Diabetic patient adherence to pathology request completion in primary care
Niamh Ramsay A D , Tracey Johnson B and Tony Badrick CA The University of Notre Dame Australia, School of Medicine Sydney, 160 Oxford Street, Darlinghurst, NSW 2010, Australia.
B Inala Primary Care, 64 Wirraway Parade, Inala, Qld 4077, Australia. Email: tjohnson@inalaprimarycare.com.au
C Royal College of Pathologists of Australasia Quality Assurance Programs, Suite 201/8 Herbert Street, St Leonards, NSW 2065, Australia. Email: tony.badrick@rcpaqap.com.au
D Corresponding author. Email: Niamh.ramsay@gmail.com
Australian Health Review 41(3) 277-282 https://doi.org/10.1071/AH16012
Submitted: 14 January 2016 Accepted: 5 June 2016 Published: 11 August 2016
Abstract
Objective Little research exists regarding the prevalence of patient non-adherence with completing pathology requests for chronic disease monitoring. The aims of the present study were to determine the extent to which this exists in diabetic patients and to identify possible reasons contributing to this behaviour.
Methods Patients diagnosed with type 2 diabetes mellitus were recruited from three general practices with different demographics. Data were collected by recording demographic patient information at the time of visit. In addition, information regarding patient pathology request adherence and the reasons provided when this was not achieved were also noted. These reasons were compared with preconceptions by medical staff in each practice.
Results General practitioner perceptions of poor patient adherence to pathology requests were confirmed, with rates of non-adherence up to 31% at one practice site. The primary reasons preventing completion of pathology testing included forgetfulness, time poorness, poor health literacy and, in some cases, language barriers.
Conclusion A high proportion of patients do not prioritise the monitoring of their diabetes, potentially because of a lack of understanding of the importance such management has on their health. Further research should be conducted to determine the effect of the implementation of point-of-care testing on patient outcomes in such areas of low non-adherence with disease management.
What is known about the topic? Little quantitative information exists regarding the adherence rate of patients to pathology request completion. Without up-to-date pathology results, a barrier is created, preventing accurate medical treatment of the patient’s condition because the doctor cannot ascertain a full picture of the patient’s current disease state at the time of consultation.
What does this paper add? This paper quantifies the rate of non-adherence among three diabetic patient groups at different practice sites, taking into account patient and site demographics. It also confirms patient non-adherence to timely pathology request completion as a prevalent issue of concern at all practice sites recruited. In addition, it looks at reasons why this issue exists as a means of addressing the problem in the future.
What are the implications for practitioners? This research may aid practitioners in addressing such issues at a local level within general practice, because reasons creating barriers to successful completion of pathology requests have been identified and potential solutions suggested.
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