TY - JOUR
T1 - Outcomes of audit-enhanced monitoring of patients with type 2 diabetes
AU - De Grauw, Wim J.C.
AU - Van Gerwen, Willem H.E.M.
AU - Van De Lisdonk, Eloy H.
AU - Van Den Hoogen, Henk J.M.
AU - Van Den Bosch, Wil J.H.M.
AU - Van Weel, Chris
PY - 2002/5
Y1 - 2002/5
N2 - OBJECTIVE: To assess the outcome of diabetes care in a practice-based research network after the introduction of an audit-enhanced monitoring system (AEMS). STUDY DESIGN: An AEMS was introduced into family practices participating in the academic research network of Nijmegen University, Nijmegen, the Netherlands. One and 7 years later, a cross-sectional analysis was performed on the outcome of care in all type 2 diabetes patients under treatment by their family physicians. POPULATION: Approximately 42,500 patients in 1993 and approximately 46,000 patients in 1999 at 10 family practices participating in the university's academic research network.OUTCOMES MEASURED: Targets of care were Hb A1c < 8.5% and blood pressure < 150/85 mm Hg. Targets for lipids depended on age, cardiovascular morbidity, and smoking status. RESULTS: In 1993, 540 type 2 diabetes patients were included; in 1999, 851 such patients were included, representing a prevalence of 1.3% and 1.9%, respectively. Glycemic control improved statistically significantly by the percentage of patients with Hb A1c < 8.5% (87% vs 59%, P = .0001) and the mean Hb A1c (7.1% vs 8.2%, P = .0001) from the first to the second cohort. Mean blood pressure and the percentage of patients above the target blood pressure did not change. The mean cholesterol level (207 mg/dL vs 238 mg/dL [5.4 mmol/L vs 6.2 mmol/L], P = .0001) and the percentage of patients who met their target lipid levels (72% vs 52%, P = .001) also improved between 1993 and 1999. In addition, an increased percentage of patients attended an annual review in the past year (73% vs 84%). CONCLUSIONS: Outcomes of diabetes care in a family practice research setting using an AEMS were comparable with those reported under randomized controlled trial conditions.
AB - OBJECTIVE: To assess the outcome of diabetes care in a practice-based research network after the introduction of an audit-enhanced monitoring system (AEMS). STUDY DESIGN: An AEMS was introduced into family practices participating in the academic research network of Nijmegen University, Nijmegen, the Netherlands. One and 7 years later, a cross-sectional analysis was performed on the outcome of care in all type 2 diabetes patients under treatment by their family physicians. POPULATION: Approximately 42,500 patients in 1993 and approximately 46,000 patients in 1999 at 10 family practices participating in the university's academic research network.OUTCOMES MEASURED: Targets of care were Hb A1c < 8.5% and blood pressure < 150/85 mm Hg. Targets for lipids depended on age, cardiovascular morbidity, and smoking status. RESULTS: In 1993, 540 type 2 diabetes patients were included; in 1999, 851 such patients were included, representing a prevalence of 1.3% and 1.9%, respectively. Glycemic control improved statistically significantly by the percentage of patients with Hb A1c < 8.5% (87% vs 59%, P = .0001) and the mean Hb A1c (7.1% vs 8.2%, P = .0001) from the first to the second cohort. Mean blood pressure and the percentage of patients above the target blood pressure did not change. The mean cholesterol level (207 mg/dL vs 238 mg/dL [5.4 mmol/L vs 6.2 mmol/L], P = .0001) and the percentage of patients who met their target lipid levels (72% vs 52%, P = .001) also improved between 1993 and 1999. In addition, an increased percentage of patients attended an annual review in the past year (73% vs 84%). CONCLUSIONS: Outcomes of diabetes care in a family practice research setting using an AEMS were comparable with those reported under randomized controlled trial conditions.
KW - Diabetes mellitus
KW - Disease management [non-MeSH]
KW - Monitoring
KW - Non-insulin-dependent
KW - Outcome and process assessment (health care)
KW - Primary health care
UR - http://www.scopus.com/inward/record.url?scp=0036256469&partnerID=8YFLogxK
M3 - Article
SN - 0094-3509
VL - 51
SP - 459
EP - 464
JO - Journal of Family Practice
JF - Journal of Family Practice
IS - 5
ER -