Health care delivery in type 2 diabetes. A survey in an Italian primary care practice

作者：Modesti Andrea; Bartaloni Roberto; Bellagamba Franca; Caglieri Rossano; Cenori Katia; Ciampalini Giorgio; Costagli Attilio; Galloni Vanni; Del Papa Cecilia; Modesti Leonardo; Dell'Omo Giulia; Pedrinelli Roberto^*

来源：Primary Care Diabetes, 2015, 9(1): 9-14.

DOI：10.1016/j.pcd.2014.04.008

• Health services
• Outcomes research
• Type 2 diabetes
• Primary care

Aims: Evidence-based guidelines provide targets and performance measures for the treatment of type 2 diabetic patients but a wide gap separates guidelines-driven recommendations from their clinical application, a phenomenon hindering the transfer of proven benefits to affected populations.
Methods: We analyzed the quality of diabetic care delivered by 8 general practitioners joint in a group practice attending 571 diabetic patients (5.6% of the total enlisted subjects) by assessing process (% of HbA(1c), SBP and LDL-C determinations) and intermediate outcome (% of patients with HbA(1c) <7% vs >8%, systolic BP <130 mmHg vs >140 mmHg, LDL-cholesterol <100 mg/dL vs >130 mg/dL) indicators.
Results: HbA(1c), was at target in 49% of patients and >8% in 22%; SBP and LDL-C determination was available in about two-thirds of patients, only a minority at target for SBP and LDL-C. Antihyperglycemic and antihypertensive treatment was prescribed in most patients but only a third was on statins. During the post-evaluation phase, percentages of patients with HbA(1c), >8%, SBP <130 mmHg and LDL-C <100 mg/dL and the drug prescription pattern did not change.
Conclusions: Several weaknesses affect primary care delivery to type 2 diabetic patients and efforts are needed to improve the management of this high-risk group.

• 出版日期2015-2