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Title: Start improving the quality of care for people with type 2 diabetes through a general practice support program: A cluster randomized trial
Authors: Goderis, Geert ×
Borgermans, Liesbeth
Grol, Richard
Van Den Broeke, Carine
Boland, Benoit
Verbeke, Geert
Carbonez, An
Mathieu, Chantal
Heyrman, Jan #
Issue Date: Apr-2010
Publisher: Elsevier Science Publishers B.V.
Series Title: Diabetes Research and Clinical Practice vol:88 issue:1 pages:56-64
Abstract: AIMS: To evaluate the effectiveness of a two-arm quality improvement program (QIP) to support general practice with limited tradition in chronic care on type 2 diabetes patient outcomes. METHODS: During 18 months, we performed a cluster randomized trial with randomization of General Practices. The usual QIP (UQIP: 53 GPs, 918 patients) merged standard interventions including evidence-based treatment protocol, annual benchmarking, postgraduate education, case-coaching for GPs and patient education. The advanced QIP (AQIP: 67 GPs, 1577 patients) introduced additional interventions focussing on intensified follow-up, shared care and patient behavioural changes. Main outcomes were HbA1c, systolic blood pressure (SBP), and low density lipoprotein cholesterol (LDL-C), analyzed by generalized estimating equations and linear mixed models. RESULTS: In UQIP, endpoints improved significantly after intervention: HbA1c -0.4%, 95% CI [-0.4; -0. 3]; SBP -3mmHg, 95% CI [-4; -1]; LDL-C -13mg/dl, 95% CI [-15; -11]. In AQIP, there were no significant additional improvements in outcomes: HbA1c -0.4%, 95% CI [-0.4; -0.3]; SBP -4mmHg, 95% CI [-5; -2]; LDL-C -14mg/dl, 95% CI [-15; -11]. CONCLUSIONS: A multifaceted program merging standard interventions in support of general practice induced significant improvements in the quality of diabetes care. Intensified follow-up in AQIP with focus on shared care and patient behaviour changes did not yield additional benefit.
URI: 
ISSN: 0168-8227
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Academic Center for General Practice
Mathematics - miscellaneous
Leuven Biostatistics and Statistical Bioinformatics Centre (L-BioStat)
Clinical and Experimental Endocrinology
Medical Clerkships Centers
× corresponding author
# (joint) last author

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