Adherence to HbA1c testing guidelines in type 2 diabetes patients: A mixed-methods retrospective cross-sectional study in Bahrain’s primary healthcare centers
- 1Department of Family Medicine, Primary Health Care, Manama, Bahrain
- 2Department of Emergency Medicine, Salmaniya Medical Complex, Manama, Bahrain
Abstract
Introduction:: Type 2 diabetes mellitus (T2DM) accounts for over 90% of diabetes cases worldwide. Glycated hemoglobin (HbA1c) testing helps manage it effectively. Despite national guidelines in Bahrain, physician adherence varies due to knowledge, resource, and system barriers. This study assesses adherence and influencing factors in Bahrain’s primary healthcare centers.
Methods:: A mixed-method retrospective cross-sectional study was conducted at eight primary healthcare centers (PHCs) in Bahrain, including 352 T2DM patient’s electronic records from 2017 to 2020. Inclusion criteria comprised adult patients (≥18 years) with a confirmed T2DM diagnosis of at least one year’s duration and at least one PHC visit during 2020. Data regarding demographics, HbA1c requests, and non-communicable disease clinic attendance were collected. Additionally, 375 PHC physicians completed structured surveys assessing their adherence to guidelines and barriers they faced. SPSS was used for descriptive, comparative, and multivariate statistical analyses.
Results:: Among 352 T2DM patients (57.4% female), significant testing gaps were identified: 13.4% had no test requests, and 18.8% had no completed tests despite guideline recommendations. Non-communicable disease clinic attendance significantly correlated with higher HbA1c test requests and completions (P < 0.001). Key barriers to testing included resource limitations, time constraints, and patient non-compliance.
Conclusion:: This study highlighted the gaps between diabetes care guidelines and practice in Bahrain’s PHCs, and also emphasized the physician support, patient attendance, and targeted interventions for improvement.
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BibTeX
@article{alaradi2026adherence,
title = {{Adherence to HbA1c testing guidelines in type 2 diabetes patients: A mixed-methods retrospective cross-sectional study in Bahrain’s primary healthcare centers}},
author = {Fatema Mohamed Alaradi and Bashayer H. Ebrahim and Fajer Ali Alhaddad and Eman Al Mulla and Sara Matrook and Mohammad Sameer},
journal = {Journal of family medicine and primary care},
year = {2026},
month = jul,
doi = {10.4103/jfmpc.jfmpc_2051_25},
url = {https://europepmc.org/article/PMC/PMC13722249},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Adherence to HbA1c testing guidelines in type 2 diabetes patients: A mixed-methods retrospective cross-sectional study in Bahrain’s primary healthcare centers
AU - Fatema Mohamed Alaradi
AU - Bashayer H. Ebrahim
AU - Fajer Ali Alhaddad
AU - Eman Al Mulla
AU - Sara Matrook
AU - Mohammad Sameer
PY - 2026
DA - 2026/07/01
JO - Journal of family medicine and primary care
DO - 10.4103/jfmpc.jfmpc_2051_25
UR - https://europepmc.org/article/PMC/PMC13722249
AB - Introduction:: Type 2 diabetes mellitus (T2DM) accounts for over 90% of diabetes cases worldwide. Glycated hemoglobin (HbA1c) testing helps manage it effectively. Despite national guidelines in Bahrain, physician adherence varies due to knowledge, resource, and system barriers. This study assesses adherence and influencing factors in Bahrain’s primary healthcare centers. Methods:: A mixed-method retrospective cross-sectional study was conducted at eight primary healthcare centers (PHCs) in Bahrain, including 352 T2DM patient’s electronic records from 2017 to 2020. Inclusion criteria comprised adult patients (≥18 years) with a confirmed T2DM diagnosis of at least one year’s duration and at least one PHC visit during 2020. Data regarding demographics, HbA1c requests, and non-communicable disease clinic attendance were collected. Additionally, 375 PHC physicians completed structured surveys assessing their adherence to guidelines and barriers they faced. SPSS was used for descriptive, comparative, and multivariate statistical analyses. Results:: Among 352 T2DM patients (57.4% female), significant testing gaps were identified: 13.4% had no test requests, and 18.8% had no completed tests despite guideline recommendations. Non-communicable disease clinic attendance significantly correlated with higher HbA1c test requests and completions (P < 0.001). Key barriers to testing included resource limitations, time constraints, and patient non-compliance. Conclusion:: This study highlighted the gaps between diabetes care guidelines and practice in Bahrain’s PHCs, and also emphasized the physician support, patient attendance, and targeted interventions for improvement.
SN - 2249-4863
SN - 2278-7135
ER -