Quality of Type II Diabetes Care in Primary Health Care Centers in Kuwait: Employment of a Diabetes Quality Indicator Set (DQIS)

Abstract

Diabetes Mellitus is one of the major public health challenges, affecting more than 347 million adults worldwide. The impact of diabetes necessitates assessing the quality of care received by people with diabetes, especially in countries with a significant diabetes burden such as Kuwait. This paper aimed at piloting an approach for measuring Type II diabetes care performance through the use of a diabetes quality indicator set (DQIS) in primary health care. The DQIS for Kuwait was adapted from that developed by the National Diabetes Quality Improvement Alliance and the International Diabetes Federation. Five key care domains/measures were employed: (1) Blood glucose level measurement, (2) Cholesterol level measurement, (3) Blood pressure measurement, (4) Kidney function testing and (5) Smoking status check. The sample included the four major primary health care centers with the highest case load in Kuwait City, 4,241 patients in 2012 and 3,211 in 2010. Findings revealed the applicability and utility of employing performance indicators for diabetes care in Kuwait. Furthermore, findings revealed that many of the primary health care centers have achieved noteworthy improvement in diabetes care between 2010 and 2012, with the exception of smoking status check. The DQIS can help policymakers identify performance gaps and investigate key system roadblocks related to diabetes care in Kuwait.

Quality of care for type 2 diabetes mellitus in Tripoli Medical Center: a retrospective study of 628 patients

“…Data from Kuwait found that doubling of the HbA 1c measurements (from 30% to 63%) between 2010 and 2012, was associated with a decrease in the rate of poorly controlled HbA 1c from around 80% to 55% [29]. Our findings regarding glycemic control are comparable with those of studies in other Arab countries, 26.4% patients achieved HbA 1c < 6.5% and 41.8% ones achieved HbA 1c < 7.5%.…”

“…In the present study, 41.5% of patients had HbA 1c above 8.5%, this is less than the 54% reported in a study looking at diabetics in primary care settings in Saudia, and the 55.4% reported rate for poor control in Kuwait [29,34].…”

“…Annual lipid measurement was documented in 34% in Kuwait, 58% in Abu Dhabi, and 87% in Saudi Arabia [29,31]. About 51% of patients had their triglyceride above the target level, and 53.8% of female patients and 43.5% of male patients had their HDL cholesterol below the recommended target level.…”

Patient-Related Determinants of Glycaemic Control in People with Type 2 Diabetes in the Gulf Cooperation Council Countries: A Systematic Review

“…Poor glycaemic control is defined as a glycated haemoglobin (HbA1c) equal to or above 7% or a fasting plasma sugar (FPS) above 7.2 mmol/l for adults who are not pregnant [ 7 ]. Poor glycaemic control (HbA1c > 7%) among people with type 2 diabetes mellitus (T2DM) in the GCC countries is common, ranging between 59% and 70.7% in Saudi Arabia [ 8 , 9 ], 68% and 69% in the UAE [ 10 , 11 ], 86.5% and 88.8% in Bahrain [ 12 , 13 ], and 54% and 65% in Oman [ 14 , 15 ], while a study reported that 55% of people with T2DM in Kuwait have HbA1c > 9% [ 16 ].…”

Patients&#39; management of type 2 diabetes in Middle Eastern countries: review of studies

“…This could be achieved by implementing strategies for assessing and improving the quality of the health care services provided. 24 , 26 , 51 Also, at the governmental level, reinforcing and strengthening strategies for prevention and early diagnosis of T2DM should be taken into consideration.…”