TY - JOUR
T1 - Identifying people at risk for undiagnosed type 2 diabetes using the GP's electronic medical record
AU - Klein Woolthuis, Erwin P.
AU - de Grauw, Wim J.C.
AU - van Gerwen, Willem H.E.M.
AU - van den Hoogen, Henk J.M.
AU - van de Lisdonk, Eloy H.
AU - Metsemakers, Job F.M.
AU - van Weel, Chris
PY - 2007/6
Y1 - 2007/6
N2 - Background. Screening for type 2 diabetes is recommended in at-risk patients. The GP's electronic medical record (EMR) might be an attractive tool for identifying them. Objective. To assess the value ofthe GP's EMR in identifying patients at risk for undiagnosed type 2 diabetes and the feasibility to use this information in usual care to initiate screening. Methods. In 11 Dutch general practices (25 GPs), we performed an EMR-derived risk assessment in all patients aged ≥45 and ≤75 years, without known diabetes, identifying those at risk according to the American Diabetes Association recommendations. Patients with an EMR-derived risk or risk after additional risk assessment during regular consultation were invited for capillary fasting plasma glucose (FPG) measurement. Results. Of 13 581 patients, 3858 (28%) had an EMR-based risk (hypertension, cardiovascular disease, lipid metabolism disorders and/or obesity). Additional risk assessment in those without an EMR-based risk showed that in 51%, greater than one risk factor was present, mainly family history (51.2%) and obesity (59%). Ninety per cent returned for the FPG measurement. In both groups, we found patients with an FPG exceeding the cut point for diabetes (5.9% versus 4.1%). Conclusions. With additional risk assessment during consultation, the GP's EMR was valuable in identifying patients at risk for undiagnosed type 2 diabetes. It was feasible to use this information to initiate screening. At-risk patients were willing to take part in screening. Better registration of family history and obesity will improve the EMR as a tool for identifying at-risk patients in opportunistic screening in general practice.
AB - Background. Screening for type 2 diabetes is recommended in at-risk patients. The GP's electronic medical record (EMR) might be an attractive tool for identifying them. Objective. To assess the value ofthe GP's EMR in identifying patients at risk for undiagnosed type 2 diabetes and the feasibility to use this information in usual care to initiate screening. Methods. In 11 Dutch general practices (25 GPs), we performed an EMR-derived risk assessment in all patients aged ≥45 and ≤75 years, without known diabetes, identifying those at risk according to the American Diabetes Association recommendations. Patients with an EMR-derived risk or risk after additional risk assessment during regular consultation were invited for capillary fasting plasma glucose (FPG) measurement. Results. Of 13 581 patients, 3858 (28%) had an EMR-based risk (hypertension, cardiovascular disease, lipid metabolism disorders and/or obesity). Additional risk assessment in those without an EMR-based risk showed that in 51%, greater than one risk factor was present, mainly family history (51.2%) and obesity (59%). Ninety per cent returned for the FPG measurement. In both groups, we found patients with an FPG exceeding the cut point for diabetes (5.9% versus 4.1%). Conclusions. With additional risk assessment during consultation, the GP's EMR was valuable in identifying patients at risk for undiagnosed type 2 diabetes. It was feasible to use this information to initiate screening. At-risk patients were willing to take part in screening. Better registration of family history and obesity will improve the EMR as a tool for identifying at-risk patients in opportunistic screening in general practice.
KW - Diabetes
KW - Diagnostic tests
KW - Family medicine
KW - Information technology
KW - Patient record
UR - http://www.scopus.com/inward/record.url?scp=34547876837&partnerID=8YFLogxK
U2 - 10.1093/fampra/cmm018
DO - 10.1093/fampra/cmm018
M3 - Article
SN - 0263-2136
VL - 24
SP - 230
EP - 236
JO - Family Practice
JF - Family Practice
IS - 3
ER -