| Does a diabetes annual review make a difference? | |
| | |
MedLine Citation:
|
PMID: 22141458 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
Aims: To determine whether a diabetes annual review, independently of other care processes, is followed by improved patient clinical measurements Methods: Audits conducted independently of the diabetes annual review were analysed for a time-trend in patient clinical measures. An interaction variable between the review and the year of audit was used to test for a change in gradient before and after a diabetes annual review. Each patient formed their own control. Results: The data included 9471 audits on 3397 patients from 92 practices, and diabetes annual reviews from 2003 to mid-2008. Percentages of patients with raised HbA(1c) , systolic blood pressure and lipids improved from first to last audit. Predicted means after a diabetes annual review for HbA(1c) decreased by 0.13% (1.0 mmol/mol), for HDL cholesterol increased by 0.04 mmol/L and for triglyceride decreased by 0.2 mmol/L. Predicted systolic and diastolic blood pressure, total cholesterol and urinary albumin:creatinine ratio did not change significantly. Conclusions: Metabolic control improved over time but this was largely independently of the diabetes annual review, which appears to add little clinical value to existing New Zealand general practice care processes. Currently, general practitioners are paid to undertake a diabetes annual review and report the measurements collected. We would argue that payment needs to be directed to demonstrating appropriate changes in clinical management or achieving meaningful clinical goals, and that the annual review results should be part of systematic feedback to general practitioners, particularly directed at clinical inertia. © 2011 The Authors. Diabetic Medicine© 2011 Diabetes UK. |
| | |
Authors:
|
T Kenealy; B Orr-Walker; R Cutfield; E Robinson; S Buetow; D Simmons |
Related Documents
:
|
15248188 - Topical disposition of two strengths of a 125i-rhegf jelly in rat skin wounds. 14688218 - Correlated endothelial caveolin overexpression and increased transcytosis in experiment... 17554258 - Advanced glycation end products decrease mesangial cell mmp-7: a role in matrix accumul... 2171538 - Imbalance between the mechanisms of activation and inhibition of metalloproteases in th... 19878258 - Impact of glucagon-like peptide-1 on endothelial function. 12566728 - Low birth weight: effect on insulin sensitivity and lipid metabolism. |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2011-12-5 |
Journal Detail:
|
Title: Diabetic medicine : a journal of the British Diabetic Association Volume: - ISSN: 1464-5491 ISO Abbreviation: - Publication Date: 2011 Dec |
Date Detail:
|
Created Date: 2011-12-6 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8500858 Medline TA: Diabet Med Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
|
© 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK. |
Affiliation:
|
University of Auckland, South Auckland Clinical School, Middlemore Hospital, Otahuhu, Auckland Endocrinologist, Counties Manukau District Health Board Endocrinologist, Waitemata District Health Board Division of Biostatistics and Epidemiology, University of Auckland Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand Institute of Metabolic Science, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: HCN channels in the heart: Lessons from mouse mutants.
Next Document: Developing the Coach Analysis and Intervention System (CAIS): Establishing validity and reliability ...