Increasing Diabetes Healthcare Capacity in Bangladesh through a Distance Learning Project
The purpose of this study was to evaluate the impact of the Distance Learning Program (DLP) on provider capacity to provide comprehensive diabetes care and improvement on patient outcomes in Bangladesh. Study was conducted among 1974 DLP trained physicians, 1876 Non-DLP physicians and 2617 diabetic...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2015-01-01
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| Series: | Journal of Diabetology |
| Subjects: | |
| Online Access: | http://www.journalofdiabetology.org/article.asp?issn=2078-7685;year=2015;volume=6;issue=1;spage=1;epage=1;aulast=Khan;type=0 |
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| author | A.K.A. Khan H Mahtab T Ahmed S M Ashrafuzzaman B Bhowmik T Ahmed F Afsana M M Ilondo D E Stevens |
| author_facet | A.K.A. Khan H Mahtab T Ahmed S M Ashrafuzzaman B Bhowmik T Ahmed F Afsana M M Ilondo D E Stevens |
| author_sort | A.K.A. Khan |
| collection | DOAJ |
| description | The purpose of this study was to evaluate the impact of the Distance Learning Program (DLP) on provider capacity to provide comprehensive diabetes care and improvement on patient outcomes in Bangladesh. Study was conducted among 1974 DLP trained physicians, 1876 Non-DLP physicians and 2617 diabetic patients. In addition, quality of patient care and clinical outcomes before and after the implementation of DLP were also studied. Historical documents including patient case records from registered patient guidebooks and biochemical profiles from laboratory database were documented and analyzed. DLP physicians had more knowledge in each clinical practice guideline of diabetes care than Non-DLP physicians (odds ratio [OR] range: 2.2 to 11.7). DLP-trained physicians performed more diabetes-related examinations including blood pressure (OR=3.0), waist and hip circumference (OR= 2.6), BMI (OR= 2.6), foot (OR= 2.2), eye (OR= 2.0) and investigated blood glucose (OR= 2.2), hemoglobin A1c (A1C) (OR= 2.1), lipids (OR=1.9), creatinine (OR=1.9), micro albumin (OR=1.8) and ECG (OR=1.6) more than non-DLP physicians. DLP physicians felt more confident to give advice on key areas of diabetes care including diet (OR=2.9), physical activity (OR=3.0), smoking cessation (OR=2.5), foot care (OR=2.9) and complications related to diabetes (OR=2.8) than non-DLP doctors. Significant improvement of patients care including dietary advice (91 to 96%), frequency of clinic visits (3 to 3.6 time), foot care referral (3 to 8%), measurement of blood pressure (73.1 to 89.2%) and blood glucose (58 to 75%) were observed from pre to post DLP period. Average values of fasting plasma glucose (FPG) and postprandial plasma glucose (PPG) significantly decreased in post DLP period. Patient satisfaction also improved between pre to post DLP period. DLP is feasible and acceptable to physicians in Bangladesh. It has made highly positive impact on patients care. We recommend that other resource-poor settings should consider the adoption of a DLP. |
| first_indexed | 2024-12-20T17:42:17Z |
| format | Article |
| id | doaj.art-88e6a89fdce34c0c9f99c28b14ba2ab7 |
| institution | Directory Open Access Journal |
| issn | 2078-7685 |
| language | English |
| last_indexed | 2024-12-20T17:42:17Z |
| publishDate | 2015-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Diabetology |
| spelling | doaj.art-88e6a89fdce34c0c9f99c28b14ba2ab72022-12-21T19:31:04ZengWolters Kluwer Medknow PublicationsJournal of Diabetology2078-76852015-01-016111Increasing Diabetes Healthcare Capacity in Bangladesh through a Distance Learning ProjectA.K.A. KhanH MahtabT AhmedS M AshrafuzzamanB BhowmikT AhmedF AfsanaM M IlondoD E StevensThe purpose of this study was to evaluate the impact of the Distance Learning Program (DLP) on provider capacity to provide comprehensive diabetes care and improvement on patient outcomes in Bangladesh. Study was conducted among 1974 DLP trained physicians, 1876 Non-DLP physicians and 2617 diabetic patients. In addition, quality of patient care and clinical outcomes before and after the implementation of DLP were also studied. Historical documents including patient case records from registered patient guidebooks and biochemical profiles from laboratory database were documented and analyzed. DLP physicians had more knowledge in each clinical practice guideline of diabetes care than Non-DLP physicians (odds ratio [OR] range: 2.2 to 11.7). DLP-trained physicians performed more diabetes-related examinations including blood pressure (OR=3.0), waist and hip circumference (OR= 2.6), BMI (OR= 2.6), foot (OR= 2.2), eye (OR= 2.0) and investigated blood glucose (OR= 2.2), hemoglobin A1c (A1C) (OR= 2.1), lipids (OR=1.9), creatinine (OR=1.9), micro albumin (OR=1.8) and ECG (OR=1.6) more than non-DLP physicians. DLP physicians felt more confident to give advice on key areas of diabetes care including diet (OR=2.9), physical activity (OR=3.0), smoking cessation (OR=2.5), foot care (OR=2.9) and complications related to diabetes (OR=2.8) than non-DLP doctors. Significant improvement of patients care including dietary advice (91 to 96%), frequency of clinic visits (3 to 3.6 time), foot care referral (3 to 8%), measurement of blood pressure (73.1 to 89.2%) and blood glucose (58 to 75%) were observed from pre to post DLP period. Average values of fasting plasma glucose (FPG) and postprandial plasma glucose (PPG) significantly decreased in post DLP period. Patient satisfaction also improved between pre to post DLP period. DLP is feasible and acceptable to physicians in Bangladesh. It has made highly positive impact on patients care. We recommend that other resource-poor settings should consider the adoption of a DLP.http://www.journalofdiabetology.org/article.asp?issn=2078-7685;year=2015;volume=6;issue=1;spage=1;epage=1;aulast=Khan;type=0Diabeteshealthcare capacityBangladeshdistance learning program |
| spellingShingle | A.K.A. Khan H Mahtab T Ahmed S M Ashrafuzzaman B Bhowmik T Ahmed F Afsana M M Ilondo D E Stevens Increasing Diabetes Healthcare Capacity in Bangladesh through a Distance Learning Project Journal of Diabetology Diabetes healthcare capacity Bangladesh distance learning program |
| title | Increasing Diabetes Healthcare Capacity in Bangladesh through a Distance Learning Project |
| title_full | Increasing Diabetes Healthcare Capacity in Bangladesh through a Distance Learning Project |
| title_fullStr | Increasing Diabetes Healthcare Capacity in Bangladesh through a Distance Learning Project |
| title_full_unstemmed | Increasing Diabetes Healthcare Capacity in Bangladesh through a Distance Learning Project |
| title_short | Increasing Diabetes Healthcare Capacity in Bangladesh through a Distance Learning Project |
| title_sort | increasing diabetes healthcare capacity in bangladesh through a distance learning project |
| topic | Diabetes healthcare capacity Bangladesh distance learning program |
| url | http://www.journalofdiabetology.org/article.asp?issn=2078-7685;year=2015;volume=6;issue=1;spage=1;epage=1;aulast=Khan;type=0 |
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