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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Barriers to the delivery of diabetes care in the Middle East and South Africa: A survey of 1,082 practising physicians in five countries
International Journal of Clinical Practice, Volume 67, No. 11, Year 2013
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Description
Aims Developing countries face a high and growing burden of type 2 diabetes. We surveyed physicians in a diverse range of countries in the Middle East and Africa (Egypt, Kingdom of Saudi Arabia, United Arab Emirates, South Africa and Lebanon) with regard to their perceptions of barriers to type 2 diabetes care identified as potentially important in the literature and by the authors. Methods One thousand and eighty-two physicians completed a questionnaire developed by the authors. Results Most physicians enroled in the study employed guideline-driven care; 80-100% of physicians prescribed metformin (with lifestyle intervention, where there are no contraindications) for newly diagnosed type 2 diabetes, with lifestyle intervention alone used where metformin was not prescribed. Sulfonylureas were prescribed widely, consistent with the poor economic status of many patients. About one quarter of physicians were not undertaking any form of continuing medical education, and relatively low proportions of practices had their own diabetes educators, dieticians or diabetic foot specialists. Physicians identified the deficiencies of their patients (unhealthy lifestyles, lack of education and poor diet) as the most important barriers to optimal diabetes care. Low-treatment compliance was not ranked highly. Access to physicians did not appear to be a problem, as most patients were seen multiple times per year. Conclusions Physicians in the Middle East and South Africa identified limitations relating to their patients as the main barrier to delivering care for diabetes, without giving high priority to issues relating to processes of care delivery. Further study would be needed to ascertain whether these findings reflect an unduly physician-centred view of their practice. More effective provision of services relating to the prevention of complications and improved lifestyles may be needed. Linked Comment: Flinders et al. Int J Clin Pract 2013; 67: 1074-5. © 2013 John Wiley & Sons Ltd.
Authors & Co-Authors
Assaad-Khalil, Samir Helmy
Egypt, Alexandria
Faculty of Medicine
Al-Arouj, Monira M.
Kuwait, Dasman
Dasman Diabetes Institute
Al-Maatouq, Mohamed A.
Saudi Arabia, Riyadh
King Khalid University Hospital
Amod, Aslam
South Africa, Durban
University of Kwazulu-natal
Assaad, Samir Naeim
Egypt, Alexandria
Faculty of Medicine
Azar, Sami T.
Lebanon, Beirut
American University of Beirut
Belkhadir, Jamal E.
Morocco, Agdal Rabat
National Coordinator of Moroccan Guidelines of Diabetes
Esmat, Khaled
Unknown Affiliation
Hassoun, Ahmed A.K.
United Arab Emirates, Dubai
Dubai Diabetes Center
Jarrah, N.
Jordan, Karak
Mutah University
Zatari, S.
Saudi Arabia, Taif
Al Hada Armed Forces Hospital
Alberti, K. George M.M.
United Kingdom, London
Imperial College London
Statistics
Citations: 21
Authors: 12
Affiliations: 10
Identifiers
Doi:
10.1111/ijcp.12205
ISSN:
13685031
e-ISSN:
17421241
Research Areas
Health System And Policy
Noncommunicable Diseases
Study Design
Randomised Control Trial
Cross Sectional Study
Study Approach
Quantitative
Study Locations
Egypt
South Africa