An audit of structured diabetes care in a rural general practice

Ackermann, EW and Mitchell, GK (2006) An audit of structured diabetes care in a rural general practice. Medical Journal of Australia, 185 2: 69-72.

Author Ackermann, EW
Mitchell, GK
Title An audit of structured diabetes care in a rural general practice
Journal name Medical Journal of Australia   Check publisher's open access policy
ISSN 0025-729X
Publication date 2006
Sub-type Article (original research)
Volume 185
Issue 2
Start page 69
End page 72
Total pages 4
Place of publication Strawberry Hills, Australia
Publisher Australasian Medical Publishing Co
Collection year 2006
Language eng
Subject C1
321208 Primary Health Care
730105 Endocrine organs and diseases (incl. diabetes)
730209 Rural health
Abstract Objective: To assess the impact of structured diabetes care in a rural general practice. Design and setting: A cohort study of structured diabetes care (care plans, multidisciplinary involvement and regular patient recall) in a large general practice in a medium-sized Australian rural town. Medical care followed each doctor's usual practice. Participants: The first 404 consecutive patients with type 2 diabetes who consented to take part in the program were evaluated 24 months after enrolment in July 2002 to December 2003. Main outcome measures: Change in cardiovascular disease risk factors (waist circumference, body mass index, serum lipid levels, blood pressure); change in indicators of risks associated with poorly controlled diabetes (glycated haemoglobin [HbA1(c]) concentration, foot lesions, clinically significant hypoglycaemia); change in 5-year cardiovascular disease risk. Results: Women had a lower 5-year risk of a cardiovascular event at enrolment than men. Structured care was associated with statistically significant reductions in mean cardiovascular disease risk factors (waist circumference, -2.6 cm; blood pressure [systolic, -3 mmHg; diastolic -7 mmHg]; and serum lipid levels [total cholesterol, -0.5 mmol/L; HDL cholesterol, 0.02 mmol/L; LDL cholesterol, -0.4 mmol/L; triglycerides, -0.3 mmol/L]); and improvements in indicators of diabetic control (proportion with severe hypoglycaemic events, -2.2%; proportion with foot lesions, -14%). The greatest improvements in risk factors occurred in patients with the highest calculated cardiovascular risk. There was a statistically significant increase in the proportion of patients with ideal blood pressure (systolic, <130 mmHg; diastolic, <80 mmHg) and LDL cholesterol level (<2.5 mmol/L) of 6.4% and 20.5%, respectively. Conclusions: Implementing structured care in this rural general practice coincided with improved risk factor management, and may have contributed to the improvement. The greatest benefits were in patients with high cardiovascular risk.
Keyword Medicine, General & Internal
Multifactorial Intervention
Risk Engine
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
2007 Higher Education Research Data Collection
School of Medicine Publications
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Created: Wed, 15 Aug 2007, 10:35:12 EST