Abstract:
BACKGROUND:The way that GP practices organize their services impacts as much on glycaemia in type 2 diabetes as does prescribing. AIM:Our aim was to evaluate the link between patients' own perception of support within primary care and the % patients at each GP practice at target glycaemic control (TGC) and at high glycaemic risk (HGR). DESIGN AND SETTING:Utilisation of National Diabetes Audit (NDA) available data combined with the General practitioner patient survey (GPPS). METHOD:The NDA 2016_17 published data on numbers of type 2 patients, levels of local diabetes services and the target glycaemic control (TGC) % and high glycaemic risk (HGR) % achieved. The GPPS 2017 published % "No" responses from long term condition (LTC) patients to the question "In the last 6 months, had you enough support from local services or organisations to help manage LTCs?". Multivariate regression was used on the set of indicators capturing patients' demographics and services provided. RESULTS:6498 practices were included (with more than 2.5 million T2DM patients) and median values with band limits that included 95% practices for % "No" response to the question above was 12% (2%-30%), for TGC 67% (54%-78%) and for HGR 6% (2%-13%). The model accounted for 25% TGC variance and 26% HGR variance. The standardised β values shown as (TGC/HGR) (+=more people; -=less people) for older age (+0.24/-0.25), sulphonylurea use (-0.21/+0.14), greater social disadvantage (-0.09/+0.21), GPPS Support %No (-0.08/+0.12), %Completion 8 checks (+0.09/-0.12) and metformin use (+0.11/-0.05). CONCLUSION:The relation between the person with diabetes and clinician in primary care is shown to be quantitatively potentially as important in influencing glycaemic outcome as the services provided and medication prescribed. We suggest that all of us in who work in the health care system can bear this in mind in our everyday work.
journal_name
Prim Care Diabetesjournal_title
Primary care diabetesauthors
Heald A,Stedman M,Lunt M,Livingston M,Cortes G,Gadsby Rdoi
10.1016/j.pcd.2019.04.005subject
Has Abstractpub_date
2020-02-01 00:00:00pages
29-32issue
1eissn
1751-9918issn
1878-0210pii
S1751-9918(18)30381-4journal_volume
14pub_type
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