HEALTH CONDITION AND COMPLIANCE OF THE CHILEAN CLINICAL GUIDELINE FOR TYPE 2 DIABETIC PATIENTS

Abstract

Objectives: To determine compliance with Chilean clinical guideline and to measure their impact through evaluation of patient’s health condition (HC), to determine associations. Methods: prevalence study, April 2010. Population: 1,100 diabetic patients controlled in the Cardiovascular Program, considering criteria of inclusion, exclusion, informed consent. Sample: 340 randomized patients (Confidence level: 95%; Loss: 10%). Information was collected in an outpatient clinic and through home visits performed by researchers and trained senior nursing students, with a validated survey, exams, staff for file information. For the purposes of the analysis, descriptive statistics was used, Chi2, Odds Ratios with CI (95%). Results: HC: decompensation (HbA1c>7%) 56.5%, derived illnesses 97.9%, complications 25%, greater frequency of diabetic retinopathy. Males with greater risk of amputation (p=0.003). Blood pressure >130/85 mm. hg. 58.2%, overweight-obesity 71.2%, self-care (older adults) 23.1%. Compliance with clinical guideline: controls/professionals/year at least fve 41.5%, CESFAM adapts this recommendation. Annual evaluation of: diabetic foot 78%, fundoscopy 41.6%. Regime indication (dietician) last control 80%. Five professional controls/year or more protect compensation for diabetes, IC (0.62-0.95), other recommendations and adaptation of recommendations are not associated with health status (p > 0.05). Conclusions: components of hC are better than expected. In none of the patients are the recommendations of the clinical guideline fulflled in a 100%. 5 or more annual outpatient visits are associated to good metabolic control. Compliance with clinical guideline recommendations is important to improve metabolic control, to lessen complications and to improve patient’s quality of life.