Factores organizativos y profesionales asociados con la prescripción correcta de glibenclamida para el manejo de la diabetes mellitus tipo 2

Abstract

Introduction

In México, there is a high proportion of patients with uncontrolled type 2 diabetes mellitus (DM2), as well as multiple problems in the quality of prescribing in first contact medical care, despite the recommendations of the regulations, evidence-based guidelines, and international reports.

Objective

To analyze the factors associated with good prescribing of treatment for DM2.

Material and methods

Survey research methods with a random multi-stage cluster sampling. Two surveys were conducted with patients and physicians to assess prescription patterns in hospitals and ambulatory care clinics. A set of bivariate logistic regressions were carried out to assess the association of the prescription patterns with organizational and medical factors, and multiple logistic regression models were finally fitted.

Results

A total of 267 physicians were evaluated, of whom 39,62% were classified as prescribing correctly. Among the principal factors associated with correct prescription were, physician experience, to have specialty training, years since graduation from the specialty, and to have a clinical practice in more than one setting.

Conclusions

The results show the need to develop educational interventions to address the factors identified with good patterns of prescription for diabetes in Mexican hospitals and ambulatory clinics.