The Wisconsin Medical Society diabetes study.
OBJECTIVE
Diabetes is a chronic and costly disease affecting approximately 330,000 people in Wisconsin. This study examined the association between use of clinical practice guidelines and outcomes of care.


METHODS
Fourteen physicians from 3 diverse sites volunteered to recruit their adult patients with type 1 and type 2 diabetes who were in continuous care in 1999 and 2000. Of 757 randomly selected patients, 492 (65%) completed a mailed survey and 471 (62%) also gave consent for medical record review. Measures included diabetes management indicators, SF-36 scores, and patient satisfaction.


RESULTS
Respondent age averaged 63 years (range 22-90 years) and 55% were men. While most clinicians measured blood pressure, lipids, and hemoglobin (A1c), less than half of the patients were at goal for these indicators. The process indicators explained a significant amount of the variability in physical functioning after controlling for demographics, comorbidities, diabetes-related factors, and clinician type. Overall, most respondents rated their diabetes care as excellent or very good and would recommend their clinician to family and friends.


CONCLUSIONS
Study patients with diabetes inconsistently met recommendations for diabetes self-management. While clinical care of study patients was often consistent with recommended guidelines, tremendous opportunities exist for achieving optimal blood pressure, A1c, and lipid levels.
Helstad
Cynthia P
CP
Wisconsin Medical Society, Madison, USA.
Wiegmann
Susan M
SM
Camponeschi
Jenny
J
Udlis
Seth
S
Meredith
Melissa
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D003920:Diabetes Mellitus / Q000628:therapy*; D005260:Female; D019983:Guideline Adherence; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D017410:Practice Guidelines as Topic; D011785:Quality Assurance, Health Care; D012189:Retrospective Studies; D012955:Societies, Medical; D011795:Surveys and Questionnaires; D014922:Wisconsin / Q000453:epidemiology