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- Stone, M. A., et al.
(författare)
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Quality of Care of People With Type 2 Diabetes in Eight European Countries: Findings from the Guideline Adherence to Enhance Care (GUIDANCE) study
- 2013
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Ingår i: Diabetes Care. - : American Diabetes Association. - 0149-5992 .- 1935-5548. ; 36:9, s. 2628-2638
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE We sought to determine levels of adherence in eight European countries to recommendations for the management of type 2 diabetes and to investigate factors associated with key intermediate outcomes.RESEARCH DESIGN AND METHODS GUIDANCE was a cross-sectional study including retrospective data extraction from the medical records of people with type 2 diabetes recruited, using a shared protocol, from primary and specialist care sites in the following eight European countries: Belgium, France, Germany, Italy, Ireland, Sweden, the Netherlands, and the United Kingdom. The dataset for analysis comprised 7,597 cases. Proportions meeting process and outcome criteria were determined, including between-country variations. Logistic regression was used to investigate potential predictors of meeting targets for HbA(1c), blood pressure, and LDL cholesterol.RESULTS In the total sample, adherence to process recommendations was high for some measures, for example, HbA(1c) recorded in past 12 months in 97.6% of cases. Target achievement for intermediate outcome measures was lower, with only 53.6% having HbA(1c) <7%. Considerable between-country variation was identified for both processes and outcomes. The following characteristics were associated with an increased likelihood of meeting targets for all three measures considered (HbA(1c), blood pressure, LDL cholesterol): shorter diagnosis of diabetes; having one or more macrovascular complications; lower BMI; being prescribed lipid-lowering medication; and no current antihypertensive prescribing.CONCLUSIONS Compared with earlier reports, we have suggested some encouraging positive trends in Europe in relation to meeting targets for the management of people with type 2 diabetes, but there is still scope for further improvement and greater between-country consistency.
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| 3. |
- Trivedi, H., et al.
(författare)
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Self-knowledge of HbA1c in people with Type 2 Diabetes Mellitus and its association with glycaemic control
- 2017
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Ingår i: Primary Care Diabetes. - : Elsevier BV. - 1751-9918. ; 11:5, s. 414-420
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this study was to evaluate the prevalence of accurate self-knowledge of a patient's own HbA1c level (HbA1c(SK)), as a component of structural education (University Hospital's of Leicester (UHL), 2013) and its association with glycaemic control. Methods: Data from the GUIDANCE study, a cross-sectional study involving 7597 participants from eight European countries was used. HbA1c(SK) was evaluated and compared with laboratory measured HbA1c levels (HbA1c(LAB)), which represented the measure of glycaemic control. Accuracy of the self-reported HbA1c was evaluated by using agreement statistical methods. Results: The prevalence of HbA1csK was 49.4%. Within this group, 78.3% of the participants had accurately reported HbA1c(SK). There was good level of agreement between HbA1c(SK) and HbA1c(LAB) (intra-class correlation statistic =0.84, p <0.0001). Participants with accurately reported HbA1c(SK) were found to have a statistically significantly lower HbA1c(LAB) compared to participants with inaccurately reported HbA1c(SK) (7.0% versus 7.3%, p <0.001). Conclusion: Nearly half of the patients had self-knowledge of their own HbA1c level. Moreover, the participants with accurately reported HbA1c(SK) were found to have associated better glycaemic control. (C) 2017 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.
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