Diabetes Knowledge, Attitudes and Practices Among Chinese Primary Care Physicians: a Cross-sectional Study

Overview

Journal BMC Prim Care

Specialties Health Services
Public Health

Date 2024 Sep 28

PMID 39342244

Authors

Linhua Pi

BinBin He

Dongxue Fei

Xiajie Shi

Zhiguang Zhou

Affiliations

Soon will be listed here.

Abstract

Background: Type 2 diabetes mellitus (T2DM) is a public health crisis that requires adequate knowledge, attitudes, and practices (KAP) by health care providers to prevent or delay the progression of the disease. This study aimed to assess the KAP regarding T2DM among primary care providers (PCPs) in Central China.

Methods: This multicenter cross-sectional study was conducted among 971 PCPs using self-employed KAP questionnaires. Questionnaires were designed to evaluate KAP regarding T2DM among PCPs, and was measured with SPSS software. Descriptive statistics, the Pearson correlation coefficients and multiple regression models used to analyze the data.70%, 80% and 70% of total values were considered as the cut-off point for defining good knowledge, positive attitude and correct practice.

Results: A total of 971 PCPs with a mean age of 44.0 ± 10.2 years were evaluated. 620 (63.9%) PCPs worked at village clinic and 605 (62.3%) PCPs have been working more than 20 years. Only 26.3% of the respondents participated in Continued Medical Education (CME) programs regarding diabetes in the past year due to Covid-19 pandemic. Overall, despite positive attitudes toward diabetes, there were substantial gaps in knowledge and practices. The PCPs scored 7.25 out of 14 points on the knowledge subscales, 7.13 out of 8 on the attitude subscales, and 4.85 out of 11 on the practice subscales. Gender, age, practice setting, professional titles, duration of practice and CME attendance were significant predictors of knowledge; Age, practice setting and duration of practice were significant predictors of attitudes; and family history of diabetes affected PCP practices.

Conclusions: Despite positive attitudes toward diabetes, there were substantial gaps in knowledge and practices. These findings call for action from relevant health authorities and policy makers to improve PCPs' KAP regarding diabetes in Central China.

References

Ugwu E, Young E, Nkpozi M . Diabetes care knowledge and practice among primary care physicians in Southeast Nigeria: a cross-sectional study. BMC Fam Pract. 2020; 21(1):128. PMC: 7330977. DOI: 10.1186/s12875-020-01202-0. View

Zhong V, Yu D, Zhao L, Yang Y, Li X, Li Y . Achievement of Guideline-Recommended Targets in Diabetes Care in China : A Nationwide Cross-Sectional Study. Ann Intern Med. 2023; 176(8):1037-1046. DOI: 10.7326/M23-0442. View

ElSayed N, Aleppo G, Aroda V, Bannuru R, Brown F, Bruemmer D . 3. Prevention or Delay of Type 2 Diabetes and Associated Comorbidities: Standards of Care in Diabetes-2023. Diabetes Care. 2022; 46(Suppl 1):S41-S48. PMC: 9810464. DOI: 10.2337/dc23-S003. View

Morrison F, Shubina M, Goldberg S, Turchin A . Performance of primary care physicians and other providers on key process measures in the treatment of diabetes. Diabetes Care. 2012; 36(5):1147-52. PMC: 3631881. DOI: 10.2337/dc12-1382. View

Eldein H, Mansour N, Mohamed S . Knowledge, attitude and practice of family physicians regarding smoking cessation counseling in family practice centers, suez canal university, egypt. J Family Med Prim Care. 2014; 2(2):159-63. PMC: 3894034. DOI: 10.4103/2249-4863.117411. View

M Jingi A, Nansseu J, Noubiap J . Primary care physicians' practice regarding diabetes mellitus diagnosis, evaluation and management in the West region of Cameroon. BMC Endocr Disord. 2015; 15:18. PMC: 4403824. DOI: 10.1186/s12902-015-0016-3. View

