Abstract
Goals Our primary objective was to describe needs for and availability of point-of-care testing for diabetes mellitus diagnosis/monitoring in Central Vietnam. Methods The field survey was designed to determine the status of point-of-care testing at 15 hospitals, comprising 1 provincial hospital (level 2), 7 district hospitals (level 3), and 7 community health centers (level 4) in Hue Province, Central Vietnam. Questions are related to diabetes and prediabetes, acute coronary syndromes, and infectious diseases. Spatial care paths for problem-solving were designed. Acute coronary syndrome results were reported open access elsewhere (see https://journals.lww.com/poctjournal/Pages/articleviewer.aspx?year=2018&issue=09000&article=00001&type=Fulltext). Results Blood glucose testing was limited. Two (28.6%) of 7 community health centers reported having glucose meters available, whereas overall, only 2 (13.3%) of 15 survey sites performed hemoglobin A1c (HbA1c) testing. Diabetes and prediabetes glucose screening cutoffs varied across levels, possibly generating erroneous/missing diagnoses. A diabetes screening program was not reported at the level 2 hospital; availability varied in levels 3 and 4. Glucose meters must be purchased at patients' expense. Microvascular and macrovascular complications, such as kidney failure, retinopathy, and neuropathy, are treated at Hue Central Hospital, the provincial hospital, and some district hospitals. Transfer depends on the extent of patient complications. Ambulance service is extremely limited. Helicopter rescue is not available. Conclusions We conclude the following: (a) diagnostic technologies should be improved; (b) HbA1c and blood glucose instruments must be supplied; (c) public health budgets should fund self-monitoring, glucose meters, and enhanced access; (d) healthcare leaders can create regional spatial care paths to improve outcomes; and (e) diagnostic cutoffs, especially HbA1c, should be harmonized after checking population differences.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1-8 |
| Number of pages | 8 |
| Journal | Point of Care |
| Volume | 18 |
| Issue number | 1 |
| DOIs | |
| State | Published - Mar 1 2019 |
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Keywords
- diabetes management
- diabetes screening programs
- fasting plasma glucose
- hemoglobin A1c
- macrovascular complications
- microvascular complications
- needs assessment survey
- overdiagnosing
- self-monitoring of blood glucose
- skin autofluorescence
- underdiagnosing
- Vietnam
- whole-blood glucose testing
ASJC Scopus subject areas
- Nursing(all)
Cite this
Rapid diagnosis and effective monitoring of diabetes mellitus in central Vietnam : Point-of-care needs, improved patient access, and spatial care paths for enhanced public health. / Ventura, Irene J.; Zadran, Amanullah; Ho, An V.D.; Zadran, Layma; Thuan, Duong T.B.; Pham, Tung T.; Kost, Gerald J.
In: Point of Care, Vol. 18, No. 1, 01.03.2019, p. 1-8.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Rapid diagnosis and effective monitoring of diabetes mellitus in central Vietnam
T2 - Point-of-care needs, improved patient access, and spatial care paths for enhanced public health
AU - Ventura, Irene J.
AU - Zadran, Amanullah
AU - Ho, An V.D.
AU - Zadran, Layma
AU - Thuan, Duong T.B.
AU - Pham, Tung T.
AU - Kost, Gerald J
PY - 2019/3/1
Y1 - 2019/3/1
N2 - Goals Our primary objective was to describe needs for and availability of point-of-care testing for diabetes mellitus diagnosis/monitoring in Central Vietnam. Methods The field survey was designed to determine the status of point-of-care testing at 15 hospitals, comprising 1 provincial hospital (level 2), 7 district hospitals (level 3), and 7 community health centers (level 4) in Hue Province, Central Vietnam. Questions are related to diabetes and prediabetes, acute coronary syndromes, and infectious diseases. Spatial care paths for problem-solving were designed. Acute coronary syndrome results were reported open access elsewhere (see https://journals.lww.com/poctjournal/Pages/articleviewer.aspx?year=2018&issue=09000&article=00001&type=Fulltext). Results Blood glucose testing was limited. Two (28.6%) of 7 community health centers reported having glucose meters available, whereas overall, only 2 (13.3%) of 15 survey sites performed hemoglobin A1c (HbA1c) testing. Diabetes and prediabetes glucose screening cutoffs varied across levels, possibly generating erroneous/missing diagnoses. A diabetes screening program was not reported at the level 2 hospital; availability varied in levels 3 and 4. Glucose meters must be purchased at patients' expense. Microvascular and macrovascular complications, such as kidney failure, retinopathy, and neuropathy, are treated at Hue Central Hospital, the provincial hospital, and some district hospitals. Transfer depends on the extent of patient complications. Ambulance service is extremely limited. Helicopter rescue is not available. Conclusions We conclude the following: (a) diagnostic technologies should be improved; (b) HbA1c and blood glucose instruments must be supplied; (c) public health budgets should fund self-monitoring, glucose meters, and enhanced access; (d) healthcare leaders can create regional spatial care paths to improve outcomes; and (e) diagnostic cutoffs, especially HbA1c, should be harmonized after checking population differences.
AB - Goals Our primary objective was to describe needs for and availability of point-of-care testing for diabetes mellitus diagnosis/monitoring in Central Vietnam. Methods The field survey was designed to determine the status of point-of-care testing at 15 hospitals, comprising 1 provincial hospital (level 2), 7 district hospitals (level 3), and 7 community health centers (level 4) in Hue Province, Central Vietnam. Questions are related to diabetes and prediabetes, acute coronary syndromes, and infectious diseases. Spatial care paths for problem-solving were designed. Acute coronary syndrome results were reported open access elsewhere (see https://journals.lww.com/poctjournal/Pages/articleviewer.aspx?year=2018&issue=09000&article=00001&type=Fulltext). Results Blood glucose testing was limited. Two (28.6%) of 7 community health centers reported having glucose meters available, whereas overall, only 2 (13.3%) of 15 survey sites performed hemoglobin A1c (HbA1c) testing. Diabetes and prediabetes glucose screening cutoffs varied across levels, possibly generating erroneous/missing diagnoses. A diabetes screening program was not reported at the level 2 hospital; availability varied in levels 3 and 4. Glucose meters must be purchased at patients' expense. Microvascular and macrovascular complications, such as kidney failure, retinopathy, and neuropathy, are treated at Hue Central Hospital, the provincial hospital, and some district hospitals. Transfer depends on the extent of patient complications. Ambulance service is extremely limited. Helicopter rescue is not available. Conclusions We conclude the following: (a) diagnostic technologies should be improved; (b) HbA1c and blood glucose instruments must be supplied; (c) public health budgets should fund self-monitoring, glucose meters, and enhanced access; (d) healthcare leaders can create regional spatial care paths to improve outcomes; and (e) diagnostic cutoffs, especially HbA1c, should be harmonized after checking population differences.
KW - diabetes management
KW - diabetes screening programs
KW - fasting plasma glucose
KW - hemoglobin A1c
KW - macrovascular complications
KW - microvascular complications
KW - needs assessment survey
KW - overdiagnosing
KW - self-monitoring of blood glucose
KW - skin autofluorescence
KW - underdiagnosing
KW - Vietnam
KW - whole-blood glucose testing
UR - http://www.scopus.com/inward/record.url?scp=85062413259&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85062413259&partnerID=8YFLogxK
U2 - 10.1097/POC.0000000000000178
DO - 10.1097/POC.0000000000000178
M3 - Article
VL - 18
SP - 1
EP - 8
JO - Point of Care
JF - Point of Care
SN - 1533-029X
IS - 1
ER -