An audit of the quality of care indicators for the management of diabetes in family practice clinics in Karachi, Pakistan

Management of diabetes is a painstaking and careful approach. This study was aimed to evaluate the quality of care for the management of diabetes provided by family practitioners to their patients having diabetes. This is a retrospective audit of medical records conducted in a tertiary care teaching hospital of private sector in Karachi for one month. For this study, 150 medical records of patients with type 2 diabetes that visited family practice clinics for their diabetes care were examined. A total of 88 patient's medical records were selected and analyzed who attended the studied clinics for at least one year and had minimum of four out-patient visits. Majority (68%) of the audited medical records were of females. Of the total medical records analyzed, only one-quarter of the cases qualified the criteria of 'excellent' or 'good' diabetes care. Monitoring of body weight of the patient was only one indicator which was according the recommendations in 100% case at every visit. The other nearest quality of care indicator documented was blood glucose advice at every visit in 79.5% (95% CI: 71.1-87.9) of cases. Physical activity advised/reinforced at every visit was least observed (27.3%; 95% CI: 18.0-36.6). In addition, blood sugar control was reported in less than a quarter (23.9%) with 95% CI of 15.0-32.8. This work has identified a big gap in the management of type 2 diabetes provided by family practitioners. In addition, majority of the patients found to have poor glycemic control. Interventions are suggested to improve the quality of diabetes care. More such audits and research are recommended at the larger scale.