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A diabetes scorecard does not improve HbA 1c , blood pressure, lipids, aspirin usage, exercise and diabetes knowledge over 9 months: a randomized controlled trial
Author(s) -
Irwig M. S.,
Sood P.,
Ni D.,
Amass T.,
Khurana P. S.,
Jayanthi V. V.,
Wang L.,
Adler S.M
Publication year - 2012
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.1464-5491.2012.03610.x
Subject(s) - medicine , balanced scorecard , aspirin , diabetes mellitus , population , blood pressure , randomized controlled trial , type 2 diabetes , physical therapy , endocrinology , environmental health , management , economics
Diabet. Med. 29, 1206–1212 (2012) Abstract Aims To test (1) whether a diabetes scorecard can improve glycaemic control, blood pressure control, LDL cholesterol, aspirin usage and exercise; (2) if the scorecard will motivate and/or educate patients to improve their scores for subsequent visits; and (3) whether the scorecard will improve rates of clinical inertia. Methods Five physicians enrolled 103 patients ≥ 40 years old with uncontrolled Type 2 diabetes [HbA 1c ≥ 64 mmol/mol (8.0%)] to randomly receive either a diabetes scorecard or not during four clinical visits over a 9‐month period. The population was predominantly urban with a disproportionately higher percentage of black people than the general population. Our scorecard assigned points to six clinical variables, with a perfect total score of 100 points corresponding to meeting all targets. The primary outcomes were total scores and HbA 1c in the scorecard and control groups at 9 months. Results There were no significant differences between the control and scorecard groups at visits 1 and 4 in total score, HbA 1c , blood pressure, LDL cholesterol, aspirin usage, exercise or knowledge about diabetic targets. By visit 4 both the control and scorecard groups had statistically significant improvements with their mean total score (9 and 7 points, respectively), HbA 1c [−9 mmol/mol (–0.8%) and −15 mmol/mol (–1.4%), respectively] and aspirin usage (33% increase and 16% increase, respectively). Rates of clinical inertia were low throughout the study. Conclusions A diabetes scorecard did not improve glycaemic control, blood pressure control, LDL cholesterol, aspirin usage, exercise or diabetic knowledge in an urban population with uncontrolled Type 2 diabetes.