Primary care physicians' practice regarding diabetes mellitus diagnosis, evaluation and management in the West region of Cameroon.

Ahmadou M Jingi,Jobert Richie N Nansseu,Jean Jacques N Noubiap

doi:10.1186/s12902-015-0016-3

Ahmadou M Jingi, Jobert Richie N Nansseu + Show 1 more

Open Access

https://doi.org/10.1186/s12902-015-0016-3

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Abstract

BackgroundPrimary care physicians (PCPs) are the main providers of diabetes care especially in resource-limited countries which experience extreme shortage of specialists. The present study aimed to evaluate PCPs’ approach towards diabetes mellitus (DM) diagnosis, evaluation and management in Cameroon.MethodsWe carried-out a cross-sectional survey in February 2012 in the West Region of Cameroon. Using a structured pretested questionnaire, we interviewed all PCPs working in the region who were present at their working place when the investigators visited, and volunteered to be enrolled in the study.ResultsSixty-six PCPs were interviewed. Their ages ranged from 24 to 56 years (mean 38.3, standard deviation 9.2 years). The levels of knowledge of PCPs regarding DM diagnosis were: 72.7%, 37.9%, 19.7% and 32.8% respectively obtained when using fasting plasma glucose, post-prandial glycemia, random glycemia and glycated hemoglobin as diagnostic tools. Only 6 PCPs (9.9%) prescribed the correct minimal work-up to evaluate diabetes patients at diagnosis. PCPs advised lifestyle modifications in 92.4% of cases, and thirty nine (53.1%) PCP’s used to prescribe both generic and specialty oral anti-diabetic drugs in case of uncomplicated type 2 DM management. The two main classes of anti-diabetic drugs prescribed were biguanides (77.3%) and sulfonamides (60.6%). Nearly all PCPs (97%) used to give frequent follow-up appointments to their patients. Ninety eight point five percent of participants were willing to receive any further continuous training on DM management.ConclusionPCPs knowledge and practices towards diabetes mellitus diagnosis, evaluation and management were not optimal, stressing the need to improve their capacities regarding diabetes care. As such, more educational initiatives should be taken on, alongside regular upgrade and dissemination of clinical guidelines.

Highlights

Primary care physicians (PCPs) are the main providers of diabetes care especially in resource-limited countries which experience extreme shortage of specialists
We included all PCPs working in the region at the time of the survey irrespective of their age, gender, specialty, seniority, sector or location of practice, who were present at their work place when the investigators visited, and who consented to be enrolled in the study
Most of PCPs were located in an urban area (69.7%), and 37 (56.1%) of them were practicing in public health facilities

Summary

Introduction

Primary care physicians (PCPs) are the main providers of diabetes care especially in resource-limited countries which experience extreme shortage of specialists. In addition to growing numbers of individuals in whom DM has been diagnosed, in numerous others DM or prediabetes remains undiagnosed or is likely to develop in the near future. Identification of such individuals at risk for DM, as well as those who may already have the disease but in whom it has not yet been diagnosed is a key element in reducing the overall burden of the disease [6]. Age was dichotomized into two groups: < 35 and ≥ 35 years. Duration of practice was divided into two groups: < 10 and ≥ 10 years. Having previously taken part in any training on DM after graduation was reported as “yes” or “no” according to the answer given by the PCP

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