rss
Qual Saf Health Care 2006;15:131-135 doi:10.1136/qshc.2005.014845
  • Original Article

Quality of diabetes care and coronary heart disease absolute risk in patients with type 2 diabetes mellitus in Australian general practice

  1. Q Wan1,
  2. M F Harris1,
  3. U W Jayasinghe1,
  4. J Flack2,
  5. A Georgiou1,
  6. D L Penn1,
  7. J R Burns1
  1. 1Centre for Primary Health Care and Equity, School of Public Health and Community Medicine, University of New South Wales, Australia
  2. 2Diabetes Centre, Bankstown Hospital, South West Sydney Area Health Service, Australia
  1. Correspondence to:
 Professor M F Harris
 School of Public Health and Community Medicine, University of New South Wales, 2052 Australia;m.f.harris{at}unsw.edu.au
  • Accepted 27 January 2006

Abstract

Objective: To examine the quality of diabetes care and prevention of cardiovascular disease (CVD) in Australian general practice patients with type 2 diabetes and to investigate its relationship with coronary heart disease absolute risk (CHDAR).

Methods: A total of 3286 patient records were extracted from registers of patients with type 2 diabetes held by 16 divisions of general practice (250 practices) across Australia for the year 2002. CHDAR was estimated using the United Kingdom Prospective Diabetes Study algorithm with higher CHDAR set at a 10 year risk of >15%. Multivariate multilevel logistic regression investigated the association between CHDAR and diabetes care.

Results: 47.9% of diabetic patient records had glycosylated haemoglobin (HbA1c) >7%, 87.6% had total cholesterol ≥4.0 mmol/l, and 73.8% had blood pressure (BP) ≥130/85 mm Hg. 57.6% of patients were at a higher CHDAR, 76.8% of whom were not on lipid modifying medication and 66.2% were not on antihypertensive medication. After adjusting for clustering at the general practice level and age, lipid modifying medication was negatively related to CHDAR (odds ratio (OR) 0.84) and total cholesterol. Antihypertensive medication was positively related to systolic BP but negatively related to CHDAR (OR 0.88). Referral to ophthalmologists/optometrists and attendance at other health professionals were not related to CHDAR.

Conclusions: At the time of the study the diabetes and CVD preventive care in Australian general practice was suboptimal, even after a number of national initiatives. The Australian Pharmaceutical Benefits Scheme (PBS) guidelines need to be modified to improve CVD preventive care in patients with type 2 diabetes.

Footnotes

  • This study was supported by a grant from the Australian Government Department of Health and Ageing.

  • Competing interests: none.

This Article

  1. Abstract
  2. Full text
  3. PDF

Responses

  1. Submit a response
  2. No responses published

Register for free content

The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.