GlycaemicControlamongPatientswithDiabetesinPrimaryCareClinicsin Jamaica,1995and2012 MAHarris 1 ,KJames 1 ,NKWaldron 2 ,TSFerguson 3 ,JPFigueroa 1 ABSTRACT Objective: To compare the quality of care received by patients with diabetes in public primary care clinics in 2012 with that reported in 1995. Methods: Patient records were audited at six randomly selected Type III health centres in the South East Health Region of Jamaica. The 2012 audit data were compared with published data from a similar audit conducted in 1995. Quality of care measures included timely screening tests and counselling of the patients. Fasting and postprandial glucose tests were used to assess glycaemic control. Results: Two hundred and forty-two patient records were analysed in 2012, and 185 in 1995. In 2012, 88% of patients were weighed within the last year compared with 43% in 1995. Advice on physical activity increased from 1% to 60% and on dietary practices from 6% to 79%. No patient had done the HBA 1C in 1995 compared to 38% in 2012. In 1995, 66% had blood glucose measured at a laboratory during the last year while in 2012, 60% had a laboratory test and 90% were tested at the clinic by glucometer. Blood pressure control increased from 19% in 1995 to 41% in 2012 (p < 0.001). Poor glucose control was recorded among 61% of patients in 1995 compared with 68% in 2012. Conclusions: There was no improvement in glycaemic control. Health providers and patients must work together to improve patient outcomes. This will involve closer patient monitoring, treatment intensification where indicated, and the adoption of lifestyle practices that can lead to better control. Keywords: Clinical audit, diabetes, hypertension, Jamaica, primary care WIMJOpen2014;1(3):99 (12, 13). One study conducted in 1995 at three different clinicsettingsinJamaicafoundthatonly40%ofpatientshad satisfactorybloodglucosecontrol(12). Asimilarstudydone in Trinidad and Tobago, Barbados and Tortola, found that 50%ofthepatientshadgoodbloodglucosecontrol. Inboth of these studies, very few patients were advised on diet, exercise or other non-pharmacological measures of control (13). In an effort to improve patient care, guidelines have been published nationally and regionally that address the management of diabetes (14–17). Theobjectiveofthisstudywastoassessthequalityof care and glycaemic control among patients with diabetes mellitus treated at public primary healthcare clinics in the South East Health Region of Jamaica and to compare the currentfindingswiththoseofthe1995study. SUBJECTSANDMETHODS This study was conducted as the baseline audit of an inter- vention trial to improve the management of cardiovascular (CVD) risk factors including diabetes mellitus within the South East Health Region of Jamaica. The audit was con- ducted between November and December of 2012 at six From: 1 Department of Community Health and Psychiatry, Faculty of Medical Sciences, 2 MonaAgeing and Wellness Centre, Faculty of Medical Sciences and 3 Tropical Medicine Research Institute (Epidemiology ResearchUnit),TheUniversityoftheWestIndies,Kingston7,Jamaica. Correspondence: Dr MA Harris, Department of Community Health and Psychiatry,FacultyofMedicalSciences,TheUniversityoftheWestIndies, Kingston 7, Jamaica. E-mail: michelle.harris06@uwimona.edu.jm INTRODUCTION Diabetes mellitus continues to be a major public health prob- lem globally and across the Caribbean (1–7). This is mani- fested by the high and rising prevalence of diabetes mellitus (DM) in the Caribbean (1, 2). The trend is consistent with projections for the Latin America and Caribbean region (LAC) which are projected to show an increase of up to 148% for the 2000 to 2030 period. (7, 8). The economic burden within the Caribbean region is also increasing with direct and indirect costs estimated to be US$1120 per person per year which translates to US $209M or 2.7% of gross domestic product (GDP) in Jamaica (9–11). Studies have been conducted to review and assess the level of care and the outcome among patients with diabetes ORIGINALARTICLE DOI: 10.7727/wimjopen.2014.085 WIMJOpen2014;1(3):99