Benchmarking is associated with improvedquality of care in type 2 diabetes : The OPTIMISE randomized, controlled trial
Hermans, Michel P. (Cliniques Universitaires St-Luc (Brussel·les, Bèlgica))
Elisaf, Moses (University of Ioannina (Ioannina, Grècia))
Michel, Georges (Centre Hospitalier de Luxembourg)
Muls, Erik (UZ Gasthuisberg (Leuven, Bèlgica))
Nobels, Frank (OLV Ziekenhuis (Aalst, Bèlgica))
Vandenberghe, Hans (AstraZeneca SA/NV (Brussel·les, Bèlgica))
Brotons, Carlos (Institut d'Investigació Biomèdica Sant Pau)
Universitat Autònoma de Barcelona

Data:	2013
Resum:	OBJECTIVE-To assess prospectively the effect of benchmarking on quality of primary care for patients with type 2 diabetes by using three major modifiable cardiovascular risk factors as critical quality indicators. RESEARCH DESIGN ANDMETHODSdPrimary care physicians treating patients with type 2 diabetes in six European countries were randomized to give standard care (control group) or standard care with feedback benchmarked against other centers in each country (benchmarking group). In both groups, laboratory tests were performed every 4 months. The primary end point was the percentage of patients achieving preset targets of the critical quality indicators HbA1c, LDL cholesterol, and systolic blood pressure (SBP) after 12 months of follow-up. RESULTS-Of 4,027 patients enrolled, 3,996 patients were evaluable and 3,487 completed 12 months of follow-up. Primary end point of HbA1c target was achieved in the benchmarking group by 58. 9 vs. 62. 1% in the control group (P = 0. 398) after 12 months; 40. 0 vs. 30. 1% patients met the SBP target (P < 0. 001); 54. 3 vs. 49. 7% met the LDL cholesterol target (P = 0. 006). Percentages of patients meeting all three targets increased during the study in both groups, with a statistically significant increase observed in the benchmarking group. The percentage of patients achieving all three targets at month 12 was significantly larger in the benchmarking group than in the control group (12. 5 vs. 8. 1%; P < 0. 001). CONCLUSIONS-In this prospective, randomized, controlled study, benchmarking was shown to be an effective tool for increasing achievement of critical quality indicators and potentially reducing patient cardiovascular residual risk profile. © 2013 by the American Diabetes Association.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Aged ; Benchmarking ; Blood Pressure ; Cardiovascular Diseases ; Cholesterol, LDL ; Diabetes Mellitus, Type 2 ; Europe ; Female ; Humans ; Male ; Middle Aged ; Physicians, Primary Care ; Primary Health Care ; Prospective Studies ; Quality Indicators, Health Care ; Risk Factors
Publicat a:	Diabetes Care, Vol. 36 Núm. 11 (november 2013) , p. 3388-3395, ISSN 1935-5548

DOI: 10.2337/dc12-1853
PMID: 23846810

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