Background
Methods
Study population
Study variables and definitions
Structure score
1
|
Points
|
---|---|
System for collecting patient experience feedback | 0 or 1 |
Regulations on access to patient files | 0 or 1 |
Quarterly multidisciplinary meetings | 0 or 1 |
Policies for checking medical equipment | 0 or 1 |
Practice nurse trained in self-management | 0 or 1 |
Policy for no-show patients | 0 or 1 |
Score range
|
0-6
|
Process score
2
| |
Annual assessment of BMI | 0-1 |
Annual assessment of blood pressure | 0-1 |
Annual assessment of HbA1c | 0-1 |
Annual assessment of LDL cholesterol | 0-1 |
Annual assessment of urine albumin | 0-1 |
Annual assessment of GFR | 0-1 |
Annual assessment of smoking behavior | 0-1 |
Annual foot examination | 0-1 |
Annual eye examination | 0-1 |
Score range
|
0-9
|
Statistical analysis
Results
Structure score
|
Guideline adherence (proportion of practices)
|
IQR
|
p-value*
|
---|---|---|---|
System for collecting patient experience feedback | 0.53 | ||
Regulations on access to patient files | 0.63 | ||
Quarterly multidisciplinary meetings | 0.66 | ||
Policies for checking medical equipment | 0.91 | ||
Practice nurse trained in self-management | 0.94 | ||
Policy for no-show patients | 0.97 | ||
Total structures of care score (points)
|
mean: 4.7 (scale 0-6)
|
4 - 5
|
1.00
|
Process score
|
Guideline adherence (proportion of patients per practice)
|
IQR
|
p-value*
|
Annual assessment of BMI | 0.70 | 0.41 - 1.00 | 0.00 |
Annual assessment of blood pressure | 0.97 | 0.92 - 1.00 | 1.00 |
Annual assessment of HbA1c | 0.91 | 0.85 - 1.00 | 0.00 |
Annual assessment of LDL cholesterol | 0.59 | 0.42 - 0.76 | 0.00 |
Annual assessment of urine albumin | 0.49 | 0.35 - 0.66 | 0.01 |
Annual assessment of GFR | 0.65 | 0.48 - 0.78 | 0.00 |
Annual assessment of smoking behavior | 0.89 | 0.86 - 0.98 | 0.00 |
Annual foot examination | 0.33 | 0.12 - 0.49 | 0.00 |
Annual eye examination | 0.28 | 0.10 - 0.43 | 0.03 |
Total processes of care score (points)
|
mean: 5.9 (scale 0-9)
|
5.3 - 6.6
|
1.00
|
Patients
|
Practices
| ||||||
---|---|---|---|---|---|---|---|
n
|
Median
|
IQR
|
Median
|
IQR
|
p-value*
| ||
Patient characteristics
| |||||||
Age (years) | 363 | 65 | 58 - 74 | 66 | 63 - 70 | 0.02 | |
Sex (% males) | 363 | 49% | 52% | 43 - 58% | 1.00 | ||
Years since diagnosis | 175 | 6 | 3 - 9 | 7 | 5 - 9 | 0.04 | |
Number of related comorbidities1 | 363 | 1 | 0 - 1 | 0.6 | 0.4 - 0.9 | 0.00 | |
Number of unrelated comorbidities2 | 363 | 0 | 0 - 1 | 0.4 | 0.2 - 0.5 | 0.02 | |
SES indicator3 |
Low
| 363 | 46% | 44% | |||
Middle
| 34% | 34% | |||||
High
| 20% | 22% | |||||
Health outcomes
| |||||||
BMI (kg/m2)4 | 343 | 29 | 26 - 33 | 29 | 29 - 31 | 0.10 | |
Systolic blood pressure (mmHg)5 | 363 | 135 | 123 - 145 | 134 | 131 - 140 | 0.02 | |
HbA1C (mmol/mol)6 | 361 | 50 | 45 - 56 | 51 | 48 - 55 | 0.01 | |
LDL cholesterol (mmol/L)7 | 358 | 2.3 | 1.9 - 2.9 | 2.5 | 2.2 - 2.6 | 1.00 | |
Urine albumin (mg/L)8 | 341 | 6 | 3 - 13 | 11 | 6 - 32 | 0.06 | |
GFR (ml/min)9 | 356 | 68 | 60 - 89 | 74 | 63 - 86 | 0.00 | |
Smoking (% smokers) | 353 | 18% | 17% | 11 - 25% | 1.00 |
β
|
(95% CI)
| |
---|---|---|
BMI (n = 343) | ||
Structure | −0.03 | (-0.88;0.82) |
Process | 0.51 | (-0.24;1.26) |
Systolic blood pressure (n = 363) | ||
Structure | 1.70 | (-1.08;4.47) |
Process | 1.97 | (-0.46;4.39) |
HbA1C (n = 361) | ||
Structure | 0.75 | (-1.01;2.50) |
Process | −0.64 | (-2.19;0.90) |
LDL cholesterol (n = 358) | ||
Structure | −0.017 | (-0.120;0.086) |
Process | −0.013 | (-0.107;0.080) |
Urine albumin (n = 341) | ||
Structure | −1.58 | (-16.44;13.29) |
Process | 3.32 | (-10.20;16.84) |
GFR (n = 356) | ||
Structure | 4.54 | (-0.39;9.47) |
Process | −2.53 | (-6.99;1.94) |
Smoking* (n = 353) | ||
Structure (OR) | 1.13 | (0.80;1.60) |
Process (OR) | 0.93 | (0.68;1.28) |