Perceptions of Dutch health care professionals regarding the Care Standard for diabetes

BMC Research Notes

Stef PJ Kremers¹  Nanne K de Vries³  Charlotte Bagchus⁴  Marloes K Martens²  Lieke GM Raaijmakers¹ 

[1] Department of Health Promotion, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands;ResCon, research & consultancy, Haarlem, The Netherlands;Caphri, School for Primary Care and Public Health, Maastricht University Medical Centre+, Maastricht, The Netherlands;Athena Institute, VU University, Amsterdam, The Netherlands

关键词: Barriers;    Health care professionals;    Care Standard;    Diabetes;   

Others  :  1141365
DOI  :  10.1186/1756-0500-6-417

 received in 2013-06-11, accepted in 2013-10-04,  发布年份 2013

【 摘 要 】

Background

The Netherlands can be regarded as unique in the use of the Netherlands Diabetes Federation (NDF) Care Standard (CS) for diabetes. The need to understand the barriers obstructing optimal health care, the dissemination and implementation of health care innovations into daily practice and the extent to which health care professionals actually adhere to guidelines has been emphasized repeatedly. Therefore, the aim of the present study was to suggest ways to optimize the implementation of the CS by examining the perceptions of Dutch health care professionals regarding the CS and the barriers to using it.

Methods

A cross-sectional questionnaire survey was conducted among health care professionals (N = 1547) in 2010.

Results

A total of 39.6% (N = 1323) of the participating health care professionals possessed the CS. Only 15.5% of the professionals who were to some extent familiar with the CS (N = 1100) described themselves as working in complete accordance with the CS. The majority (83.9%) thought the CS contributed greatly to ensuring the quality of care; the judgment on the feasibility of working in accordance with the CS was positive (mean = 3.9 on a 5-point Likert scale). However, professionals tended to perceive the guidelines issued by the own professional association as the norm for high quality diabetes care, rather than the CS. The main barrier to using the CS was the lack of effective lifestyle interventions (or access to them) to provide care for people with diabetes or those at increased risk for the disorder.

Conclusions

A limited percentage of health care professionals were found to posses the CS. It is questionable whether possession of the CS is a prerequisite for delivering high quality care. Overall, professionals were largely positive about the CS, although only a minority indicated they were working in complete accordance with it. Professionals and professional organizations should be further educated about the content of the CS and especially its added value with respect to the guidelines for their own professional group, in terms of the multidisciplinary approach to diabetes care. Furthermore, attention should be given to the most important perceived barriers, to facilitate adherence to the CS.

