scholarly journals Prevalence of amputations amongst people with type 2 diabetes enrolled in primary care in England

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
B Meza-Torres ◽  
C Heiss ◽  
S Cunningham ◽  
F Carinci ◽  
S de Lusignan
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Quality Of Care ◽  
General Practitioners ◽  
Distinct Pattern ◽  
National Database ◽  
Cross Sectional ◽  
Clinical Records

Abstract Background Different patterns of co-morbidities observed among people with type 2 diabetes (T2D) and lower extremity amputations (LEA) compared with those without may provide insights into the quality of care provided by general practitioners in England. We analysed routinely recorded clinical data to build predictive models for benchmarking and continuous improvement. Methods A cross-sectional computerized data extraction of clinical records from the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) database of people with T2D in England. Key target cases were defined as adults with T2D and a record of major/minor LEA between 2008-2019 vs all subjects with T2D without amputation. Quality of care was assessed in terms of percentage of patients treated with optimal medical therapy and diagnostic procedures and referred to specialized care according to their clinical profile. The association between quality of care and outcomes was explored using a logistic regression model, adjusting for case-mix. Results During the last decade, in a sample covering approximately 7.4% of all general practitioners in England, a total of 1,052 subjects out of 127,100 adults with T2D had a LEA (832 per 100,000). The median time since amputation was 3.4 years. Only 410 (38%) patients had a recorded DFU diagnosis prior to the amputation, with a median of 2 years from diagnosis to amputation. Major LEA was recorded in 280 (27%) cases. People with a record of retinopathy, peripheral arterial disease, renal disease, neuropathy and DFU had a higher risk of amputations. Quality of care was heterogeneous between patients with and without LEA. Conclusions People with T2D and LEA have a distinct pattern of co-morbidities some of which may be sensitive to improved primary care management, and differential quality of care. Models built using this national database can routinely monitor amputations in England. Variation in treatment should be properly investigated. Key messages The automated extraction of clinical cases from a national database may help shed light on clinical patterns among people with diabetes at high risk of amputations, based on evidence-based criteria. Variation in treatment and quality of care among amputated vs non-amputated subjects can be rapidly explored using a cross-sectional analysis of current records.

scholarly journals Quality of Care for Patients With Type 2 Diabetes in Primary Care in Norway Is Improving: Results of cross-sectional surveys of 33 general practices in 1995 and 2005

Diabetes Care ◽  
2008 ◽  
Vol 32 (1) ◽  
pp. 81-83 ◽  
Author(s):  
J. G. Cooper ◽  
T. Claudi ◽  
A. K. Jenum ◽  
G. Thue ◽  
M. F. Hausken ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Quality Of Care ◽  
Cross Sectional ◽  
General Practices

Quality of Care in Patients with Type 2 Diabetes in Iran: A 5-year retrospective study

2019 ◽  
Author(s):  
yahya bayazidi ◽  
Majid Davari ◽  
Abbas Kebriaeezadeh ◽  
Bagher Larijani ◽  
Alireza Esteghamati ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Quality Of Care ◽  
Hemoglobin A1c ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Cross Sectional ◽  
Private And Public

Abstract Background The object of this study was to evaluate the quality of care indicators (process- and outcome-related) in patients with type 2 diabetes using patient-level data during the last 5 years in Iran, in private and public diabetes centers in five provinces (Tehran, Isfahan, Yazd, Mazandaran, and Kurdistan).Method Our study was a cross-sectional study carried out on patients with type 2 diabetes at 13 diabetes centers (private and public). Annual tests for hemoglobin A1C, serum lipid (LDL) and screening for nephropathy (urine protein or urine albumin quantitative test) were used to evaluate process-related and hemoglobin A1C, blood pressure and lipids levels were used to assess outcome-related outcomes.Findings Among 1976 patients, 54% were women with an average of 15 years of diabetes duration and approximately 83% of patients were obese or overweight. About 9% of patients had a hemoglobin A1C test every three months. The values obtained were favorable for controlling lipid profile but less than standard for screening for nephropathy and only about 30% of patients were within the optimal range for simultaneous control of process-related indicators. Findings for outcome- related indicators show that the achievement of blood glucose, blood pressure, and low-density lipoprotein targets were 31, 49 and 70%, respectively and concurrent achievement was 13.8% in the last year.Conclusion The performance of the health system has much room for improvement and diabetes control programs have not been favorable in any of the provinces studied and have not led to optimal control.

