Evaluating adherence to recommended clinical guidelines for the prevention of cardiovascular disease in patients with Type 2 diabetes mellitus at primary care level

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dc.contributor.advisorZweigenthal, Virginiaen_ZA
dc.contributor.authorLangenhoven, Williamen_ZA
dc.date.accessioned2017-09-23T06:37:06Z
dc.date.available2017-09-23T06:37:06Z
dc.date.issued2017en_ZA
dc.description.abstractBackground: Globally, type 2 diabetes (T2D) is a significant cause of avoidable mortality and morbidity. It is a major risk factor for cardiovascular disease (CVD). Evidence-based guidelines lower cardiovascular risk in diabetics. Adherence to clinical guidelines for the prevention of CVD in South African primary care public sector facilities is unknown. Aim: This study determined adherence of Cape Town primary care clinicians to recommended clinical guidelines for the prevention of cardiovascular disease in T2D. Methods: This 2013 cross-sectional study extracted data from 300 folders of known T2D patients sampled from three Community Health Centres (CHCs). Compliance with guidelines, and patient demographic factors were analysed. Results: Most (71% or 194/273) hypertensive diabetics were appropriately managed with first-line- medication - an Angiotensin Converting Enzyme Inhibitor (ACEI). There was appropriate supporting documentation for only 39% not on first line therapy. A fifth (22%) with drug intolerance received the recommended alternative. Most were appropriately prescribed a statin (74%) and aspirin (69%). Other cardiovascular risk factors were poorly controlled: mean weights were in the obese range (BMI=31.3 [SD: 5.7]); the mean total cholesterol level was 5.5 (SD: 1.4); there was incomplete data for smoking (19% had no record) and 93% had no record of a family history of CVD. Conclusions: Whilst pharmacological interventions for the prevention of CVD were moderately implemented, patient factors – such as obesity and smoking were poorly addressed. Improving documentation, adherence to recommended clinical guidelines and, health promotion to address modifiable risks are required to improve quality of care for T2D.en_ZA
dc.identifier.apacitationLangenhoven, W. (2017). <i>Evaluating adherence to recommended clinical guidelines for the prevention of cardiovascular disease in patients with Type 2 diabetes mellitus at primary care level</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. Retrieved from http://hdl.handle.net/11427/25354en_ZA
dc.identifier.chicagocitationLangenhoven, William. <i>"Evaluating adherence to recommended clinical guidelines for the prevention of cardiovascular disease in patients with Type 2 diabetes mellitus at primary care level."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2017. http://hdl.handle.net/11427/25354en_ZA
dc.identifier.citationLangenhoven, W. 2017. Evaluating adherence to recommended clinical guidelines for the prevention of cardiovascular disease in patients with Type 2 diabetes mellitus at primary care level. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Langenhoven, William AB - Background: Globally, type 2 diabetes (T2D) is a significant cause of avoidable mortality and morbidity. It is a major risk factor for cardiovascular disease (CVD). Evidence-based guidelines lower cardiovascular risk in diabetics. Adherence to clinical guidelines for the prevention of CVD in South African primary care public sector facilities is unknown. Aim: This study determined adherence of Cape Town primary care clinicians to recommended clinical guidelines for the prevention of cardiovascular disease in T2D. Methods: This 2013 cross-sectional study extracted data from 300 folders of known T2D patients sampled from three Community Health Centres (CHCs). Compliance with guidelines, and patient demographic factors were analysed. Results: Most (71% or 194/273) hypertensive diabetics were appropriately managed with first-line- medication - an Angiotensin Converting Enzyme Inhibitor (ACEI). There was appropriate supporting documentation for only 39% not on first line therapy. A fifth (22%) with drug intolerance received the recommended alternative. Most were appropriately prescribed a statin (74%) and aspirin (69%). Other cardiovascular risk factors were poorly controlled: mean weights were in the obese range (BMI=31.3 [SD: 5.7]); the mean total cholesterol level was 5.5 (SD: 1.4); there was incomplete data for smoking (19% had no record) and 93% had no record of a family history of CVD. Conclusions: Whilst pharmacological interventions for the prevention of CVD were moderately implemented, patient factors – such as obesity and smoking were poorly addressed. Improving documentation, adherence to recommended clinical guidelines and, health promotion to address modifiable risks are required to improve quality of care for T2D. DA - 2017 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2017 T1 - Evaluating adherence to recommended clinical guidelines for the prevention of cardiovascular disease in patients with Type 2 diabetes mellitus at primary care level TI - Evaluating adherence to recommended clinical guidelines for the prevention of cardiovascular disease in patients with Type 2 diabetes mellitus at primary care level UR - http://hdl.handle.net/11427/25354 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/25354
dc.identifier.vancouvercitationLangenhoven W. Evaluating adherence to recommended clinical guidelines for the prevention of cardiovascular disease in patients with Type 2 diabetes mellitus at primary care level. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2017 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/25354en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentDepartment of Public Health and Family Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherFamily Medicineen_ZA
dc.titleEvaluating adherence to recommended clinical guidelines for the prevention of cardiovascular disease in patients with Type 2 diabetes mellitus at primary care levelen_ZA
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMMeden_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
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