RESUMO
AIMS: To assess the evolution of type 2 diabetes mellitus (T2DM) quality indicators in primary care centers (PCC) as part of the Group for the Study of Diabetes in Primary Care (GEDAPS) Continuous Quality Improvement (GCQI) programme in Catalonia. METHODS: Sequential cross-sectional studies were performed during 1993-2007. Process and outcome indicators in random samples of patients from each centre were collected. The results of each evaluation were returned to each centre to encourage the implementation of correcting interventions. Sixty-four different educational activities were performed during the study period with the participation of 2041 professionals. RESULTS: Clinical records of 23,501 patients were evaluated. A significant improvement was observed in the determination of some annual process indicators: HbA(1c) (51.7% vs. 88.9%); total cholesterol (75.9% vs. 90.9%); albuminuria screening (33.9% vs. 59.4%) and foot examination (48.9% vs. 64.2%). The intermediate outcome indicators also showed significant improvements: glycemic control [HbA(1c) ≤ 7% (< 57 mmol/mol); (41.5% vs. 64.2%)]; total cholesterol [≤ 200 mg/dl (5.17 mmol/l); (25.5% vs. 65.6%)]; blood pressure [≤ 140/90 mmHg; (45.4% vs. 66.1%)]. In addition, a significant improvement in some final outcome indicators such as prevalence of foot ulcers (7.6% vs. 2.6%); amputations (1.9% vs. 0.6%) and retinopathy (18.8% vs. 8.6%) was observed. CONCLUSIONS: Although those changes should not be strictly attributed to the GCQI programme, significant improvements in some process indicators, parameters of control and complications were observed in a network of primary care centres in Catalonia.
Assuntos
Diabetes Mellitus Tipo 2/terapia , Atenção Primária à Saúde/normas , Qualidade da Assistência à Saúde , Adulto , Idoso , Idoso de 80 Anos ou mais , Glicemia/metabolismo , Estudos Transversais , Feminino , Hemoglobinas Glicadas/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , EspanhaAssuntos
Glicemia/análise , Diabetes Mellitus/diagnóstico , Hemoglobinas Glicadas/análise , Fatores Etários , Idoso , Diabetes Mellitus/sangue , Teste de Tolerância a Glucose , Humanos , Valores de Referência , Fatores de Risco , Sensibilidade e Especificidade , Fatores de Tempo , Organização Mundial da SaúdeRESUMO
No disponible
Assuntos
Humanos , Idoso , Fatores de Risco , Fatores Etários , Organização Mundial da Saúde , Sensibilidade e Especificidade , Valores de Referência , Diabetes Mellitus , Glicemia , Fatores de Tempo , Hemoglobinas Glicadas , Teste de Tolerância a GlucoseRESUMO
No disponible
Assuntos
Humanos , Guias de Prática Clínica como Assunto , Glicemia , Diabetes Mellitus , Programas de Rastreamento , Teste de Tolerância a GlucoseRESUMO
The results of a physician-based intervention on smoking done by general practitioners in Barcelona (Spain) are described one month and one year after its inception. Among the 208 smokers in the intervention group there were more attempts to quit, and they were more successful than in the 216 smokers in the control group. The proportions of quitters after a year was 5.3% and 2.3% in each group (p less than 0.05). Among the variables related to success in quitting are self-reliance, the willingness to reduce or quit smoking, the intensity of the habit and the family environment.
