Testing interventions for improving adherence to diabetic guideline : a randomised controlled study in Bahrain

Abstract EN

Objectives : To assess the effect of adopting an extended consultation time policy combined with one of two interventions (peer-review discussion with feedback and feedback only) in changing physicians' adherence in implementing an agreed clinical guideline for diabetic follow-up, in primary health care centres in Bahrain.

Design : Experimental randomized controlled intervention study, conducted from July 1994 to June 1995.

Setting: Ten primary health care centres in Bahrain, were thirty-three primary care physicians working in.

Subjects: Records of Nine fifty diabetic patients who attended the health centers during the study period.

Main Outcome measures: Change in the proportion of diabetic patients' records containing a diabetic record form; change in the proportion of records with documented data on patients’ weight, blood pressure, blood sugar and haemoglobin Ale, in accordance with the guideline, compared before and after the intervention.

Results : After the intervention, the usage of the diabetic form increased by 66.9 % in the peer-review discussion group with feedback, 18% in the feedback only group, and only 1.4 % in the control group; the differences were highly significant.

Recording of patients' weight, blood pressure and Haemoglobin Ale was also significantly increased in peer-review discussion with feedback intervention group.

Health centres with an extended consultation time policy yield a significant change in recording some of the items in both I feedback and control group.