Quality of Care for Patients with Type 2 Diabetes Mellitus in Dubai: A HEDIS-Like Assessment

Abstract

Objective. As little data are available on the quality of type 2 diabetes mellitus (T2DM) care in the Arabian Gulf States, we estimated the proportion of patients receiving recommended monitoring at the Dubai Hospital for T2DM over one year. Methods. Charts from 150 adults with T2DM were systematically sampled and quality of care was assessed during one calendar year, using a Healthcare Effectiveness Data and Information Set- (HEDIS-) like assessment. Screening for glycosylated haemoglobin (HbA1c), low-density lipoprotein (LDL), blood pressure, retinopathy, and nephropathy was considered. Patients were classified based on their most recent test in the period, and predictors of receiving quality care were examined. Results. Mean age was 58 years (standard deviation (SD): 12.4 years) and 33% were males. Over the year, 98% underwent HbA1c screening (50% had control and 28% displayed poor control); 91% underwent LDL screening (65% had control); 55% had blood pressure control; 30% had retinopathy screening; and 22% received attention for nephropathy. No individual characteristics examined predicted receiving quality care. Conclusion. Some guideline monitoring was conducted for most patients; and rates of monitoring for selected measures were comparable to benchmarks from the United States. Greater understanding of factors leading to high adherence would be useful for other areas of preventive care and other jurisdictions.

Indicators of Quality of Clinical Care for Type 2 Diabetes Patients in Primary Health Care Centers in Qatar: A Retrospective Analysis

“…The current study adds to the limited pool of studies on the same topic in the region. In conformity with Szabo's study in the UAE that found all UAE clinical care indicators exceed the US HEDIS diabetes care measure except for the HbA1c [6]; our study results also showed most clinical indicators exceed Szabo's study results [6] and the BRFSS benchmarks except for the HbA1c.…”

“…In keeping with findings in similar studies [6, 18], metformin was the most prescribed diabetes medication at 89.9%. The second most prescribed medication comprised DDP-4 inhibitors (61.1%), and the third most prescribed medication comprised sulfonylureas (49.3).…”

“…The demographic imbalance in the male-female ratio in non-Qataris is due to the high influx of male expatriate workers [16]. The previous study on diabetes in Qatar [4] showed a majority of women as it included only Qataris, matching a similar study conducted in Dubai [6].…”

“…The second most prescribed medication comprised DDP-4 inhibitors (61.1%), and the third most prescribed medication comprised sulfonylureas (49.3). This contrasts with two studies in which sulfonylureas were the second most prescribed [6, 18]. The DDP-4 inhibitor has a low risk of hypoglycemia and is weight neutral; as the cost is paid by the public health care system in Qatar, it is preferable to sulfonylureas.…”

“…Some regional studies have reported modest to low compliance with international benchmarks in the level of care provided to patients with diabetes [6, 7]. The Healthcare Effectiveness Data and Information Set (HEDIS) results also showed variable levels of comprehensive diabetes care in the USA [8].…”