MEDICAL AND SOCIAL EFFICIENCY OF THE NEW PROTOCOL IMPLEMENTATION IN MANAGEMENT OF TYPE 2 DIABETES IN UKRAINE
DOI:
https://doi.org/10.54890/.v3i3.1187Abstract
Assessment of quality of care during implementation of new guidelines is relevant and necessary.
Objective: to determine the medical and social effectiveness of new guideline implementation in type 2 diabetes management.
Materials and methods. The study involved 173 patients with type 2 diabetes (ages 55,13±0,61 years, 112 women and 61 men) who, depending on the specialty of the doctor were divided into 2 groups: 1st – managed by primary care physicians, 2nd - by endocrinologist. The survey and study of HbA1c level, fasting glucose, lipid profile were conducted to assess the medical and social effectiveness. Effectiveness was assessed using coefficients. Statistical analysis was performed using Excel 2007, SPSS, Statistica 6.0.
Results. The low treatment satisfaction and poor quality of life were determined in patients in general, and diabetes provided additional significant adverse impact. Quality of life, treatment satisfaction, and the degree of diabetes control were independent of doctor specialty, but depended on the type of therapy. Patients on insulintherapy had significantly higher levels of HbA1c and cholesterol LDL; the quality of life was assessed higher, although the impact of diabetes on quality of life were more significant than in patients on the tablets. In addition, there was a correlation between the weighted average impact of diabetes on quality of life and the duration of diabetes (r= -0,32, p <0,001), as well as treatment satisfaction and quality of life (r= - 0,20, p <0,05).
Conclusion. No significant differences between the groups of patients who were managed by primary care physicians and by endocrinologist were found, indicating that primary care physicians provide sufficient level of quality of diabetes care. Integral efficiency coefficient was higher in primary care physicians, that may be caused by management of patients with more mild diabetes.
Keywords:
type 2 diabetes, clinical guidelines, efficiency, primary care.References
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