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Sharing the Care of Diabetic Patients between Hospital and General Practitioners: Does it Work?
Author(s) -
Hoskins P.L.,
Fowler P.M.,
Constantino M.,
Forrest J.,
Yue D.K.,
Turtle J.R.
Publication year - 1993
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.1993.tb02001.x
Subject(s) - medicine , shared care , attendance , diabetes mellitus , randomized controlled trial , blood pressure , medical record , emergency medicine , family medicine , primary care , endocrinology , economics , economic growth
A randomized controlled trial was conducted to compare three forms of diabetes follow‐up: (1) general practitioner care, (2) a system of care shared between the general practitioner (GP) and clinic and (3) conventional clinic care. Two hundred and six diabetic patients without significant diabetes‐related or other medical complications were randomized to one of these follow‐up systems. Metabolic control and blood pressure improved significantly and equally in all three groups ( p < 0.05). The shared care group performed as well as or better than either of the other two groups in all other outcome measures. In particular, final attendance rates were 72 % for shared care compared with only 35 % for GP care and 53 % for clinic care. Data collection rates for shared care were comparable with the clinic group for random blood glucose (88.9 % vs 95.1 %), weight (93.5 % vs 98.3 %), and blood pressure (94.8 % vs 92.7 %). Only in the case of glycosylated haemoglobin did shared care have poorer data collection (66.0 % vs 98.4 %). In all these parameters, except blood pressure, shared care out‐performed the GP group. We conclude that with adequate support from and communication with hospital‐based diabetes services, GPs are capable of providing care appropriate to the needs of uncomplicated diabetic patients.