Physicians' therapeutic practice and compliance of diabetic patients attending rural primary health care units in Alexandria

J Family Community Med. 2010 Sep;17(3):121-8. doi: 10.4103/1319-1683.74325.


Objectives: The objectives of the study were to investigate physician's therapeutic practice and the compliance of diabetic patients attending rural primary health units in Alexandria.

Material and methods: A cross-sectional study was conducted and a multistage stratified random sample method was used for the selection of 600 diabetic patients. Data were collected by means of an interviewing questionnaire, an observation checklist, review of prescriptions and laboratory investigations. A scoring system was made for a diabetic patient's knowledge and skills, patient's compliance, doctor-patient relationship, and glycemic control.

Results: About 57% always took their medication as prescribed by doctor and on time, only 2.2% always complied with dietary regimen while no one reported regular compliance with exercise regimen. Complications of the regimen was the commonest cause (63.3%) of noncompliance. A highly statistically significant difference was found between compliance with all regimens and patient's knowledge of diabetes. The scores for doctor-patient relationship were all unsatisfactory. Results of glycosylated hemoglobin (HbA1c) revealed that metabolic control of four-fifth of the patients was satisfactory, 12% had fair and 8% had poor metabolic control.

Conclusions: Patient's compliance with most of the diabetes regimen was low. Doctor-patient relationship and patient's compliance should be improved by conducting educational and training programs.

Keywords: Compliance; diabetes; doctor-patient relationship; knowledge; skills.