RESEARCH ARTICLE


Exploring the Type 2 Diabetes Management in the Primary Care Setting in Ratchaburi Province, Thailand



Phenchamat Khamthana1, Yaowaluck Meebunmak1, Issara Siramaneerat2, *
1 Boromrajonani College of Nursing Ratchaburi, Ministry of Public Health, Bangkok, Thailand
2 Department of Social Science, Faculty of Liberal Art, Rajamangala University of Technology Thanyaburi, Khlong Hok, Thailand


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Creative Commons License
© 2019 Khamthana et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Social Science, Faculty of Liberal Art, Rajamangala University of Technology Thanyaburi, Khlong Hok, Thailand; E-mail: issara_sira@hotmail.com, issara_s@rmutt.ac.th


Abstract

Purpose:

We aimed to describe the outcomes of primary care setting of type 2 diabetes patient at Sub-District Health Promoting Hospital (SDHPH).

Methods:

This study was a cross-sectional study on 1,890 patients with type 2 diabetes who were participating in the primary care research networks in the Ratchaburi Province of Thailand. Data was obtained through a self-administered questionnaire about the state of health and care. Patient medical records were used to examine the condition of complications, treatment and several indicators of DM care. The data was processed by using logistic regression to analyse the effect of independent variables on the dependent variable. The hypothesis-null was rejected at p-values <0.05.

Results:

The participants in this study were of age 57.56 years (SD=12.10), and most (55.58%) were female. Most respondents (36.20%) completed a Bachelor’s degree and were working as employees (28.35%). Regarding duration of diabetes, the majority (28.35%) had 11-20 years. In terms of body mass index, 29.67% had body mass index between 25.0-29.9 (overweight). Regarding complications and comorbidities, the common complication and comorbidity was nephropathy (33.63%) while Ischemic heart disease was the major of other comorbid health problems (48.3%). Furthermore, patients were mostly taking Antihypertensive (67.80%) and ACE Inhibitor or ARB (59.00%). The majority of HbA1c level (42.74%) was lower than 7.0%. Regarding the logistic analysis, it showed that education and treatment significantly influenced Hemoglobin A1c level at significant levels of 0.05.

Conclusion:

Only modest numbers of patients achieved established targets of diabetes control. Reengineering primary care practice may be necessary to substantially improve health care.

Keywords: Diabetes control, Diabetes mellitus, Primary care, Reengineering primary care practice, Ratchaburi Province, Thailand.