Endocrine Abstracts

Diabetes mellitus is a serious health problem that requires continuous medical care to reduce the risk of its long-term complications. Although several guidelines have been developed to improve diabetes care, the compliance with diabetes clinical practice recommendations remains inadequate in some primary care clinics.

The objective of this study was to assess the effectiveness of an intervention targeted at primary care physicians to improve the screening for diabetes related long-term complications.

Thirty three primary care physicians were randomly assigned to work either with helper 19 (intervention group), or without helper 14 (control group). The study was carried out in the period between 1/8/2008 and 31/7/2009. The helper reviewed patients’ charts and entered information into a specially designed computer program. A checklist was generated by the program with the clinical and laboratory tests that need to be done for the patient at his/her current visit according to the recommended clinical practice guidelines. The checklist was then handled to the physician upon seeing the patient.

At the end of the study, the achievement of the standards of care in screening for diabetes complications was assessed in both groups (total of 299 patients). Both groups had met the clinical practice recommendations in measuring blood pressure, and checking HbA1c and lipids. However, the control group failed to achieve the standards of care, when compared to the intervention group, in performing annual eye examination (23.9 vs 93.9%), annual complete foot examination (23.1 vs 86%), and annual screening for nephropathy (35.8 vs 70.9) (P<0.001 in all). We concluded that the intervention used did significantly improve the standards of care for patients with diabetes in primary care clinics.