Katulanda P, Constantine G, Weerakkody M, Perera Y, Jayawardena M, Wijegoonawardena P . Can we bridge the gap? Knowledge and practices related to Diabetes Mellitus among general practitioners in a developing country: A cross sectional study. Asia Pac Fam Med. 2011; 10(1):15. PMC: 3247021. DOI: 10.1186/1447-056X-10-15. View

Rushforth B, McCrorie C, Glidewell L, Midgley E, Foy R . Barriers to effective management of type 2 diabetes in primary care: qualitative systematic review. Br J Gen Pract. 2016; 66(643):e114-27. PMC: 4723210. DOI: 10.3399/bjgp16X683509. View

Cheung A, Stukel T, Alter D, Glazier R, Ling V, Wang X . Primary Care Physician Volume and Quality of Diabetes Care: A Population-Based Cohort Study. Ann Intern Med. 2016; 166(4):240-247. DOI: 10.7326/M16-1056. View

10.

Li X, Lu J, Hu S, Cheng K, De Maeseneer J, Meng Q . The primary health-care system in China. Lancet. 2017; 390(10112):2584-2594. DOI: 10.1016/S0140-6736(17)33109-4. View

11.

. U.K. prospective diabetes study 16. Overview of 6 years' therapy of type II diabetes: a progressive disease. U.K. Prospective Diabetes Study Group. Diabetes. 1995; 44(11):1249-58. View

12.

Holman R, Paul S, Bethel M, Matthews D, Neil H . 10-year follow-up of intensive glucose control in type 2 diabetes. N Engl J Med. 2008; 359(15):1577-89. DOI: 10.1056/NEJMoa0806470. View

13.

Strange P . Treat-to-target insulin titration algorithms when initiating long or intermediate acting insulin in type 2 diabetes. J Diabetes Sci Technol. 2009; 1(4):540-8. PMC: 2769634. DOI: 10.1177/193229680700100412. View

14.

Thepwongsa I, Kirby C, Paul C, Piterman L . Management of type 2 diabetes: Australian rural and remote general practitioners' knowledge, attitudes, and practices. Rural Remote Health. 2014; 14:2499. View

15.

Dennis J, Henley W, McGovern A, Farmer A, Sattar N, Holman R . Time trends in prescribing of type 2 diabetes drugs, glycaemic response and risk factors: A retrospective analysis of primary care data, 2010-2017. Diabetes Obes Metab. 2019; 21(7):1576-1584. PMC: 6618851. DOI: 10.1111/dom.13687. View

16.

Starfield B, Shi L, Macinko J . Contribution of primary care to health systems and health. Milbank Q. 2005; 83(3):457-502. PMC: 2690145. DOI: 10.1111/j.1468-0009.2005.00409.x. View

17.

Khan A, Al Abdul Lateef Z, Khamseen M, Al Aithan M, Khan S, Al Ibrahim I . Knowledge, attitude and practice of ministry of health primary health care physicians in the management of type 2 diabetes mellitus: a cross-sectional study in the Al Hasa District of Saudi Arabia, 2010. Niger J Clin Pract. 2011; 14(1):52-9. DOI: 10.4103/1119-3077.79241. View

18.

ElSayed N, Aleppo G, Aroda V, Bannuru R, Brown F, Bruemmer D . 8. Obesity and Weight Management for the Prevention and Treatment of Type 2 Diabetes: Standards of Care in Diabetes-2023. Diabetes Care. 2022; 46(Suppl 1):S128-S139. PMC: 9810466. DOI: 10.2337/dc23-S008. View

19.

Aghili R, Malek M, Baradaran H, Peyvandi A, Valojerdi A, Khamseh M . General Practitioners' Knowledge and Clinical Practice in Management of People with Type 2 Diabetes in Iran; The Impact of Continuous Medical Education Programs. Arch Iran Med. 2015; 18(9):582-5. DOI: 0151809/AIM.007. View

20.

Li Y, Teng D, Shi X, Qin G, Qin Y, Quan H . Prevalence of diabetes recorded in mainland China using 2018 diagnostic criteria from the American Diabetes Association: national cross sectional study. BMJ. 2020; 369:m997. PMC: 7186854. DOI: 10.1136/bmj.m997. View