Adherence to clinical practice guidelines and outcomes in diabetic patients

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

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    33 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

    Keywords

    • Clinical practice guideline
    • Diabetes
    • Guideline adherence
    • Outcome

    ASJC Scopus subject areas

    • Health Policy
    • Public Health, Environmental and Occupational Health

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