TY - JOUR
T1 - Adherence to guidelines in people with screen-detected type 2 diabetes, ADDITION, Denmark Exemplified by treatment initiation with an ACE inhibitor or an angiotensin-II receptor antagonist
AU - Juul, Lise
AU - Sandbaek, Annelli
AU - Foldspang, Anders
AU - Frydenberg, Morten
AU - Borch-Johnsen, Knut
AU - Lauritzen, Torsten
PY - 2009/12/28
Y1 - 2009/12/28
N2 - Objective. In people with screen-detected type 2 diabetes in primary care, (1) to assess adherence to guidelines, recommending consultation with the GP every three months and treatment initiation with an ACE inhibitor or an angiotensin-II receptor antagonist when systolic BP was > 120 mmHg and/or diastolic BP was > 80 mmHg, and (2) to identify predictors for adherence. Design. Prospective follow-up of a fixed cohort of patients. Setting. Fifty-four Danish general practices. Subjects and main outcome measures. A total of 361 people with screen-detected type 2 diabetes were followed up for 410 days to assess planned consultations with their GP and recording of BP. Some 226 people, with BP recorded above guideline threshold(s) and where treatment was not already initiated, were followed for up to 410 days to monitor prescription redemption. Results. At 3, 6, 9 and 12 months 80%, 77%, 74%, and 73% of the cohort attended a consultation. A total of 89% of the cohort attended two of the four planned consultations. The probability of redeemed prescriptions for an ACE inhibitor or an angiotensin-II receptor antagonist according to the guideline during the first year following diagnosis was 51%. High initial BP was associated with prescription redemption. No other analysed individual or organisational characteristics were found to be associated with treatment initiation. Conclusion. The consultation attendance was reasonably high, and treatment initiation with an ACE inhibitor or an angiotensin-II receptor antagonist according to the guideline was found in half of the cases. High initial BP increased the probability of treatment initiation.
AB - Objective. In people with screen-detected type 2 diabetes in primary care, (1) to assess adherence to guidelines, recommending consultation with the GP every three months and treatment initiation with an ACE inhibitor or an angiotensin-II receptor antagonist when systolic BP was > 120 mmHg and/or diastolic BP was > 80 mmHg, and (2) to identify predictors for adherence. Design. Prospective follow-up of a fixed cohort of patients. Setting. Fifty-four Danish general practices. Subjects and main outcome measures. A total of 361 people with screen-detected type 2 diabetes were followed up for 410 days to assess planned consultations with their GP and recording of BP. Some 226 people, with BP recorded above guideline threshold(s) and where treatment was not already initiated, were followed for up to 410 days to monitor prescription redemption. Results. At 3, 6, 9 and 12 months 80%, 77%, 74%, and 73% of the cohort attended a consultation. A total of 89% of the cohort attended two of the four planned consultations. The probability of redeemed prescriptions for an ACE inhibitor or an angiotensin-II receptor antagonist according to the guideline during the first year following diagnosis was 51%. High initial BP was associated with prescription redemption. No other analysed individual or organisational characteristics were found to be associated with treatment initiation. Conclusion. The consultation attendance was reasonably high, and treatment initiation with an ACE inhibitor or an angiotensin-II receptor antagonist according to the guideline was found in half of the cases. High initial BP increased the probability of treatment initiation.
KW - ACE inhibitors
KW - Family practice
KW - General practice
KW - Guideline adherence
KW - Patient compliance
KW - Screening
KW - Type 2 diabetes mellitus
UR - http://www.scopus.com/inward/record.url?scp=72449135367&partnerID=8YFLogxK
U2 - 10.3109/02813430903279117
DO - 10.3109/02813430903279117
M3 - Article
C2 - 19929182
AN - SCOPUS:72449135367
SN - 0281-3432
VL - 27
SP - 223
EP - 231
JO - Scandinavian Journal of Primary Health Care
JF - Scandinavian Journal of Primary Health Care
IS - 4
ER -