An Evaluation of Hemoglobin A_1cTest Ordering Patterns in a Primary Care Setting

Glycated hemoglobin: A powerful tool not used enough in primary care

“…The HbA1c/1000 inhabitants ratio was significantly different among the AACCs, ranging from 73.4 to 126.3 (Table 1). There are significant differences (P < .05) between AACC 1 and AACCs 3,4,5,6,7,9 and 11;between AACC 2 and AACCs 3,4,5,and 9;between AACC 4 and AACCs 7,8,10,and 11;between AACC 5 and AACC 6,7,8,10 and 11; and between AACC 10 and AACC 11.…”

“…In 2008, we first detected an inappropriate HbA1c over‐ and also under‐ request in patients with and without diabetes in eight health departments (HDs) in Valencia community . The same results were observed in every one of the primary care centres . Since 2010, two national scale studies to compare laboratory test ordering in Spain (REDCONLAB), further showed a high variability for HbA1c demand in primary care and a global, significant, and potentially dangerous under‐request .…”

“…4 The same results were observed in every one of the primary care centres. 5 Since 2010, two national scale studies to compare laboratory test ordering in Spain (REDCONLAB), further showed a high variability for HbA1c demand in primary care 6 and a global, significant, and potentially dangerous under-request. 6,7 In the earlier studies, not enough collaborators were available to compare the regional differences in the request between the Spanish autonomous communities (AACCs).…”

Primary Care Use of Laboratory Tests in Spain: Measurement Through Appropriateness Indicators

“…Triglycerides, cholesterol, creatinine, and glucose are considered routine laboratory tests for preventive health exams to promote healthier behaviours, and their high demand may be justified. On the other hand, glycosylated hemoglobin [12] and TSH are probably under requested [13]. The first is the best disease marker in diabetic patients and its use has been extended not only to monitor but also to the diagnosis of the disease [14].…”

Gestión de las peticiones de NT-proBNP y procalcitonina mediante reglas computarizadas basadas en criterios clínicos

“…Esto requiere la implicación del analista clínico en la gestión de la demanda, tanto en la reducción del volumen de las peticiones como en la generación de test apropiados cuando es necesario 3 . En este campo, todavía incipiente de la gestión de la demanda analítica, que requiere dedicación y valentía por parte del profesional de laboratorio, se han realizado recientemente, algunas aportaciones de interés en nuestro país 4 .…”