Adherence to clinical practice guidelines and outcomes in diabetic patients

Se Won Oh, Ha Jeong Lee, Ho Jun Chin, Jee In Hwang

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Objective. To examine the level of adherence to clinical practice guidelines and its relationship to outcomes in patients with diabetes. Design. Retrospective cohort study. Setting. A tertiary teaching hospital in Korea. Participants. Patients aged ≥18 years with diabetes (n = 4994) who visited the study hospital once or more during 2004. Main Outcome Measures. The outcomes were mortality from the database of the Statistics Korea and end-stage renal disease (ESRD) incidence from ESRD registry in the Korean Society of Nephrology until December 2009. Results. Testing rates for blood pressure, eye examination, HbA1c, renal function and lipid profiles were 93.9, 32.8, 84.9, 33.5 and 45.9%, respectively. The percentage of patients achieving each treatment goal was 27.8% for blood pressure, 44.2% for HbA1c and 49.4% for low-density lipoprotein (LDL) cholesterol. There were 11.7% patients with composite outcome (death and/or ESRD). Male gender, level of HbA1c (<7%), presence of HbA1c data, checking eye examination, presence of data on urine albumin-to-creatinine ratio (UACR) and having anti-platelet medication were associated with better outcome. Conclusions. The adherence to recommendations was unsatisfactory, especially in checking eye examination, testing UACR and LDL cholesterol, and achieving a target goal for each parameter. Guideline adherence was positively related to better prognosis. Active strategies to apply the guidelines to clinical practice should be developed to improve patient outcomes.

Original languageEnglish
Article numbermzr036
Pages (from-to)413-419
Number of pages7
JournalInternational Journal for Quality in Health Care
Volume23
Issue number4
DOIs
Publication statusPublished - 2011 Aug 1
Externally publishedYes

Fingerprint

Practice Guidelines
Chronic Kidney Failure
Korea
LDL Cholesterol
Albumins
Creatinine
Urine
Blood Pressure
Guideline Adherence
Nephrology
Tertiary Care Centers
Teaching Hospitals
Registries
Cohort Studies
Blood Platelets
Retrospective Studies
Outcome Assessment (Health Care)
Databases
Guidelines
Kidney

Keywords

  • Clinical practice guideline
  • Diabetes
  • Guideline adherence
  • Outcome

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health

Cite this

Adherence to clinical practice guidelines and outcomes in diabetic patients. / Oh, Se Won; Lee, Ha Jeong; Chin, Ho Jun; Hwang, Jee In.

In: International Journal for Quality in Health Care, Vol. 23, No. 4, mzr036, 01.08.2011, p. 413-419.

Research output: Contribution to journalArticle

Oh, Se Won ; Lee, Ha Jeong ; Chin, Ho Jun ; Hwang, Jee In. / Adherence to clinical practice guidelines and outcomes in diabetic patients. In: International Journal for Quality in Health Care. 2011 ; Vol. 23, No. 4. pp. 413-419.
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