Clinicians’ Perspectives on Glucose Tolerance Test Practices at a Tertiary Care Hospital in Coimbatore, Tamil Nadu, India

Abstract

Introduction: The overuse of laboratory investigations is prevalent in hospital settings, with a major contributing factor being ignorance of test characteristics. The utilisation of laboratory tests depends on clinicians' perspectives. Aim: Present study aimed to assess clinicians' perspectives on Glucose Tolerance Test (GTT) practices in a tertiary care hospital in Coimbatore and identify any process deviations. Materials and Methods: A descriptive study was conducted in the Department of Biochemistry at PSG IMSR, Coimbatore, Tamil Nadu, India, involving 27 clinicians. Structured interviews were conducted in March 2019, covering indications for GTT, preferred glucose loads, fasting duration, blood sample collection time intervals, cut-off levels for glucose values at different time intervals (0, 1, 2, 3, 4 hours), and reference criteria used for interpretation {World Health Organisation (WHO), American Diabetes Association (ADA), The International Association of Diabetes and Pregnancy Study Groups (IADPSG)} . Test Request Forms (TRFs) for GTT over a one-month period were also analysed. Quantitative data was expressed as mean±SD, and qualitative data was expressed as frequency and percentage. Results: The structured interviews were conducted with 27 clinicians, predominantly from the Department of Obstetrics and Gynaecology. GTT usage was rare in other departments. A total of 217 TRFs were received for the one-month duration, with 94.9% indicating a glucose load of 75 grams (g). Conclusion: GTT is influenced by various factors throughout the testing process, that can have an impact on results and patient care. This study revealed differences between end- users' requirements and the laboratory's procedures. By revising the TRF and sample collection manual according to clinicians' needs, better optimisation between the laboratory and end-users of the test can be achieved.