Prescribing quality indicators of type 2 diabetes mellitus ambulatory care.
BACKGROUND: Existing performance indicators for assessing quality of care in type 2 diabetes mellitus (T2DM) focus mostly on registration of measurements and clinical outcomes, and not on quality of prescribing. OBJECTIVE: To develop a set of valid prescribing quality indicators (PQI) for internal u...
| Publicado en: | Quality & Safety in Health Care Vol. 17; no. 5; pp. 318 - 324 |
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| Autores principales: | , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
BMJ Publishing Group
Oct2008
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105353878&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105353878 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14753898 C0K jtl: Quality & Safety in Health Care issn: 14753898 maglogo: N pubinfo: dt: Oct2008 vid: 17 iid: 5 pid: 8280 pub: BMJ Publishing Group artinfo: ui: 105353878 2010308283 10.1136/qshc.2007.024224 NLM18842968 105353878 ppf: 318 ppct: 6 formats: tig: atl: Prescribing quality indicators of type 2 diabetes mellitus ambulatory care. aug: au: Martirosyan L Braspenning J Denig P de Grauw WJ Bouma M Storms F Haaijer-Ruskamp FM affil: Department of Clinical Pharmacology, University Medical Centre Groningen, University of Groningen, The Netherlands. l.martirosyan@med.umcg.nl sug: subj: Ambulatory Care Clinical Indicators Diabetes Mellitus, Type 2 Drug Therapy Diabetes Mellitus, Type 2 Complications Hypoglycemic Agents Therapeutic Use Outcome Assessment Methods Practice Guidelines Human ab: BACKGROUND: Existing performance indicators for assessing quality of care in type 2 diabetes mellitus (T2DM) focus mostly on registration of measurements and clinical outcomes, and not on quality of prescribing. OBJECTIVE: To develop a set of valid prescribing quality indicators (PQI) for internal use in T2DM, and assess the operational validity of the PQI using electronic medical records. METHODS: Potential PQI for hypertension, hyperglycaemia, dyslipidaemia and antiplatelet treatment in T2DM were based on clinical guidelines, and assessed on face and content validity in an expert panel followed by a panel of GPs and diabetologists. Analysis of ratings was performed using the RAND/UCLA Appropriateness Method. The operational validity of selected indicators was assessed in a dataset of 3214 T2DM patients registered with 70 GPs. RESULTS: Out of 31 potential prescribing indicators, the expert panel considered 18 indicators as sufficiently valid, of which 14 indicators remained valid after assessment by the panel of GPs and diabetologists. Of these 14 indicators, one could not be calculated because of an absence of eligible patients. For the remaining indicators, outcomes varied from 10% for timely prescribing of insulin to 96% for prescribing of any antihyperglycemic medication in patients with elevated HbA1c levels. CONCLUSIONS: This study provides a set of face- and content-valid PQI for pharmacological management of patients with T2DM. While outcomes of some PQI were limited to patients with registration of clinical values, the selected PQI had good operational validity to be used in practice for assessment of prescribing quality. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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