title: Adherence to clinical practice guidelines and outcomes in diabetic patients.
abstract: OBJECTIVE
  To examine the level of adherence to clinical practice guidelines and its relationship to outcomes in patients with diabetes.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  A tertiary teaching hospital in Korea.
  
  
  METHODS
  Patients aged ≥18 years with diabetes (n = 4994) who visited the study hospital once or more during 2004.
  
  
  METHODS
  The outcomes were mortality from the database of the Statistics Korea and end-stage renal disease (ESRD) incidence from ESRD registry in the Korean Society of Nephrology until December 2009.
  
  
  RESULTS
  Testing rates for blood pressure, eye examination, HbA1c, renal function and lipid profiles were 93.9, 32.8, 84.9, 33.5 and 45.9%, respectively. The percentage of patients achieving each treatment goal was 27.8% for blood pressure, 44.2% for HbA1c and 49.4% for low-density lipoprotein (LDL) cholesterol. There were 11.7% patients with composite outcome (death and/or ESRD). Male gender, level of HbA1c (<7%), presence of HbA1c data, checking eye examination, presence of data on urine albumin-to-creatinine ratio (UACR) and having anti-platelet medication were associated with better outcome.
  
  
  CONCLUSIONS
  The adherence to recommendations was unsatisfactory, especially in checking eye examination, testing UACR and LDL cholesterol, and achieving a target goal for each parameter. Guideline adherence was positively related to better prognosis. Active strategies to apply the guidelines to clinical practice should be developed to improve patient outcomes.
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Se-Won
authors.initials: SW
authors.lastname: Oh
authors.forename: Ha Jeong
authors.initials: HJ
authors.lastname: Lee
authors.forename: Ho Jun
authors.initials: HJ
authors.lastname: Chin
authors.forename: Jee-In
authors.initials: JI
authors.lastname: Hwang
mesh_terms: D000368:Aged; D015331:Cohort Studies; D016208:Databases, Factual; D003920:Diabetes Mellitus / Q000188:drug therapy*; D003955:Diagnostic Tests, Routine; D005260:Female; D019983:Guideline Adherence; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D017410:Practice Guidelines as Topic; D056910:Republic of Korea; D012189:Retrospective Studies