Abstract
The aim of this research was to evaluate if the training on the use of the “Protocol for the Nutritional Management of Obesity, Diabetes and Hypertension in the Caribbean” improves the quality of care delivered to patients with Type 2 Diabetes in Jamaica, Guyana, Belize, St. Vincent and the Grenadines, and Suriname. The main goals of the protocol were to improve the standards of care for diabetics in the Caribbean region by providing tools essential for nutrition management. This study looked at healthcare professionals from the five countries and evaluated practice change following continuing professional development (CPD), in the use of the protocol. The training consisted of a two and a half day workshop led by the Caribbean Food and Nutrition Institute (CFNI). The training overviewed noncommunicable diseases in the region and the role of nutrition management; nutrition assessment and the management processes.The 279 participants for the CPD were chosen by the respective Ministries of Health. Of these, 133 were randomly selected by the national coordinators for a chart audit. For each healthcare professional, up to ten patients, medical charts were randomly selected totaling 1140 (25% male and 75% female) charts selected from the five countries. An evaluation instrument was developed and used for the audit and results were analysed using McNemar test to establish change. A statistical improvement in the quality of care following CPD was found through the chart audit, showing that using a protocol of care improves practice in primary care settings in the Caribbean.
Highlights
The ever growing challenge of the increasing prevalence of noncommunicable diseases, namely diabetes mellitus, hypertension and obesity, throughout the world has led to an increasing spectrum of research into different strategies to respond effectively to this epidemic
The aim of this research was to evaluate if the training on the use of the “Protocol for the Nutritional Management of Obesity, Diabetes and Hypertension in the Caribbean” improves the quality of care delivered to patients with Type 2 Diabetes in Jamaica, Guyana, Belize, St
Practice guidelines for nutrition care have been developed for patients with Type 2 diabetes in various countries, and evaluation studies carried out on the therapy that follows these guidelines have shown that the management is more cost effective when the guidelines are followed (Dijkstra, 2006)
Summary
The ever growing challenge of the increasing prevalence of noncommunicable diseases, namely diabetes mellitus, hypertension and obesity, throughout the world has led to an increasing spectrum of research into different strategies to respond effectively to this epidemic. Clinical practice guidelines or protocols of care have been developed by the Caribbean Health Research Council (2006) to improve the quality of health care for many chronic conditions with the more commonly used protocols for chronic disease being directed at primary care. Over the last fifteen years various regional institutions in the Caribbean have developed protocols for the clinical management of diabetes and hypertension which have been used to improve the quality of care of persons living with these conditions (CHRC, 2006). The nutritional component of care has not been adequately addressed in these protocols and no standard guidelines existed in the region for the nutritional management of obesity, diabetes and hypertension. The Caribbean Food and Nutrition Institute (CFNI), in 2004, launched a regional protocol for the nutritional management of diabetes, obesity and high blood pressure (hypertension). The training involved all the members of the healthcare team at the primary health setting to ensure that a whole team approach is facilitated, and allow all the members of the team to be well equipped to participate efficiently in the patients’ management
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