Kalafong Hospital, Pretoria.
Study design. Quasi-experimental controlled before-and-after study.
Methods. A baseline audit of the quality of care in two comparable diabetes clinics was performed. Three hundred patients were randomly selected for audit of their hospital records: 141 from the intervention and 159 from the control clinics. Thereafter a physician training programme and a structured consultation schedule were introduced to the intervention clinic and maintained for a 1-year period. The control clinic continued with care as usual. Process and outcome measures were determined at a post-intervention audit and compared between the two groups. Consultation time was measured for both the intervention and control groups and data were compared.
Results. At baseline the intervention and control groups did not differ significantly with regard to process and outcome measures. After intervention the intervention group had significantly higher process measure scores than the control group (p < 0.01). HbA1c did not significantly differ between the two groups (p = 0.60). The average number of clinic visits reduced over time for the intervention group compared with the control group (p < 0.01), but the average consultation times were significantly longer (p < 0.01).
Conclusion. The introduction of a physician education programme and a structured consultation schedule improved the quality of care delivered at a tertiary care diabetes clinic.



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