title: A controlled before-after trial of structured diabetes care in primary health centres in a newly developed country.
abstract: OBJECTIVE
  To evaluate the long-term impact of a structured approach to improving the quality of diabetes care in general practice in the United Arab Emirates.
  
  
  METHODS
  Controlled before-after trial within a health district with three primary health centres (PHCs) in the intervention group and the six remaining serving as controls. Outcomes and adherence to guidelines were measured over the year before the intervention began and for a second 1-year period at the end of the intervention period. Data were collected by chart abstraction.
  
  
  METHODS
  The study was performed in PHCs in the United Arab Emirates, a newly developed country on the Arabian peninsula.
  
  
  METHODS
  Subjects continuously followed in nine PHCs for diabetes care for the period of the study (N = 738) were included in the study.
  
  
  METHODS
  Structured diabetes care, including the development of general practice diabetes clinics, a patient education program, a health care professional education program, and improved recording of clinical information, was provided for the 33-month time period.
  
  
  RESULTS
  There was a statistically significant improvement in three of the process of care variables (ordering HbA1c, cholesterol, and documenting foot examinations) whereas the four remaining variables did not improve. There was limited impact on outcome variables.
  
  
  CONCLUSIONS
  The intervention described in this study demonstrated an improvement in some process of care measures suggesting an impact of this type of delivery model in this environment.
authors.affiliation: United Arab Emirates University, Family Medicine, Al Ain, Abu Dhabi, United Arab Emirates. rreed@uaeu.ac.ae
authors.forename: Richard L
authors.initials: RL
authors.lastname: Reed
authors.forename: Anthony D
authors.initials: AD
authors.lastname: Revel
authors.forename: Anne O
authors.initials: AO
authors.lastname: Carter
authors.forename: Hussein F
authors.initials: HF
authors.lastname: Saadi
authors.forename: Earl V
authors.initials: EV
authors.lastname: Dunn
mesh_terms: D002784:Cholesterol / Q000097:blood; D002985:Clinical Protocols; D019049:Developed Countries; D003920:Diabetes Mellitus / Q000628:therapy*; D004496:Education, Continuing / Q000379:methods; D005260:Female; D006442:Glycated Hemoglobin; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods; D011320:Primary Health Care / Q000379:methods*; D014479:United Arab Emirates
chemical_list: D002784:Cholesterol; D006442:Glycated Hemoglobin