scholarly journals Forgone Care in Patients With Type 2 Diabetes: A Cross-Sectional Study

2021 ◽  
Author(s):  
Habib Jalilian ◽  
Somayeh Heydari ◽  
Habibeh Mir ◽  
Saeedeh Fehresti ◽  
Nasser Hatamzadeh ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Quality Of Care ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Sectional Study ◽  
Cross Sectional ◽  
Financial Barriers ◽  
History Of

Abstract Background and objective: Diabetes mellitus is a complex chronic disease requiring appropriate continuous medical care and delayed, or forgone care may exacerbate the severity of the disease. This study aimed to investigate the factors affecting forgone care in diabetic patients.Materials and methods: This was a cross-sectional study involving 1139 patients with type 2 diabetes aged 18 years and older in East Azerbaijan. Data collected using a researcher-made questionnaire and analyzed using SPSS software version 22. Results: Of the 1139 patients, 510 patients (45%) reported forgone care during the last year. The percentage of forgoing care was higher in patients without supplementary insurance coverage (P=0.01), those with complications (P=0.01) and those with the history of hospitalization (P=0.006). The majority of patients (41.5%) reported that the most important reason for forgoing care is financial barriers resulting from disease treatment costs. Of the main four factors, quality of care had the highest impact on forgone care at 61.28±39.74, followed by accessibility (37.01±25.12), awareness and attitude towards disease (18.52±18.87) and social support (17.22±18.80).Conclusion: The results showed that, despite the implementation of the Islamic Republic of Iran on a fast-track to beating non-communicable diseases (IraPEN), a considerable number of diabetics had a history of forgoing care, and the most important reasons for forgoing care were related to the financial pressure and dissatisfaction with the quality of care. Therefore, not only more financial support programs should be carried out, but the quality of care should be improved.

scholarly journals 2019 Endocrine Society Measures Set for Older Adults With Type 2 Diabetes Who Are at Risk for Hypoglycemia

2019 ◽  
Vol 105 (4) ◽  
pp. 969-990
Author(s):  
James L Rosenzweig ◽  
Paul R Conlin ◽  
Jasmine D Gonzalvo ◽  
Stephanie B Kutler ◽  
Nisa M Maruthur ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Older Adults ◽  
Primary Care ◽  
Quality Of Care ◽  
Primary Care Physicians ◽  
Negative Impact ◽  
Quality Measures ◽  
Endocrine Society

Abstract Context Hypoglycemia in the outpatient setting has a significant financial impact on the health care system and negative impact on a person’s quality of life. Primary care physicians must address a multitude of issues in a visit with a person with type 2 diabetes mellitus (T2DM), often leaving little time to ask about hypoglycemia. Objective To develop quality measures that focus on outpatient hypoglycemia episodes for patients 65 and older with T2DM, which facilitate a clinician’s ability to identify opportunities to improve the quality of care and reduce hypoglycemic episodes. Participants and Process A technical expert panel established by the Endocrine Society in March 2019, which includes endocrinologists, primary care physicians, a diabetes care and education specialist/pharmacist, and a patient, developed 3 outpatient hypoglycemia quality measures. The measure set is intended to improve quality of care for patients with T2DM who are at greatest risk for hypoglycemia. The measures were available for public comment in July 2019. A fourth measure on shared decision-making was removed from the final measure set based on public feedback. Conclusion A lack of outpatient hypoglycemia measures focusing on older adults with T2DM is a barrier to improving care of people with diabetes and reducing hypoglycemic episodes. This paper provides measure specifications for 3 measures that may be used to focus quality improvement efforts on patients at greatest risk for hypoglycemia.

Comorbidity and patient-reported quality of care: an evaluation of the primary care based German disease management program for type 2 diabetes

2011 ◽  
Vol 20 (1) ◽  
pp. 41-46 ◽  
Author(s):  
Dominik Ose ◽  
Tobias Freund ◽  
Elisabeth Urban ◽  
Cornelia Ursula Kunz ◽  
Joachim Szecsenyi ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Quality Of Care ◽  
Disease Management ◽  
Disease Management Program ◽  
Management Program ◽  
Patient Reported
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