Barriers associated with poor control in Spanish diabetic patients. A consensus study
M C Carratalá-Munuera1, V F Gil-Guillen, D Orozco-Beltran
1Cátedra de Medicina de Familia, Departamento de Medicina Clínica, Universidad Miguel Hernández, Alicante, Spain. atencion.primaria@umh.es
International Journal of Clinical Practice
|June 14, 2013
Summary
Improving Type-2 Diabetes Mellitus (DM2) control requires addressing patient non-compliance and clinical inertia. Strategies include enhanced patient education, family involvement, and healthcare professional motivation, alongside better clinical workflows and resources.
Area of Science:
- Endocrinology
- Public Health
- Healthcare Management
Background:
- The Delphi technique facilitates multidisciplinary consensus building for problem-solving.
- Effective management of Type-2 Diabetes Mellitus (DM2) is crucial for patient outcomes.
Purpose of the Study:
- To identify barriers and solutions for improving Type-2 Diabetes Mellitus (DM2) control.
- To establish consensus among experts on strategies for better DM2 management.
Main Methods:
- An observational study employed a two-round Delphi technique from June to August 2011.
- A panel of 108 DM2 experts (physicians and nurses) responded to a 41-item Likert scale questionnaire.
- Agreement levels were assessed using statistical measures, including Kappa index and McNemar chi-square for group comparisons.
Main Results:
- A 65% response rate was achieved, with higher agreement in nursing (78.1%) than medicine (63.4%).
- Therapy non-compliance improves with patient education, motivation, family involvement, and shared decision-making.
- Clinical inertia is reduced by healthcare professional motivation and cardiovascular risk assessment, but exacerbated by time constraints, poor record-keeping, and lack of clear treatment goals or teamwork.
Conclusions:
- Experts reached a consensus on interventions to improve therapeutic compliance and reduce clinical inertia in DM2 management.
- The findings highlight key areas for intervention to enhance patient adherence and healthcare provider efficiency in DM2 care.
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