Poor control and management of type 2 diabetes mellitus at an under-resourced South African Hospital: is it a case of clinical inertia?

Evidence shows that even with the implementation of evidence-based medicine, the attainment of optimal glycaemic control is difficult and challenging for both patients and healthcare providers. This study was a one-year retrospective chart review with data collected during the period October 2010 to...

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Main Authors: Romona Devi Govender, Prem Gathiram, Miljenko Panajatovic
Format: Article
Language:English
Published: AOSIS 2017-10-01
Series:South African Family Practice
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Online Access:https://safpj.co.za/index.php/safpj/article/view/4634
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author Romona Devi Govender
Prem Gathiram
Miljenko Panajatovic
author_facet Romona Devi Govender
Prem Gathiram
Miljenko Panajatovic
author_sort Romona Devi Govender
collection DOAJ
description Evidence shows that even with the implementation of evidence-based medicine, the attainment of optimal glycaemic control is difficult and challenging for both patients and healthcare providers. This study was a one-year retrospective chart review with data collected during the period October 2010 to December 2010 of patients with Type 2 diabetes mellitus (T2DM) who attended the outpatients’ department at the Port Shepstone Regional Hospital (PSRH), South Africa (SA). The total study population was 360 patients with 51% Black African, 32% Indian, 16% White and 1% Coloured. Of the 111 patients’ charts only 78 had two consecutive HbA1c levels recorded. Of the 78/111 patients, only 10 patients had the target HbA1c level of < 7% at visit 1. By visit two, 15.4% (n = 12) had achieved the target HbA1c level. Over the one-year chart review only 3/111 (2.7%) maintained their HbA1c level of < 7% and 5/111 patients whose treatment was revised according to the 2009 SEMDSA guidelines reached HbA1c < 7% by visit 2 whilst 4/111 patients, whose treatment schedule was not modified according to the 2009 SEMDSA guidelines, also reached HbA1c < 7% at visit 2. However, this one-year chart review showed that glycaemia was poorly managed at this hospital, which may be explained by clinical inertia. (Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp) S Afr Fam Pract 2017; DOI: 10.1080/20786190.2017.1307909
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spelling doaj-art-77a5f9ce8067497f8ea4a070dfa1d8042025-08-20T03:06:53ZengAOSISSouth African Family Practice2078-61902078-62042017-10-0159510.4102/safp.v59i5.46343790Poor control and management of type 2 diabetes mellitus at an under-resourced South African Hospital: is it a case of clinical inertia?Romona Devi Govender0Prem Gathiram1Miljenko Panajatovic2University of KwaZulu-NatalUniversity of KwaZulu-NatalPort Shepstone Regional HospitalEvidence shows that even with the implementation of evidence-based medicine, the attainment of optimal glycaemic control is difficult and challenging for both patients and healthcare providers. This study was a one-year retrospective chart review with data collected during the period October 2010 to December 2010 of patients with Type 2 diabetes mellitus (T2DM) who attended the outpatients’ department at the Port Shepstone Regional Hospital (PSRH), South Africa (SA). The total study population was 360 patients with 51% Black African, 32% Indian, 16% White and 1% Coloured. Of the 111 patients’ charts only 78 had two consecutive HbA1c levels recorded. Of the 78/111 patients, only 10 patients had the target HbA1c level of < 7% at visit 1. By visit two, 15.4% (n = 12) had achieved the target HbA1c level. Over the one-year chart review only 3/111 (2.7%) maintained their HbA1c level of < 7% and 5/111 patients whose treatment was revised according to the 2009 SEMDSA guidelines reached HbA1c < 7% by visit 2 whilst 4/111 patients, whose treatment schedule was not modified according to the 2009 SEMDSA guidelines, also reached HbA1c < 7% at visit 2. However, this one-year chart review showed that glycaemia was poorly managed at this hospital, which may be explained by clinical inertia. (Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp) S Afr Fam Pract 2017; DOI: 10.1080/20786190.2017.1307909https://safpj.co.za/index.php/safpj/article/view/4634type 2 diabetes mellitus control and managementclinical inertiaglycated haemoglobin
spellingShingle Romona Devi Govender
Prem Gathiram
Miljenko Panajatovic
Poor control and management of type 2 diabetes mellitus at an under-resourced South African Hospital: is it a case of clinical inertia?
South African Family Practice
type 2 diabetes mellitus control and management
clinical inertia
glycated haemoglobin
title Poor control and management of type 2 diabetes mellitus at an under-resourced South African Hospital: is it a case of clinical inertia?
title_full Poor control and management of type 2 diabetes mellitus at an under-resourced South African Hospital: is it a case of clinical inertia?
title_fullStr Poor control and management of type 2 diabetes mellitus at an under-resourced South African Hospital: is it a case of clinical inertia?
title_full_unstemmed Poor control and management of type 2 diabetes mellitus at an under-resourced South African Hospital: is it a case of clinical inertia?
title_short Poor control and management of type 2 diabetes mellitus at an under-resourced South African Hospital: is it a case of clinical inertia?
title_sort poor control and management of type 2 diabetes mellitus at an under resourced south african hospital is it a case of clinical inertia
topic type 2 diabetes mellitus control and management
clinical inertia
glycated haemoglobin
url https://safpj.co.za/index.php/safpj/article/view/4634
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AT premgathiram poorcontrolandmanagementoftype2diabetesmellitusatanunderresourcedsouthafricanhospitalisitacaseofclinicalinertia
AT miljenkopanajatovic poorcontrolandmanagementoftype2diabetesmellitusatanunderresourcedsouthafricanhospitalisitacaseofclinicalinertia