BACKGROUND: Diabetes is an illness with multiple quality indicators. This retrospective cohort study sought to determine if interventions directed at physicians to target improvements in hemoglobin A1c (HgA1c) quality indicators had collateral benefits on similarly measured low-density lipoprotein (LDL) indicators. METHODS: We initially analyzed the primary care diabetic patient electronic databases from 2008 (N = 16,503) and 2010 (N = 23,040). We then identified and selected for the study the cohort of patients who appeared in both databases (N = 11,288) and analyzed various measures of process and outcomes. RESULTS: Mean HgA1c decreased from 7.34% to 7.21% (P < .0001). Mean LDL level also improved from 100.2 mg/dL to 95.6 mg/dL (P < .0001). The proportion of patients with poor glycemic control and poor lipid control decreased from 10.3% to 8.42% (P < .0001) and from 38.2% to 32.1% (P < .0001), respectively. CONCLUSIONS: Sustained interventions directed at the glycemic control of a large population of diabetic patients were associated with significant improvement in their glycemic control and had collateral benefits for indicators of their lipid control. Targeted interventions to improve HgA1c levels may have further benefits in improving other quality measures of diabetic care.
BACKGROUND:Diabetes is an illness with multiple quality indicators. This retrospective cohort study sought to determine if interventions directed at physicians to target improvements in hemoglobin A1c (HgA1c) quality indicators had collateral benefits on similarly measured low-density lipoprotein (LDL) indicators. METHODS: We initially analyzed the primary care diabeticpatient electronic databases from 2008 (N = 16,503) and 2010 (N = 23,040). We then identified and selected for the study the cohort of patients who appeared in both databases (N = 11,288) and analyzed various measures of process and outcomes. RESULTS: Mean HgA1c decreased from 7.34% to 7.21% (P < .0001). Mean LDL level also improved from 100.2 mg/dL to 95.6 mg/dL (P < .0001). The proportion of patients with poor glycemic control and poor lipid control decreased from 10.3% to 8.42% (P < .0001) and from 38.2% to 32.1% (P < .0001), respectively. CONCLUSIONS: Sustained interventions directed at the glycemic control of a large population of diabeticpatients were associated with significant improvement in their glycemic control and had collateral benefits for indicators of their lipid control. Targeted interventions to improve HgA1c levels may have further benefits in improving other quality measures of diabetic care.
Authors: Warren P Newton; Ann Lefebvre; Katrina E Donahue; Thomas Bacon; Allen Dobson Journal: J Contin Educ Health Prof Date: 2010 Impact factor: 1.355
Authors: Carol M Mangione; Robert B Gerzoff; David F Williamson; W Neil Steers; Eve A Kerr; Arleen F Brown; Beth E Waitzfelder; David G Marrero; R Adams Dudley; Catherine Kim; William Herman; Theodore J Thompson; Monika M Safford; Joe V Selby Journal: Ann Intern Med Date: 2006-07-18 Impact factor: 25.391
Authors: Patrick J O'Connor; Noni L Bodkin; Judith Fradkin; Russell E Glasgow; Sheldon Greenfield; Edward Gregg; Eve A Kerr; L Gregory Pawlson; Joseph V Selby; John E Sutherland; Michael L Taylor; Carol H Wysham Journal: Diabetes Care Date: 2011-07 Impact factor: 19.112