Abstract
INTRODUCTION: The Malaysian Clinical Practice Guideline (CPG) for Type-2 Diabetes Management emphasizes the importance for annual proteinuria testing for early detection of diabetic nephropathy. Annual proteinuria and micro-albuminuria screening have been incorporated into the model of good care for diabetes patients in primary care. This study aims to describe the coverage of nephropathy screening among type-2 diabetes patients receiving treatment at MOH health clinics, and factors influencing the coverage. METHODS: Data on proteinuria testing was extracted from the National Diabetes Registry for year 2015 to 2018. Feedbacks on the test coverage were elicited from each State Health Department using a standardised format. RESULTS: Overall, nephropathy screening coverage in Malaysia was low at 69.1% for 2018, but with an increasing trend from 66.5% in 2015. There are variations between states, with several states showing an increasing trend over time, some relative unchanged, and of concern some states showed decreasing trend. Huge variations were observed between districts as well. Several factors were identified to contribute to influencing the trend of coverage within the domains of healthcare facilities and systems, healthcare provider factors and patient-related factors. DISCUSSION: This paper highlighted the variations of quality of care in diabetes management in terms of nephropathy screening between states and districts over the time period of 2015 to 2018. Improving and narrowing the variations in nephropathy screening coverage would require addressing the multiple factors, and solutions have to be customised for each specific setting.
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@proceedings{APCPH-2019-146,
title = {Coverage of Diabetic Nephropathy Screening in Malaysia 2015-2018},
author = {Feisul Idzwan Mustapha and Arunah Chandran},
year = {2019},
date = {2019-07-22},
urldate = {2019-07-22},
journal = {6th Asia-Pacific Conference on Public Health 2019 Proceedings},
issue = {6},
abstract = {INTRODUCTION: The Malaysian Clinical Practice Guideline (CPG) for Type-2 Diabetes Management emphasizes the importance for annual proteinuria testing for early detection of diabetic nephropathy. Annual proteinuria and micro-albuminuria screening have been incorporated into the model of good care for diabetes patients in primary care. This study aims to describe the coverage of nephropathy screening among type-2 diabetes patients receiving treatment at MOH health clinics, and factors influencing the coverage. METHODS: Data on proteinuria testing was extracted from the National Diabetes Registry for year 2015 to 2018. Feedbacks on the test coverage were elicited from each State Health Department using a standardised format. RESULTS: Overall, nephropathy screening coverage in Malaysia was low at 69.1% for 2018, but with an increasing trend from 66.5% in 2015. There are variations between states, with several states showing an increasing trend over time, some relative unchanged, and of concern some states showed decreasing trend. Huge variations were observed between districts as well. Several factors were identified to contribute to influencing the trend of coverage within the domains of healthcare facilities and systems, healthcare provider factors and patient-related factors. DISCUSSION: This paper highlighted the variations of quality of care in diabetes management in terms of nephropathy screening between states and districts over the time period of 2015 to 2018. Improving and narrowing the variations in nephropathy screening coverage would require addressing the multiple factors, and solutions have to be customised for each specific setting.},
note = {Type: POSTER PRESENTATION; Organisation: Disease Control Division, Ministry of Health Malaysia},
keywords = {diabetes, nephropathy, primary care, proteinuria},
pubstate = {published},
tppubtype = {proceedings}
}