Analysis of the Factors Impacting the Awareness and Utilization of Traditional Chinese Medicine Guidelines for Diabetes among Primary Care Practitioners

Abstract

Background Primary care physicians (PCPs), who play a crucial role in providing primary healthcare services, utilize clinical practice guidelines as valuable tools for guiding their practice. By investigating these physicians' awareness and usage of guidelines, we can offer innovative strategies for promoting guideline adherence and enhancing physicians' training. This, in turn, can ultimately improve the quality of primary healthcare. Objective To explore the level of awareness and the current status of reference use of traditional Chinese medicine (TCM) guidelines for diabetes among PCPs, and to identify the influencing factors. Methods From September 22 to October 29, 2021, an online questionnaire survey was conducted among physicians affiliated with the Specialist Committee for Primary Diabetes Care of China Association of Chinese Medicine, using the snowball sampling method to ensure a broader representation of physicians. The questionnaire consists of three parts: basic information, current status and needs of physicians in using TCM for diabetes prevention and treatment, and a survey on physicians' current awareness and needs regarding diabetes guidelines. Ordered multiclass Logistic regression analysis was used to identify the influencing factors of PCPs' awareness and usage of TCM guidelines for diabetes. Results A total of 382 questionnaires were collected from PCPs, 35.34% (135/382) of the physicians were very familiar or fairly familiar with TCM guidelines for diabetes, while 28.80% (110/382) of the physicians referred to these guidelines regularly for diabetes management. The results of the univariate analysis showed that, PCPs with differences in gender, specialty, department, number of diabetic patients treated per week, evaluation of TCM treatment efficacy, availability of TCM herbs and Chinese patent drugs in physicians' institutions, and physicians' awareness of guidelines, showed statistically significant differences in their reference status of TCM guidelines for diabetes (P<0.05). The results of the ordered multinomial Logistic regression analysis showed that, the factors influencing PCPs' awareness of TCM guidelines for diabetes included PCPs' evaluation of TCM treatment efficacy (OR=5.783, 95%CI=1.283-26.102), availability of TCM herbs and Chinese patent drugs in physicians' institutions (OR=2.399, 95%CI=1.548-3.717), and their previous participation in specialized training on diabetes prevention and control guidelines (OR=1.751, 95%CI=1.149-2.667). The factors influencing PCPs' reference to TCM guidelines for diabetes included the physicians' level of familiarity with the guidelines [very or fairly familiar (OR=15.721, 95%CI=7.584-32.557), somewhat familiar (OR=5.392, 95%CI=2.841-10.237) ], work experience less than 5 years (OR=14.083, 95%CI=1.390-142.594), different specialties [TCM (OR=6.869, 95%CI=1.483-31.849), integrated Chinese and western medicine (OR=6.613, 95%CI=1.551-28.219) ], and geographical regions [northeast (OR=2.962, 95%CI=1.064-8.240), southeast (OR=2.686, 95%CI=1.004-7.178) ]. Conclusion The awareness and reference usage of TCM guidelines for diabetes among PCPs need to be improved. Factors such as guideline awareness, work experience, professional orientation, and geographical region play a significant role in influencing physicians' utilization of the guidelines. In the future, training for PCPs should be strengthened, particularly focusing on the northwest and southwest regions, and PCPs with a background in TCM should receive more training on TCM-related guidelines for diabetes prevention and treatment.

Keywords

• diabetes mellitus|traditional chinese medicine therapy|guideline|primary healthcare|community health services|root cause analysis