【 授权许可】

   
2013 Raaijmakers et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]International Diabetes Federation: Diabetes Atlas 5th edition, update 2012. Retrieved October 9, 2013, from http://www.idf.org/diabetesatlas/ webcite
• [2]Baan CA, Poos MJJC: How often does diabetes occur and how many people die from it? (Hoe vaak komt diabetes mellitus voor en hoeveel mensen sterven eraan?). In VTV public health forecast, National Public Health Compass. Bilthoven: RIVM; 2013.
• [3]American Diabetes Association: Standards of Medical Care in Diabetes-2013. Diabetes Care 2013, 136(Suppl1):S11-S66.
• [4]Gulliford MC, Naithani S, Morgan M: Continuity of care and intermediate outcomes of type 2 diabetes mellitus. Fam Pract 2007, 24(3):245-251.
• [5]Haggerty JL, Reid RJ, Freeman GK, Starfield BH, Adair CE, McKendry R: Continuity of care: a multidisciplinary review. BMJ 2003, 327:1219-1221.
• [6]Ministry of Health WaS: Programmatisch approach of chronic diseases (Programmatische aanpak van chronische ziekten). The Hague: VWS; 2008.
• [7]Bodenheimer T, Wagner EH, Grumbach K: Improving primary care for patients with chronic illness: the chronic care model, Part 2. JAMA 2002, 288(15):1909-1914.
• [8]The Council for Public Health and Health Care: The Chronic Care Model in the Netherlands (Het Chronic Care Model in Nederland). The Hague: The Council for Public Health and Health Care; 2011.
• [9]Netherlands Diabetes Federation: National Diabetes Action Program proposal (Nationaal Actieprogramma Diabetes Programmavoorstel). Amersfoort: NDF; 2009.
• [10]Seidell JCHJ, Noordam H, Niemer S: An integrated health care standard for the management and prevention of obesity in The Netherlands. Fam Pract 2012, 29:153-156.
• [11]Coordination platform Care Standards: Care Standards in model. Report on the model of Care Standard for chronic diseases Zorgstandaarden in model. Zorgstandaarden in model (Rapport over het model voor zorgstandaarden bij chronische ziekten). The Hague: ZONMW; 2010.
• [12]Care Standard (Zorgstandaard). http://ndf.lvbtest.nl/extrapage/totstandkoming-achtergronden-en-lieteratuu/ webcite
• [13]Health care (Zorg). http://ndf.lvbtest.nl/extrapage/de-norm-voor-diabeteszorg-en-preventie/ webcite
• [14]Struijs JN, Baan CA: Integrating care through bundled payments–lessons from The Netherlands. N Engl J Med 2011, 364(11):990-991.
• [15]Grol R, Grimshaw J: From best evidence to best practice: effective implementation of change in patients’ care. Lancet 2003, 362(9391):1225-1230.
• [16]Cochrane LJ, Olson CA, Murray S, Dupuis M, Tooman T, Hayes S: Gaps between knowing and doing: Understanding and assessing the barriers to optimal health care. J Contin Educ Health Prof 2007, 27(2):94-102.
• [17]Grol R, Cluzeau FA, Burgers JS: Clinical practice guidelines: towards better quality guidelines and increased international collaboration. Br J Cancer 2003, 89(Suppl 1):S4-S8.
• [18]Cabana MD, Rand CS, Powe NR, Wu AW, Wilson MH, Abboud P-A C, Rubin HR: Why don’t physicians follow clinical practice guidelines? JAMA 1999, 282:15.
• [19]Francke AL, Smit MC, De Veer AJ, Mistiaen P: Factors influencing the implementation of clinical guidelines for health care professionals: a systematic meta-review. BMC Med Inform Decis Mak 2008, 8:38. BioMed Central Full Text
• [20]Farquhar CM, Kofa EW, Slutsky JR: Clinicians’ attitudes to clinical practice guidelines: a systematic review. Med J Aust 2002, 177(9):502-506.
• [21]Nam S, Chesla C, Stotts NA, Kroon L, Janson SL: Barriers to diabetes management: Patient and provider factors. Diabetes Res Clin Pract 2010, 93:1-9.
• [22]Carlsen B, Bringedal B: Attitudes to clinical guidelines-do GOs differ from other medical doctors? BMJ Qual Saf 2011, 20:158-162.
• [23]Raaijmakers LGM, Martens MK, Bagchus L, Jonkers R, Kremers SPJ: NAD monitor: research among health care professionals and patients (NAD monitor: onderzoek onder zorgprofessionals en patiënten). Maastricht: Maastricht University; 2010.
• [24]Lemmens L, De Jong-van Til J, Struijs J, Kooistra M, Baan C: Does the NDF Care Standard provide care groups enough support? (Biedt de NDF Zorgstandaard zorggroepen voldoende houvast? Tijdschrift voor Gezondheidswetenschappen 2012, 90:5.
• [25]Puder JJ, Keller U: Quality of diabetes care: problem of patient or doctor adherence? Swiss Med Wkly 2003, 133(39–40):530-534.
• [26]Helmink JH, Meis JJ, De Weerdt I, Visser FN, De Vries NK, Kremers SP: Development and implementation of a lifestyle intervention to promote physical activity and healthy diet in the Dutch general practice setting: the BeweegKuur programme. Int J Behav Nutr Phys Act 2010, 7:49. BioMed Central Full Text
• [27]Hosper K, Deutekom M, Stronks PK: The effectiveness of “Exercise on Prescription” in stimulating physical activity among women in ethnic minority groups in the Netherlands: protocol for a randomized controlled trial. BMC Public Health 2008, 8:406. BioMed Central Full Text
• [28]Brug J, Van Dale D, Lanting L, Kremers S, Veenhof C, Leurs M, Van Yperen T, Kok G: Towards evidence-based, quality-controlled health promotion: the Dutch recognition system for health promotion interventions. Health Educ Res 2010, 25(6):1100-1106.
• [29]The Netherlands Court of Audit: Coordination in the care for chronic diseases; review 2010. (Afstemming in de zorg rond chronische aandoeningen; terugblik 2010.). The Hague: The Netherlands Court of Audit; 2010.
• [30]Van Till JT, de Wildt E, Struijs JN: The organisation of Care Groups anno 2010: Current state of the art and developments in the past years (De organisatie van zorggroepen anno 2010: Huidige stand van zaken en de ontwikkelingen in de afgelopen jaren). RIVM: Bilthoven; 2010.