Does a Diabetes Annual Review make a difference?

Show simple item record Kenealy, Timothy en Orr-Walker, B en Cutfield, R en Robinson, Elizabeth en Buetow, Stephen en Simmons, D en 2012-03-19T02:40:49Z en 2014-04-23T02:25:23Z en 2012 en
dc.identifier.citation Diabetic Medicine 29(8):e217-e222 2012 en
dc.identifier.issn 0742-3071 en
dc.identifier.uri en
dc.description.abstract Aims:  To determine whether a diabetes annual review, independently of other care processes, is followed by improved patient clinical measurements Methods:  Audits conducted independently of the diabetes annual review were analysed for a time-trend in patient clinical measures. An interaction variable between the review and the year of audit was used to test for a change in gradient before and after a diabetes annual review. Each patient formed their own control. Results:  The data included 9471 audits on 3397 patients from 92 practices, and diabetes annual reviews from 2003 to mid-2008. Percentages of patients with raised HbA1c, systolic blood pressure and lipids improved from first to last audit. Predicted means after a diabetes annual review for HbA1c decreased by 0.13% (1.0 mmol/mol), for HDL cholesterol increased by 0.04 mmol/L and for triglyceride decreased by 0.2 mmol/L. Predicted systolic and diastolic blood pressure, total cholesterol and urinary albumin:creatinine ratio did not change significantly. Conclusions:  Metabolic control improved over time but this was largely independently of the diabetes annual review, which appears to add little clinical value to existing New Zealand general practice care processes. Currently, general practitioners are paid to undertake a diabetes annual review and report the measurements collected. We would argue that payment needs to be directed to demonstrating appropriate changes in clinical management or achieving meaningful clinical goals, and that the annual review results should be part of systematic feedback to general practitioners, particularly directed at clinical inertia. en
dc.publisher Wiley-Blackwell Publishing, Inc. en
dc.relation.ispartofseries Diabetic Medicine en
dc.relation.replaces en
dc.relation.replaces 2292/14665 en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. Details obtained from en
dc.rights.uri en
dc.title Does a Diabetes Annual Review make a difference? en
dc.type Journal Article en
dc.identifier.doi 10.1111/j.1464-5491.2011.03533.x en
pubs.issue 8 en
pubs.begin-page e217 en
pubs.volume 29 en
dc.identifier.pmid 22141458 en
pubs.end-page e222 en
pubs.publication-status Published en
dc.rights.accessrights en
pubs.subtype Article en
pubs.elements-id 436087 en Medical and Health Sciences en Population Health en Gen.Practice& Primary Hlthcare en School of Medicine en Medicine Department en
pubs.record-created-at-source-date 2012-02-11 en
pubs.dimensions-id 22141458 en

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