Diabetes care scale: a first line screening of self-care and treatment behavior in diabetics seeking treatment at a tertiary care setting in Bhubaneswar, Odisha

Abstract

Background: Quality in diabetic management is the need of the hour, in eye of the menacing increase in the disease in India. Hence, a sensitive qualitative handling of outpatient visits is warranted and an inbuilt mechanism of Quality of life scales (which are proxy of the patient’s response to disease) and Diabetic care scales (proxy for patient’s satisfaction to the care extended), would offer supportive evidence to physicians, of areas where they will have to be more careful. Aims and Objectives: To assess the Diabetic Care scale (DCS) for the subjects seeking management from the diabetic care unit. To find out the factors associated with the DCS and derive inferences to improve upon quality of management in the given sample Methodology: Diabetics were made to answer to Quality of Life in Diabetics (QOLID) and Diabetic Care Scale (DCS), validated and pretested for Indian populations; and factors affecting patient’s responses were ascertained, to improve care. Final sample of 599 interviews were assessed. To identify the predictors of diabetic care, diabetic care scale was dichotomized on the basis of its median value. Results: QOLID domains were inversely correlated with DCS, strongly significant (treatment satisfaction, general health, symptom botherness, financial worries, emotional health and physical endurance). Role limitations to physical health were also positively related to DCS (-0.422; p<0.001), which indicated that this domain affected DCS positively and significantly. Overall QOLID and DCS scores were negatively correlated and significant (-0.650; p<0.005). Education (UOR 0.76; SD 0.64 - 0.90, p=0.002), treatment, medical adherence in diabetics about being careless with medications (AOR=2.38 SD 1.50 - 3.77, <0.001) emerged predictors of poor DCS scores. DCS can be used as a prelim screening to evaluate the quality of care in diabetic management in early stages so as to rectify any gaps and improve through specialized counselling in subsequent visits. Wide use of these tools is recommended, both in rural and urban scenario to improve and control the diabetic epidemic in India.