title: Adherence to recommended standards of diabetes care by Swiss primary care physicians.
abstract: OBJECTIVE
  To assess adherence to recommended standards of diabetes care by Swiss primary care physicians.
  
  
  METHODS
  Medical files of community-based primary care physician were reviewed to assess adherence to recommended standards of diabetes care. These standards of care were based on a uniform set of definitions addressing medical care processes involved in the detection and follow-up of pre-diabetic and diabetic patients.
  
  
  RESULTS
  186 physicians agreed to participate and 3,682 medical files were assessed. The prevalence of diabetes was 11% and 5% had impaired glucose tolerance (pre-diabetic). Screening of diabetes based on family or personal history was reported for 83% of the patients and on cardiovascular risk factors for 69%. Counselling for dietary changes was reported for 91% of diabetic patients and for 79% for physical activity, but only for 66% and respectively 60% of pre-diabetic patients. Among diabetic patients, regular HbA1c control was reported for 65%, yearly fundoscopy for 62%, yearly feet examination for 65%, yearly microalbuminuria control for 49%, regular blood pressure control for 96%, and yearly lipid profile for 89%. Regular screening of microangiopathic complications was reported for only 33% of diabetic patients.
  
  
  CONCLUSIONS
  Adherence to recommended standards of diabetes care displayed important variations among this convenience sample of Swiss primary care patients. Screening and counselling of diabetic patients were frequent, whereas counselling for lifestyle changes of pre-diabetic patients and regular follow-up of microangiopathic complications among diabetic patients were suboptimal. These results could help to target areas of diabetes care that need to be addressed to improve adherence to recommended standards.
authors: Medical Outpatient Clinic, Geneva University Hospital, Geneva, Switzerland. patrick.bovier@hcuge.ch
authors: Patrick A
authors: PA
authors: Bovier
authors: Paul
authors: P
authors: Sebo
authors: Gilbert
authors: G
authors: Abetel
authors: François
authors: F
authors: George
authors: Hans
authors: H
authors: Stalder
mesh_terms: D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000175:diagnosis* / Q000628:therapy*; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D015438:Health Behavior; D006801:Humans; D010821:Physicians, Family / Q000592:standards*; D017410:Practice Guidelines as Topic / Q000592:standards*; D011787:Quality of Health Care; D013557:Switzerland