Encouraging structured personalised diabetes care in general practice. A 6-year follow-up study of process and patient outcomes in newly diagnosed patients.
Scand J Prim Health Care
; 21(2): 89-95, 2003 Jun.
Article
en En
| MEDLINE
| ID: mdl-12877371
OBJECTIVE: To evaluate the quality of diabetes care achieved on the process and outcomes of care in the context of a multifaceted intervention directed at general practitioners (GPs) encouraging regular follow-up and individualised goal-setting. DESIGN: A 6-year follow-up study. SETTING: A total of 243 Danish GPs and a population-based sample of 729 newly diagnosed, predominantly type 2 diabetic patients participated. MAIN OUTCOME MEASURES: Questionnaires and laboratory assessments were used to determine the proportion of patients reviewed regularly, and their pharmacological treatment and risk factors. RESULTS: During the study, the proportion of patients who had an annual clinical examination decreased from 100% to 77%. The proportion given oral anti-diabetic agents or insulin increased from 43% to 71%. Median glycated haemoglobin (HbA1c) dropped in the 2nd year to 7.7% (normal range 5.4-7.4%), after which it increased gradually, but remained on average at 1.3% above the upper limit of the normal range. Median blood pressure (systolic/diastolic), total cholesterols and fasting triglycerides were maintained at 145-150/81-85 mmHg, 6.0-6.2 mmol/l and 1.66-1.96 mmol/l, respectively. Initial weight loss was partly regained over 6 years. CONCLUSION: Among centrally supported GPs, most patients were regularly reviewed and obtained acceptable levels of risk factors for at least 6 years, although glycaemic control progressively deteriorated after an initial drop to near-normal average level.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Evaluación de Procesos y Resultados en Atención de Salud
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Autocuidado
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Pautas de la Práctica en Medicina
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Diabetes Mellitus
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Medicina Familiar y Comunitaria
Tipo de estudio:
Diagnostic_studies
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Etiology_studies
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Evaluation_studies
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Observational_studies
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Prognostic_studies
Aspecto:
Implementation_research
Límite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
Scand J Prim Health Care
Año:
2003
Tipo del documento:
Article
País de afiliación:
Dinamarca
Pais de publicación:
Estados Unidos