Awareness, agreement, adoption and adherence to type 2 diabetes mellitus guidelines: a survey of Indonesian primary care physicians

Widyahening, Indah Suci; Graaf, Yolanda van der; Soewondo, Pradana; Glasziou, Paul; Heijden, Geert J. M. G. van der

doi:10.1186/1471-2296-15-72

Cited by 33 publications

(31 citation statements)

References 15 publications

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“…Indeed, the UKPDS risk engine may both overestimate [24,26,27,34,35] and underestimate [36,37] the CHD risk and therefore its use as a basis for initiating treatment is questioned. Barriers to guideline adherence may occur among GPs and some are patient related [16,17,38]. Comparable to the current study, the study of Lugtenberg et al [38] also showed that a significant number of GPs did not initiate or intensify therapy, even if they had underestimated the CHD risk.…”

Section: Comparison With Existing Literaturecontrasting

confidence: 43%

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Impact of UKPDS risk estimation added to a first subjective risk estimation on management of coronary disease risk in type 2 diabetes – An observational study

Wind

Gorter

Donk

et al. 2016

Primary Care Diabetes

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Section: Comparison With Existing Literaturecontrasting

confidence: 43%

“…Clinicians may wonder why they should use them if there is no proof of added value to clinical management. For all these reasons, the use of risk prediction tools is not a routine in general practice [13][14][15][16][17]. Diabetes is a major risk factor for cardiovascular disease, although it is not a coronary risk equivalent [18].…”

Section: Introductionmentioning

confidence: 99%

Impact of UKPDS risk estimation added to a first subjective risk estimation on management of coronary disease risk in type 2 diabetes – An observational study

Wind

Gorter

Donk

et al. 2016

Primary Care Diabetes

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“…Well-evidenced interventions intended to improve patient well-being may not be used optimally across healthcare professions [1–8] with many barriers identified to the uptake of best evidence [5, 6, 9–12] and interventions designed to overcome these [13–15]. Implementation science seeks to promote the uptake of research and other evidence-based findings into practice [16], but for healthcare professionals, this is complex as practice draws on, in addition to scientific principles, rules of thumb and a store of practical wisdom [17] acquired from a range of informational and experiential sources.…”

Section: Introductionmentioning

confidence: 99%

Describing knowledge encounters in healthcare: a mixed studies systematic review and development of a classification

Hurst

Mickan

2017

Implementation Sci

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BackgroundImplementation science seeks to promote the uptake of research and other evidence-based findings into practice, but for healthcare professionals, this is complex as practice draws on, in addition to scientific principles, rules of thumb and a store of practical wisdom acquired from a range of informational and experiential sources. The aims of this review were to identify sources of information and professional experiences encountered by healthcare workers and from this to build a classification system, for use in future observational studies, that describes influences on how healthcare professionals acquire and use information in their clinical practice.MethodsThis was a mixed studies systematic review of observational studies. DATA SOURCES: OVID MEDLINE and Embase and Google Scholar were searched using terms around information, knowledge or evidence and sharing, searching and utilisation combined with terms relating to healthcare groups. ELIGIBILITY: Studies were eligible if one of the intentions was to identify information or experiential encounters by healthcare workers. DATA EXTRACTION: Data was extracted by one author after piloting with another. STUDY APPRAISAL: Studies were assessed using the Mixed Methods Appraisal Tool (MMAT). PRIMARY OUTCOME: The primary outcome extracted was the information source or professional experience encounter. ANALYSIS: Similar encounters were grouped together as single constructs. Our synthesis involved a mixed approach using the top-down logic of the Bliss Bibliographic Classification System (BC2) to generate classification categories and a bottom-up approach to develop descriptive codes (or “facets”) for each category, from the data. The generic terms of BC2 were customised by an iterative process of thematic content analysis. Facets were developed by using available theory and keeping in mind the pragmatic end use of the classification.ResultsEighty studies were included from which 178 discreet knowledge encounters were extracted. Six classification categories were developed: what information or experience was encountered; how was the information or experience encountered; what was the mode of encounter; from whom did the information originate or with whom was the experience; how many participants were there; and where did the encounter take place. For each of these categories, relevant descriptive facets were identified.ConclusionsWe have sought to identify and classify all knowledge encounters, and we have developed a faceted description of key categories which will support richer descriptions and interrogations of knowledge encounters in healthcare research.Electronic supplementary materialThe online version of this article (doi:10.1186/s13012-017-0564-1) contains supplementary material, which is available to authorized users.

