Type 2 diabetes in family practice. Room for improvement
Stewart B Harris, Moira Stewart, Judith Belle Brown, Stephen Wetmore, Catherine Faulds, Susan Webster-Bogaert, Sheila Porter, Stewart B Harris, Moira Stewart, Judith Belle Brown, Stephen Wetmore, Catherine Faulds, Susan Webster-Bogaert, Sheila Porter
Abstract
Objective: To further knowledge of diabetes management in family practice. DESIGN Retrospective, observational chart audit study.
Setting: Southwestern Ontario.
Participant: A random sample of non-academic family physicians and a random selection of their patients with type 2 diabetes mellitus.
Main outcome measures: Glycemic control as measured by HbA1c and adherence to recommendations in clinical practice guidelines (CPGs).
Results: Eighty-four percent of patients had at least one HbA1c test ordered in the previous year. Overall mean HbA1c was 0.079 and half-the patients had levels deemed acceptable by 1992 CPGs. Screening for microvascular complications was disappointing; only 28% were tested for microalbuminuria, and 15% were examined for diabetes-related foot conditions. Screening for macrovascular complications was more comprehensive; blood pressure was measured in 88%, and lipid profiles documented in 48%, of patient charts.
Conclusion: Management of glycemic control and screening for microvascular and macrovascular disease in family practice can be improved.
References
- JAMA. 1999 Oct 20;282(15):1458-65
- CMAJ. 1999 Aug 24;161(4):388-92
- CMAJ. 2000 May 16;162(10):1441-7
- J Fam Pract. 2000 Sep;49(9):796-804
- Diabetes Care. 2001 Jun;24(6):1038-43
- Diabetes Care. 2002 Jan;25 Suppl 1:S1-147
- Am J Health Syst Pharm. 2002 Jan 15;59(2):147-9
- CMAJ. 2002 May 28;166(11):1407-11
- Fam Pract. 2002 Aug;19(4):344-9
- Qual Saf Health Care. 2002 Jun;11(2):125-30
- Acta Endocrinol (Copenh). 1982 Aug;100(4):550-5
- Diabetes Care. 1989 Jan;12(1):24-31
- Fam Pract. 1989 Sep;6(3):168-72
- N Engl J Med. 1989 Nov 9;321(19):1306-11
- Br J Gen Pract. 1991 Jul;41(348):282-5
- Ann Intern Med. 1993 Jul 1;119(1):36-41
- J Fam Pract. 1993 Jul;37(1):17-9
- Br J Gen Pract. 1993 Jul;43(372):291-5
- Diabetes Care. 1993 Nov;16(11):1507-10
- Br J Gen Pract. 1994 Apr;44(381):153-6
- Ann N Y Acad Sci. 1993 Dec 31;703:210-24; discussion 224-5
- Diabetes Care. 1994 Dec;17(12):1495-7
- Diabetes Care. 1995 Aug;18(8):1124-32
- Diabetes Res Clin Pract. 1995 May;28(2):103-17
- Ann Intern Med. 1996 Jan 1;124(1 Pt 2):146-8
- J Community Health. 1996 Jun;21(3):175-82
- J Gen Intern Med. 1996 Aug;11(8):497-9
- Fam Pract. 1996 Oct;13(5):468-76
- J Fam Pract. 1997 Apr;44(4):374-81
- CMAJ. 1997 Jun 15;156(12):1705-12
- Arch Intern Med. 1997 Jul 14;157(13):1413-8
- Scand J Prim Health Care. 1997 Sep;15(3):141-5
- J Fam Pract. 1997 Oct;45(4):341-7
- Can Fam Physician. 1997 Oct;43:1739-44
- Diabet Med. 1998 Jan;15(1):80-4
- J Fam Pract. 1998 Apr;46(4):311-8
- BMJ. 1998 Jul 25;317(7153):273-6
- BMJ. 1998 Sep 26;317(7162):862-3
- Qual Health Care. 1998 Sep;7(3):149-58
- CMAJ. 1998;159 Suppl 8:S1-29
- J Fam Pract. 1998 Nov;47(5 Suppl):S55-62
- BMJ. 1999 Feb 20;318(7182):527-30
- JAMA. 1999 Jun 2;281(21):2005-12
Source: PubMed