Nivel de adherencia a guías de práctica clínica y desarrollo de complicaciones en diabéticos Centro Médico Naval Cirujano Mayor Santiago Távara 2019

Abstract

Objective: Determine if in the medical attentions of diabetic patients, it exists association between guidelines adherence of the endocrinologists and development of microvascular complications in five year; in the Naval Medical Center “Cirujano Mayor Santiago Távara”. Methodology: Quantitative, observational, analytical, cohorts, retrospective study, performed in registered medical attentions in 281 clinical records of patients with diagnosis of type 2 diabetes mellitus in the year 2014; in which were determined if there was or wasn´t adherence by the endocrinologists; and then, in the year 2019, it was performed a tracking in the development of microvascular complications (diabetic retinopathy and nephropathy). The descriptive analysis was conducting with frequencies and percentages for qualitative variables; and with averages with standard deviation for the numeric variables. The multivariate statistical analysis of association was done between qualitative and quantitative variables, with p value<0.05. Results: The predominant gender in the diabetic patients was male 54.8%, the mean age and mean time of diabetes in the group with global adherence to GCP was 58.87+6.63 and 7.25+5.99 years; and without global adherence was 57.04+7.97 and 9.03+6.74 years, respectively. The percentage of medical records of diabetic patients with registry of microvascular complications with global adherence was 17.8%. The level of adherence to GPC in monitoring was 97.86+8.85% and in metabolic control 61.64+27.91%; and according to development or not of microvascular complications, the level of adherence to GCP in metabolic control was 50.79+25.60% and 65.66+27.71%, respectively (p<0.05) The global adherence to GCP was found in 35.9% of clinical records. It was found an association between time of diabetes registered in the clinical records and the development of microvascular complications (p<0.05). Conclusions: In the medical attentions of diabetic patients, it exists association between guidelines adherence of the endocrinologists and the development of microvascular complications in five years.