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“…Engaging potential end users in the process of evaluating and adapting existing guidelines may help improve the uptake and utilization of the guideline . This process has also been overlooked in the Indonesian type 2 diabetes mellitus guideline development; hence, we found in our previous study that the adherence to the recommendations on the Indonesian type 2 diabetes mellitus guidelines is very low …”

Section: Discussionmentioning

confidence: 90%

“…we found in our previous study that the adherence to the recommendations on the Indonesian type 2 diabetes mellitus guidelines is very low. 49 As far as we know, this is a first study that examines how the recommendations from different guidelines were being adapted to develop a local diabetes guideline. Previous studies compared the quality and recommendations from different diabetes guidelines from different countries or different institutions.…”

Section: This Was Also a Finding Of Aarts Et Al In Their Study On Obsmentioning

confidence: 99%

Adapting clinical guidelines in low‐resources countries: a study on the guideline on the management and prevention of type 2 diabetes mellitus in Indonesia

Widyahening

Wangge

Graaf

et al. 2016

Evaluation Clinical Practice

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Rationale, aims and objectivesMost of the clinical guidelines in low‐resource countries are adaptations from preexisting international guidelines. This adaptation can be problematic when those international guidelines are not based on current evidence or original evidence‐based international guidelines are not followed. This study aims to evaluate the quality of an Indonesian type 2 diabetes mellitus guideline adapted from selected international guidelines.MethodsThe “Consensus on the Management and Prevention of type 2 Diabetes in Indonesia 2011” is a guideline by the Indonesian Society of Endocrinology (Perkeni). Four parent guidelines identified from its list of references were from the International Diabetes Federation (IDF), American Association of Clinical Endocrinologist (AACE), American Diabetes Association (ADA), and one jointly released by ADA and European Association for the Study of Diabetes (EASD). Two reviewers independently assessed its quality using the Appraisal of Guidelines, Research and Evaluation Collaboration (AGREE II) instrument. Six recommendations were compared: (1) screening for diabetes; (2) diagnosis; (3) control of hyperglycemia; (4) target blood glucose; (5) target blood pressure; and (6) treatment of dyslipidemia.ResultsPerkeni's guideline satisfied 55% of the AGREE II items, while its parent guidelines satisfied 59% to 74%. Perkeni's shows low score on “rigor of development” and “applicability” and the lowest score in the “scope and purpose” domain. Differences were found in 4 recommendations: the screening of diabetes, control of hyperglycemia, target blood glucose, and treatment of dyslipidemia. In 3 of 4, Perkeni followed the ADA's recommendation.ConclusionDerivation of recommendations from parent guidelines and their adaptation to the context of Indonesian health care lacks transparency. When guidelines are either derived from other guidelines or adapted for use in different context, evidence‐based practice principles should be followed and adhered to.

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Awareness, agreement, adoption and adherence to type 2 diabetes mellitus guidelines: a survey of Indonesian primary care physicians

Cited by 33 publications

References 15 publications

Impact of UKPDS risk estimation added to a first subjective risk estimation on management of coronary disease risk in type 2 diabetes – An observational study

Impact of UKPDS risk estimation added to a first subjective risk estimation on management of coronary disease risk in type 2 diabetes – An observational study

Describing knowledge encounters in healthcare: a mixed studies systematic review and development of a classification

Adapting clinical guidelines in low‐resources countries: a study on the guideline on the management and prevention of type 2 diabetes mellitus in Indonesia

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