Endocrine Abstracts

Objetives: To analyze the profile of patients referred from Primary Care (PC) to Outpatient Diabetes Center (ODC), as well as the evolution of self-assessment measured by Chronic Care Model IEMAC (Instrument for the Evaluation of Attention Chronicity Models) tool after implementation of a coordinated Task Force between Primary Care and Endocrinology Unit.

Methods: The working group of the Advanced Diabetes Center in Cádiz-San Fernando Sanitary Area was constituted in 2014, with health professionals of different profiles and care’s level (one primary care physician from each of the 10 Health Centers of the area, 4 primary care nurses, 5 endocrinologists and 2 endocrinology nurses) The initial self-assessment was made by using IEMAC-Diabetes tool. A value proposal was developed with priority areas of intervention, aimed primarily to propagate Outpatient Diabetes Center’s service portfolio and thus optimizing its use. The data of patients referred to ODC were analyzed from April 2015 to December 2016.

Results: A total of 295 patients were derived to ODC (aged 63.03±16.3 years) with HbA1c of 8.54%. The association with other cardiovascular risk factors was 66% hypertension, 56.6% dyslipidemia and 57.8% excess weight. The rate of micro and macrovascular complications was 46.6% and 44.4% respectively. After one year follow up, a significant HbA1c reduction was observed. In 2015, only 40% fulfilled criteria included in the agreed Outpatient Diabetes Center’s portfolio and in 2016 amounted to 76%. The most common reason for referral was diabetic foot (37%). Of these, 24% required minor amputation and 9% greater. The self-assessment over attention of patients with diabetes, evaluated through IEMAC among the professionals of the task force, improved from an overall score of 32/100 initially to 55/100 after two years.

Conclusions: After implementation of a coordinated task force group between Primary Care and Endocrinology Unit in Puerta del Mar Hospital, the adequacy in the referral to Outpatient Diabetes Center has improved significantly, with an increase in the score of the self-assessment on attention to patients with diabetes in the area.