Patient Knowledge Compared With National Guidelines for Diabetes Care

Data collected on a randomly selected group of 428 patients with insulin-dependent and noninsulin-dependent diabetes from 61 physician practices in eight Michigan communities were compared with national standards for diabetes patient knowledge. Comparisons were performed using a standardized Diabetes Knowledge Test (DKT) and selected items from the Diabetes Education Profile (DEP). Patient performance on these instruments was compared with corresponding items in the Ambulatory Care Facilities section of the Guide lines for Diabetes Care published by the American Diabetes Associ ation and the American Associ ation of Diabetes Educators. In general, insulin-dependent persons scored higher than noninsulin-dependent persons. Those taking insulin (whether insulin-dependent or not) scored higher than noninsulin-dependent persons whose regimen did not include insulin. The findings emphasize the need to subdivide any analysis of clinical diabetes or diabetes education into groups based on insulin use or nonuse.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/69139/2/10.1177_014572178801400312.pd

Patients and nurses determine variation in adherence to guidelines at Dutch hospitals more than internists or settings.

Contains fulltext : 59148.pdf (publisher's version ) (Closed access)AIMS: To measure adherence to recently developed diabetes guidelines at Dutch hospital outpatient clinics and distinguish determinants for variations in care on hospital, internist and patient levels. METHODS: Thirteen general hospitals with 58 internists recruited 1950 diabetic patients. Data were extracted from medical files (n = 1915) and from patient questionnaires (n = 1465). Multilevel logistic regression analysis was performed to explain differences in adherence rates to the guidelines. RESULTS: Adherence to process measures was high, except for the examination of feet, calculation of the body mass index and patient education activities (the mean of 12 process measures was 64%). Adherence to intermediate outcome indicators was moderate. The mean percentage of patients with HbA(1c) < 7.0% was 23%. Adherence variation on a hospital level was very small (0.6-7.9%), on an internist level moderate (0.4-18.8%) and on a patient level high (74.4-98.8%). Adherence to all process measures and most of the intermediate outcome indicators was highest in the patients seen by a diabetes specialist nurse. DISCUSSION: More focus on patient involvement in diabetic care and the contribution of diabetes specialist nurses may be important factors in improving the quality of diabetes care