Encouraging structured personalised diabetes care in general practice. A 6-year follow-up study of process and patient outcomes in newly diagnosed patients.
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.


METHODS
A 6-year follow-up study.


METHODS
A total of 243 Danish GPs and a population-based sample of 729 newly diagnosed, predominantly type 2 diabetic patients participated.


METHODS
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.


CONCLUSIONS
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.
Hansen
Lars J
LJ
Central Research Unit and Department of General Practice, University of Copenhagen, Copenhagen, Denmark. L.Hansen@gpract.ku.dk
Olivarius
Niels de Fine
Nde F
Siersma
Volkert
V
Beck-Nielsen
Henning
H
Pedersen
Poul A
PA
D000328:Adult; D000368:Aged; D003718:Denmark; D003920:Diabetes Mellitus / Q000628:therapy*; D005194:Family Practice / Q000458:organization & administration*; D005260:Female; D005500:Follow-Up Studies; D006302:Health Services Research; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010818:Practice Patterns, Physicians'; D015397:Program Evaluation; D012307:Risk Factors; D012648:Self Care