R E Glasgow1, S M Boles2, D Calder3, L Dreyer4, J Bagdade3. 1. The AMC Cancer Research Center, Denver, Colorado (Dr Glasgow) 2. The Oregon Research Institute, Eugene (Dr Boles) 3. The Oregon Medical Group, Sacred Heart Hospital, Eugene (Drs Calder and Bagdade) 4. The Oregon Health Division, Portland (Ms Dreyer)
Abstract
PURPOSE: There has been substantial recent interest in diabetes disease management interventions, guidelines, and care practices. As the vast majority of diabetes care occurs in primary care settings, it makes sense to evaluate current levels of recommended practices in different primary care settings. METHODS: We report on two separate studies that included a combined total of 389 patients seen by over 30 different providers. Three different sets of recommended practices were assessed: (1) the ADA provider recognition measures, (2) the proposed Diabetes Quality Improvement Project measures, and (3) the state of Oregon Population-Based Guidelines for Diabetes. RESULTS: In general, there was only a moderate level of adherence to recommended practices, and adherence was much lower for behavioral or patient-focused practices as contrasted with laboratory tests. There was considerable variability across providers and across different guidelines activities. CONCLUSIONS: Policy and quality improvement implications and future research issues are discussed, including the need for studying different measurement approaches for evaluating guidelines adherence.
PURPOSE: There has been substantial recent interest in diabetes disease management interventions, guidelines, and care practices. As the vast majority of diabetes care occurs in primary care settings, it makes sense to evaluate current levels of recommended practices in different primary care settings. METHODS: We report on two separate studies that included a combined total of 389 patients seen by over 30 different providers. Three different sets of recommended practices were assessed: (1) the ADA provider recognition measures, (2) the proposed Diabetes Quality Improvement Project measures, and (3) the state of Oregon Population-Based Guidelines for Diabetes. RESULTS: In general, there was only a moderate level of adherence to recommended practices, and adherence was much lower for behavioral or patient-focused practices as contrasted with laboratory tests. There was considerable variability across providers and across different guidelines activities. CONCLUSIONS: Policy and quality improvement implications and future research issues are discussed, including the need for studying different measurement approaches for evaluating guidelines adherence.
Authors: Russell E Glasgow; Paul A Nutting; Diane K King; Candace C Nelson; Gary Cutter; Bridget Gaglio; Alanna Kulchak Rahm; Holly Whitesides; Hilarea Amthauer Journal: J Gen Intern Med Date: 2004-12 Impact factor: 5.128
Authors: Paul A Nutting; W Perry Dickinson; L Miriam Dickinson; Candace C Nelson; Diane K King; Benjamin F Crabtree; Russell E Glasgow Journal: Ann Fam Med Date: 2007 Jan-Feb Impact factor: 5.166
Authors: Michele Heisler; Sandeep Vijan; Robert M Anderson; Peter A Ubel; Steven J Bernstein; Timothy P Hofer Journal: J Gen Intern Med Date: 2003-11 Impact factor: 5.128