Quality of care of patients with diabetes: collation of data from multi-practice audits of diabetes in primary care

Abstract

This study shows the feasibility of collating audit data and the potential of this approach for describing patterns of care and highlighting general and local deficiencies. Information about levels of performance in large numbers of patients can be used to set standards or norms against which individual practitioners can compare their own activity. Comparison of the health needs of local populations with national data could be used to inform commissioning services. However, audits should employ uniform evidence-based criteria so as to facilitate collation and allow comparison.

Patient Characteristics do not Predict Poor Glycaemic Control in type 2 Diabetes Patients Treated in Primary Care

“…In current guidelines HbA 1c <7% is considered as treatment goal for most patients [2,3]. However, many patients in general practice do not meet this target [4,5]. To improve quality of care, information might be helpful on patient and treatment characteristics that are possibly associated with poor levels of HbA 1c .…”

The impact of non‐vitamin K antagonist oral anticoagulants (NOACs) on anticoagulation therapy in rural Australia

“…In comparing the rate of microalbumin testing, the PoCT Trial obtained a much higher rate compared with that found in Divisions of General Practice, where less than half the patients received this test in a 12 month period in 2002. 143 While direct comparison of the PoCT Trial results with other studies is not possible because of different data collection and analysis methods, it seems clear that uptake of the more common process of care actions for diabetes is similar to other studies, but for one of the least common measures of care, microalbumin testing, the GPs in the intervention group achieved much higher levels of compliance than found by Georgiou et al 143 and Khunti et al 151 Microalbuminuria is an important indicator of renal damage and it is for this reason that annual review is part of the recommended annual cycle of care for diabetes patients. However, as shown above, testing for urine albumin is low and management poor.…”

“…This result is also similar to studies that analysed the audit data from general practices in the UK. 151,152 These studies found a wide variation in compliance with process measures for diabetes, the most common being review of HbA1c results and measurement of blood pressure while the checking of lipids and microalbumin received less than 50% compliance. In comparing the rate of microalbumin testing, the PoCT Trial obtained a much higher rate compared with that found in Divisions of General Practice, where less than half the patients received this test in a 12 month period in 2002.…”

Necesidades en salud del diabético usuario del primer nivel de atención

“…La mayor atención al diabético ocurre en instalaciones del primer nivel de atención, por lo que es más que fundamental el papel que juegan los médicos generales y familiares en el control de esta enfermedad. 14,17,21,22 Khunti 23 reporta que 37% de los obstáculos que se enfrentan en la práctica diaria de atención al diabético, en el primer nivel de atención, están relacionados con el médico; el 25.9% con el paciente y 37.0% con la organización. Se requiere que éste se haga partícipe y responsable del control de su enfermedad.…”