English abstract
Objectives: Primary care audits in Bahrain have consistently revealed a failure to meet recognised
standards of delivery of process and outcome measures to patients with diabetes. This study aimed to establish for
the first time the quality of diabetes care in a Bahraini hospital setting. Methods: A retrospective clinical audit was
conducted of a random sample of patients attending the Diabetes and Endocrine Center at the Bahrain Defence
Forces Hospital over a 15-month period which ended in June 2010. The medical records of 287 patients with
diabetes were reviewed electronically and manually for process and outcome measures, and a statistical analysis
was performed. Results: Of the patients, 47% were male, with a median age of 54 years, and 5% had type 1 diabetes.
Measured processes, including haemoglobin A1c, blood pressure, lipids, creatinine and weight, were recorded in
over 90% of the patients. Smoking (8%) and the patient's body mass index (19%) were less frequently recorded.
Screening for complications was low, with retinal screening in 42%, foot inspection in 22% and microalbuminuria
in 23% of patients. Conclusion: This study shows that the implementation of recognised evidence-based practice
continues to pose challenges in routine clinical care. Screening levels for the complications of diabetes were low
in this hospital diabetes clinic. It is important to implement a systematic approach to diabetes care to improve the
quality of care of patients with diabetes which could lead to a lowering of cardiovascular risk and a reduction in
healthcare costs in the long term.
