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Improved quality of Type 2 diabetes care following electronic feedback of treatment status to general practitioners: a cluster randomized controlled trial
Author(s) -
Guldberg T. L.,
Vedsted P.,
Kristensen J. K.,
Lauritzen T.
Publication year - 2011
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.1464-5491.2010.03178.x
Subject(s) - medicine , type 2 diabetes , randomized controlled trial , medical prescription , diabetes mellitus , glycated haemoglobin , cluster randomised controlled trial , glycated hemoglobin , type 1 diabetes , cluster (spacecraft) , physical therapy , family medicine , endocrinology , nursing , computer science , programming language
Diabet. Med. 28, 325–332 (2011) Abstract Aims To evaluate the effect of an electronic feedback system to general practitioners on quality of Type 2 diabetes care. Methods A cluster randomized, controlled trial with 15 months follow‐up. Eighty‐six general practices (158 general practioners) in a Danish county caring for 2458 people 40–70 years old with Type 2 diabetes were randomized to receive or not to receive electronic feedback on quality of care. People with Type 2 diabetes were identified using a validated algorithm. Primary end‐points were processes of care according to guidelines on prescriptions redeemed for Type 2 diabetes treatments, measuring of glycated haemoglobin and cholesterol and visits to ophthalmologists. Secondary end‐points were changes in level of glycated haemoglobin and serum cholesterol. Data were analysed using generalized linear models accounting for clustering at practice level. Results During follow‐up, people with Type 2 diabetes in the intervention group more often redeemed recommended prescriptions than people in the control group, respectively, as follows: oral antidiabetic treatment (32.8 vs. 12.0%, P = 0.002), insulin treatment (33.8 vs. 12.4%, P < 0.001), lipid‐lowering medication (38.3 vs. 18.6%, P = 0.004) and blood pressure medication (27.6 vs. 16.3%, P = 0.026). There were no differences in mean glycated haemoglobin and serum cholesterol between the two groups. Conclusions Electronic feedback to general practitioners on the quality of Type 2 diabetes care resulted in significantly improved quality regarding processes of care according to guidelines. It was not possible to demonstrate any effect on secondary end‐point measures within the follow‐up period. Electronic feedback on quality of diabetes care can be effective in improving adherence to treatment according to evidence‐based guidelines.