title: Analysis of the healthcare process of patients with type 2 diabetes mellitus and associated comorbidity treated in Spain's National Health System: A perspective of medical professionals. IMAGINE study.
abstract: OBJECTIVE
  To analyse the care received by patients with type 2 diabetes mellitus (DM2) and comorbidity in Spain's National Health System.
  
  
  METHODS
  Cross-sectional study using an online survey. A total of 302 family physicians, internists and endocrinologists participated in the study. The participants were recruited voluntarily by their respective scientific societies and received no remuneration.
  
  
  RESULTS
  Patients with DM2 and comorbidity are mostly treated in Primary Care (71.8%). Forty percent are referred to hospital care, mainly due to renal failure, poor glycaemic control and for a retinopathy assessment. Only 52% of those surveyed conducted medication reconciliation in the transition between healthcare levels. Fifty-eight percent reported conducting interconsultations, clinical meetings or consultancies between healthcare levels. The 3 main factors identified for improving the follow-up and control of DM2 with comorbidity were the multidisciplinary study (80.8%), the continuing education of health professionals (72.3%) and therapeutic education programmes (72%). A lack of time, a lack of qualified personnel for lifestyle interventions and organisational shortcomings were mentioned as the main obstacles for improving the care of these patients.
  
  
  CONCLUSIONS
  Most patients with DM2 and comorbidity are treated in Primary Care. Promoting multidisciplinary care and training programmes for practitioners and patients can help improve the quality of care. Therapy reconciliation represents a priority area for improvement in this population.
authors.affiliation: Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, FIMABIS, Málaga, España. Electronic address: ricardogomezhuelgas@hotmail.com.
authors.forename: R
authors.initials: R
authors.lastname: Gómez-Huelgas
authors.affiliation: Atención Primaria, Centro de Salud José Marvá, Madrid, España.
authors.forename: S
authors.initials: S
authors.lastname: Artola-Menéndez
authors.affiliation: Servicio de Endocrinología y Nutrición, Hospital Universitario Central de Asturias, Oviedo, España.
authors.forename: E
authors.initials: E
authors.lastname: Menéndez-Torre
keywords: Atención sanitaria; Comorbidity; Comorbilidad; Coordinación multidisciplinar; Diabetes mellitus tipo 2; Health care; Healthcare pathways; Hábitos de vida; Lifestyle; Multidisciplinary coordination; Rutas asistenciales; Type 2 diabetes mellitus