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乌干达姆巴拉拉地区转诊医院糖尿病诊所成年糖尿病患者基本糖尿病服务的利用情况:一项横断面研究。

Utilization of basic diabetes mellitus services among adult patients with diabetes mellitus at Mbarara Regional Referral Hospital diabetes clinic, Uganda: a cross-sectional study.

作者信息

Muramuzi Dan, Mugambe Richard, Muteebwa Laban, Albert Ipola Patrick, Nduhukyire Lawrence, Nnannyanzi Claire, Mukose Aggrey David

机构信息

Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda.

Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda.

出版信息

Front Clin Diabetes Healthc. 2024 Dec 3;5:1290559. doi: 10.3389/fcdhc.2024.1290559. eCollection 2024.

Abstract

BACKGROUND

Utilization of diabetic care services remains a challenge among adult patients in low- and middle-income countries. Optimal utilization of diabetic care services could reduce morbidity and mortality and delay the development of long-term complications. This study assessed the utilization of basic diabetic care services and associated factors among diabetes mellitus patients at Mbarara Regional Referral Hospital in Western Uganda.

METHODS

We enrolled 208 patients with either type 1 or 2 diabetes mellitus in a cross-sectional study between June and August 2022 at Mbarara Regional Referral Hospital, Uganda. Consecutive sampling was used to select patients with diabetes mellitus who attended the diabetes clinic based on their scheduled date of appointment. Optimal utilization of basic diabetic services was defined as receiving at least three of the four core services: health education, assessment of vital signs (blood sugar, blood pressure, and body mass index), assessment of diabetic complications, and diabetic drug refills. Modified Poisson regression analysis was used to assess the determinants of utilization of basic diabetic services in STATA version 14.0.

RESULTS

Three-quarters of the study participants were female patients (75.0%), and the median (inter-quartile range, IQR) age was 52 (43, 56). Moreover, 62.0% [95% confidence interval (CI): 55.3-68.7] self-reported to have utilized basic diabetic care services. In the adjusted analysis, waiting longer than 120 min to receive any service [adjusted prevalence ratio (aPR) 0.46, 95% CI 0.27-0.80), being 45-54 years old (aPR 1.48, 95% CI:1.11-1.98), and being 55-60 years old (aPR, 1.38, 95% CI: 1.02 1.86)] were significantly associated with the utilization of basic diabetic care services.

CONCLUSION

Utilization of basic diabetic care services among adult patients remains sub-optimal. Age and waiting time were significantly associated with the utilization of diabetic care services. Interventions should be directed toward shortening the waiting time in service delivery at diabetes clinics.

摘要

背景

在低收入和中等收入国家的成年患者中,糖尿病护理服务的利用仍然是一项挑战。优化糖尿病护理服务的利用可以降低发病率和死亡率,并延缓长期并发症的发展。本研究评估了乌干达西部姆巴拉拉地区转诊医院糖尿病患者基本糖尿病护理服务的利用情况及相关因素。

方法

2022年6月至8月,我们在乌干达姆巴拉拉地区转诊医院进行了一项横断面研究,纳入了208例1型或2型糖尿病患者。采用连续抽样的方法,根据预约日期选择到糖尿病门诊就诊的糖尿病患者。基本糖尿病服务的最佳利用被定义为接受四项核心服务中的至少三项:健康教育、生命体征评估(血糖、血压和体重指数)、糖尿病并发症评估和糖尿病药物续方。使用修正泊松回归分析在STATA 14.0版本中评估基本糖尿病服务利用的决定因素。

结果

四分之三的研究参与者为女性患者(75.0%),年龄中位数(四分位间距,IQR)为52岁(43,56)。此外,62.0%[95%置信区间(CI):55.3 - 68.7]的患者自我报告已利用基本糖尿病护理服务。在调整分析中,等待超过120分钟才能获得任何服务[调整患病率比(aPR)0.46,95% CI 0.27 - 0.80]、年龄在45 - 54岁之间(aPR 1.48,95% CI:1.11 - 1.98)以及年龄在55 - 60岁之间(aPR,1.38,95% CI:1.02 - 1.86)与基本糖尿病护理服务的利用显著相关。

结论

成年患者基本糖尿病护理服务的利用仍未达到最佳水平。年龄和等待时间与糖尿病护理服务的利用显著相关。应采取干预措施缩短糖尿病门诊的服务等待时间。

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