Hypertension and Diabetes: Poor care for patients at community health centres
OBJECTIVES: To identify health-care and provider-related determinants of diabetes and hypertension patients attending public sector community health centres (CHCs).
METHODS: A random sample of 18 CHCs in the Cape Peninsula providing hypertension and diabetes care was selected. Twenty-five diabetes and 35 hypertension patients were selected per clinic and interviewed by trained fieldworkers and their medical records audited. Regression analyses identified predictors of controlled hypertension (< 140/90 mmHg) and diabetes (HbA1c < 7%). Analyses of in-depth interviews with nurses and doctors explored their experiences at the CHCs. Height, weight and blood pressure (BP) were measured and a random blood sample collected for lipids, glucose, HbA1c and creatinine.
RESULTS: Hypertension and diabetes participants numbered 923 and 455, respectively (289 had both conditions). There were 33% hypertensive patients with a BP < 140/90 mmHg, while 42% of diabetes patients had non-fasting glucose levels below 11.1 mmol/ℓ. Knowledge about their conditions was poor. Prescriptions for drugs were not recorded in medical records of 22.6% of the diabetes and 11.4% of the hypertension patients.
CONCLUSIONS: Primary care for patients with hypertension and diabetes at public sector CHCs is suboptimal. This highlights the urgent need to improve health care for patients with these conditions in the public sector of the Cape Peninsula.
jean marguerite fourie, MRC
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Date published: 2008-08-04
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