Abstract
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.
| Original language | English |
|---|---|
| Pages (from-to) | 223-231 |
| Number of pages | 9 |
| Journal | Scandinavian Journal of Primary Health Care |
| Volume | 27 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 28 Dec 2009 |
Funding
This study was supported by the UCSF Lundbeckfund (j.nr.FP 25/2007),the Tryg-Fund,the Snedkermester Sophus Jacobsen and hustru Astrid Jacobsens Fund, the Kristine Petrea Marius Claus and Erik Feldthusens Fund of 5 10 1975, and the Ulla and Mogens Folmer Andersens Fund. The ADDITION study in Denmark was supported by the National Health Services in the counties of Copenhagen, Aarhus, Ringkøbing, Ribe, and South Jutland, together with the Danish Research Foundation for General Practice, Danish Centre for Evaluation and Health Technology Assessment, the diabetes fund of the National Board of Health, the Danish Medical Research Council, the Aarhus University Research Foundation, and the Novo Nordisk Foundation.The study received unrestricted grants from Novo Nordisk AS, Novo Nordisk Scandinavia AB, Astra Denmark, Pfizer Denmark, GlaxoSmithKline Pharma Denmark, Servier Denmark A/S, and HemoCue Denmark A/S.
Keywords
- ACE inhibitors
- Family practice
- General practice
- Guideline adherence
- Patient compliance
- Screening
- Type 2 diabetes mellitus