title: Benchmarking is associated with improved quality of care in type 2 diabetes: the OPTIMISE randomized, controlled trial.
abstract: OBJECTIVE
  To assess prospectively the effect of benchmarking on quality of primary care for patients with type 2 diabetes by using three major modifiable cardiovascular risk factors as critical quality indicators.
  
  
  METHODS
  Primary care physicians treating patients with type 2 diabetes in six European countries were randomized to give standard care (control group) or standard care with feedback benchmarked against other centers in each country (benchmarking group). In both groups, laboratory tests were performed every 4 months. The primary end point was the percentage of patients achieving preset targets of the critical quality indicators HbA1c, LDL cholesterol, and systolic blood pressure (SBP) after 12 months of follow-up.
  
  
  RESULTS
  Of 4,027 patients enrolled, 3,996 patients were evaluable and 3,487 completed 12 months of follow-up. Primary end point of HbA1c target was achieved in the benchmarking group by 58.9 vs. 62.1% in the control group (P = 0.398) after 12 months; 40.0 vs. 30.1% patients met the SBP target (P < 0.001); 54.3 vs. 49.7% met the LDL cholesterol target (P = 0.006). Percentages of patients meeting all three targets increased during the study in both groups, with a statistically significant increase observed in the benchmarking group. The percentage of patients achieving all three targets at month 12 was significantly larger in the benchmarking group than in the control group (12.5 vs. 8.1%; P < 0.001).
  
  
  CONCLUSIONS
  In this prospective, randomized, controlled study, benchmarking was shown to be an effective tool for increasing achievement of critical quality indicators and potentially reducing patient cardiovascular residual risk profile.
authors.affiliation: Corresponding author: Michel P. Hermans, michel.hermans@uclouvain.be.
authors.forename: Michel P
authors.initials: MP
authors.lastname: Hermans
authors.forename: Moses
authors.initials: M
authors.lastname: Elisaf
authors.forename: Georges
authors.initials: G
authors.lastname: Michel
authors.forename: Erik
authors.initials: E
authors.lastname: Muls
authors.forename: Frank
authors.initials: F
authors.lastname: Nobels
authors.forename: Hans
authors.initials: H
authors.lastname: Vandenberghe
authors.forename: Carlos
authors.initials: C
authors.lastname: Brotons
mesh_terms: D000368:Aged; D019985:Benchmarking; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000503:physiopathology; D008078:Cholesterol, LDL / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058007:Physicians, Primary Care; D011320:Primary Health Care; D011446:Prospective Studies; D019984:Quality Indicators, Health Care; D012307:Risk Factors
chemical_list: D008078:Cholesterol, LDL