Good Outcome of Anti-Diabetic Therapy: A Proposal for Evidence-Based Process Indicators

Abstract

Background: The need to search for reliable process indicators for the effectiveness of anti-diabetic therapy has been expressed in the literature. Process indicators have been described as essential processes that contribute to achieving outcomes.
 Objective: This study seeks to identify and propose evidence-based process indicators for a good outcome (effectiveness) of anti-diabetic therapy in a Nigerian University Teaching Hospital.
 Methods: A crossectional study was conducted using a questionnaire about the degree of subjects' knowledge/practice of lifestyle/dietary modification based on set criteria. Glycemic control based on the latest monitoring tests and physician's remarks were extracted from the case notes of each selected subject: sample Size, n=1200. Subjects were selected by systematic random sampling (Sampling Interval=1).
 Results: Three Hundred and Thirteen (77.7%) out of 403 subjects with reasonable glycemic control were effects by exercise. Those were with excellent knowledge about signs and symptoms of hyperglycemia, the beneficial effects of exercise, treatment, and excellent practice of self-monitoring. About 311 (77.2%) out of 403 subjects who had reasonable glycemic control were those who had excellent knowledge about dietary modification. Almost 308 (76.4%) out of 403 subjects who had reasonable glycemic control were those who had excellent knowledge about lifestyle modification. Three Hundred and Six (75.9%) out of 403 subjects who had reasonable glycemic control were those who had excellent knowledge about complications of diabetes mellitus. Many subjects with excellent lifestyle/dietary modification practices had reasonable glycemic control.
 Conclusion: Evidence-based process indicators for a good outcome (effectiveness) of anti-diabetic therapy have been identified/proposed as the degree of knowledge about signs and symptoms of hyperglycemia, complications of diabetes mellitus, beneficial effects of exercise, treatments, dietary modification, and lifestyle modification. Other process indicators identified/proposed are the degree of self-monitoring practice, lifestyle, and dietary modification.