Article type
Year
Abstract
Background: Transferring of evidence into practice cannot be successfully implemented in clinical setting without strong support and active involvement of leadership. However, little is known about the primary care physicians’ (PCPs) practice of delivering guidelines in primary health care in Korea.
Objectives: To explore the attitudes towards and factors associated with the routine provision of type 2 diabetes and hypertension in primary care through surveying representative samples of the PCPs.
Methods: In order to identify gaps in practicing guidelines in primary care settings, an End-user Steering Committee for Guideline Implementation was created and questionnaires drawn up based on the recommendation A grade from ‘Evidence based hypertension and type 2 diabetes guidelines for primary care’. Basic survey questionnaires include six domains from guidelines, resulting in 18 questions. More specific questions were added to each item if PCPs' practices were low. Web-based surveys were mailed to 10% of Korean PCPs from August to September 2014.
Results: A total of 698 PCPs responded (93.2%), saying they provided low implementation on ‘home blood sugar monitoring (47.1%)’, ‘cardiovascular risk factor test (32.5%)’, ‘kidney dysfunction management (30.5%)’, and ‘life style modification (22.1%)’ for type 2 diabetes patient treatment. With regard to hypertension treatment, provision of ‘target organ damage assessment (37.1%), ‘hypertension examinations (28.6%)’, ‘high blood pressure laboratory tests (21.0%)’ and ‘life style modification (19.9%)’ showed low implementation.
Conclusions: The data yielded low levels of practice in the domain of patient health behaviors that is mostly due to a lack of consultation time in which to deliver them, and guidelines gaps between items for which insurance will pay. Co-morbid diseases (hypertension, dyslipidemia) were better managed than pre-complications (kidney and cardiovascular risk factor assessment) for which no specific instruments are provided in primary care settings. These gaps will be considered in the building of future implementation strategies.
Objectives: To explore the attitudes towards and factors associated with the routine provision of type 2 diabetes and hypertension in primary care through surveying representative samples of the PCPs.
Methods: In order to identify gaps in practicing guidelines in primary care settings, an End-user Steering Committee for Guideline Implementation was created and questionnaires drawn up based on the recommendation A grade from ‘Evidence based hypertension and type 2 diabetes guidelines for primary care’. Basic survey questionnaires include six domains from guidelines, resulting in 18 questions. More specific questions were added to each item if PCPs' practices were low. Web-based surveys were mailed to 10% of Korean PCPs from August to September 2014.
Results: A total of 698 PCPs responded (93.2%), saying they provided low implementation on ‘home blood sugar monitoring (47.1%)’, ‘cardiovascular risk factor test (32.5%)’, ‘kidney dysfunction management (30.5%)’, and ‘life style modification (22.1%)’ for type 2 diabetes patient treatment. With regard to hypertension treatment, provision of ‘target organ damage assessment (37.1%), ‘hypertension examinations (28.6%)’, ‘high blood pressure laboratory tests (21.0%)’ and ‘life style modification (19.9%)’ showed low implementation.
Conclusions: The data yielded low levels of practice in the domain of patient health behaviors that is mostly due to a lack of consultation time in which to deliver them, and guidelines gaps between items for which insurance will pay. Co-morbid diseases (hypertension, dyslipidemia) were better managed than pre-complications (kidney and cardiovascular risk factor assessment) for which no specific instruments are provided in primary care settings. These gaps will be considered in the building of future implementation strategies.