title: Diabetes management in an Australian primary care population.
abstract: OBJECTIVE
  Worldwide studies have shown that significant proportions of patients with type 2 diabetes (T2DM) do not meet targets for glycaemic control, blood pressure (BP) and lipids, putting them at higher risk of developing complications. However, little is known about medicines management in Australian primary care populations with T2DM. The aim of this study was to (i) describe the management of a large group of patients in primary care, (ii) identify areas for improvement in management and (iii) determine any relationship between adherence and glycaemic, BP and lipid control.
  
  
  METHODS
  This was a retrospective, epidemiological study of primary care patients with T2DM diabetes, with HbA(1c) of >7%, recruited in 90 Australian community pharmacies. Data collected included demographic details, diabetes history, current medication regimen, height, weight, BP, physical activity and smoking status.
  
  
  CONCLUSIONS
  Of the 430 patients, 98% used antidiabetics, 80% antihypertensives, 73% lipid lowering drugs and 38% aspirin. BP and all lipid targets were met by only 21% and 14% of the treated patients and 21% and 12% of the untreated patients respectively. Medication adherence was related to better glycaemic control (P = 0.04).
  
  
  CONCLUSIONS
  An evidence-base prescribing practice gap was seen in this Australian primary care population of T2DM patients. Patients were undertreated with antihypertensive and lipid lowering medication, and several subgroups with co-morbidities were not receiving the recommended pharmacotherapy. Interventions are required to redress the current evidence-base prescribing practice gap in disease management in primary care.
authors.affiliation: Faculty of Pharmacy, Sydney University, Sydney, NSW, Australia. ines.krass@sydney.usyd.edu.au
authors.forename: I
authors.initials: I
authors.lastname: Krass
authors.forename: R
authors.initials: R
authors.lastname: Hebing
authors.forename: B
authors.initials: B
authors.lastname: Mitchell
authors.forename: J
authors.initials: J
authors.lastname: Hughes
authors.forename: G
authors.initials: G
authors.lastname: Peterson
authors.forename: Y J C
authors.initials: YJ
authors.lastname: Song
authors.forename: K
authors.initials: K
authors.lastname: Stewart
authors.forename: C L
authors.initials: CL
authors.lastname: Armour
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001315:Australia; D001786:Blood Glucose / Q000187:drug effects; D001794:Blood Pressure / Q000187:drug effects; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy*; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008055:Lipids / Q000097:blood; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000592:standards / Q000706:statistics & numerical data*; D012189:Retrospective Studies
chemical_list: D000959:Antihypertensive Agents; D001786:Blood Glucose; D007004:Hypoglycemic Agents; D000960:Hypolipidemic Agents; D008055:Lipids