Office-based management of diabetes: two-year trial of primary care quality improvement.
OBJECTIVE
The goals of this study were to learn different approaches to improve the quality of care for the diabetic patients of the family practice setting FMC.


METHODS
Participants of the study were 34 adult diabetic patients (Type 1 or 2) seen in the University of Arkansas of Medical Sciences' Family Medical Center by either family practice residents or faculty. Each CQI innovation was introduced in a stepwise fashion. The study team used a biopsychosocial, economic and environmental model of care to impact each dimension of ambulatory care. Not all cycles included all patients in the study, but patients and physicians received multiple interventions designed to improve hypertension control.


RESULTS
The project intended to assess the feasibility of introducing a "package" of approaches to improve the outpatient management of diabetes rather than assess whether a specific innovation was efficacious. Improvement in blood pressure control, increased referral for eye exams, improved prescribing and/or use of aspirin and improved patient satisfaction with care were noted.


CONCLUSIONS
The study demonstrated that the biopsychosocial and economic dimensions of the patients' diabetes must be addressed to achieve optimal care and that many approaches to improving outcomes can feasibly be introduced in a family practice setting.
Goldsmith
Geoffrey
G
Department of Family and Community Medicine, University of Arkansas for Medical Sciences, Little Rock, USA.
Ward
Kristin
K
Howard
Jamie
J
D000328:Adult; D001131:Arkansas; D001794:Blood Pressure; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D010353:Patient Education as Topic; D011787:Quality of Health Care