Optimizing diabetes care regarding cardiovascular targets at general practice level: Direct@GP

Prim Care Diabetes. 2011 Apr;5(1):19-24. doi: 10.1016/j.pcd.2010.09.006. Epub 2010 Oct 27.

Abstract

Aims: The objective of this study was to assess the adherence to national guidelines on cardiovascular (CV) prevention and target attainment for patients with type 2 diabetes mellitus followed-up in general practice.

Methods: Non-interventional, cross-sectional survey.

Results: Type 2 diabetes patients remain undertreated with statins (63% treated), even so those with a cardiovascular history (80% treated). Although more patients received antihypertensive treatment (82%) compared to hypolipidemic medication (69%), the proportion of patients attaining targets for total cholesterol (TC) (35%), HDL-cholesterol (HDL-C) (65%), and LDL-cholesterol (LDL-C) (42%) exceeded far those attaining blood pressure control (13%). The primary endpoint of reaching the goal for LDL-cholesterol (<100mg/dL; 2.59 mmol/L) was attained by 42% of patients, of which only 13% reached the more stringent target of LDL-C<70 mg/dL (1.81 mmol/L). About half of the patients (49%) attained glycemic control (HbA1c<7%) and 55% had triglycerides<150 mg/dL (1.69 mmol/L).

Conclusions: The majority of type 2 diabetes patients are treated for hypercholesterolemia and hypertension, although, there is still under treatment, especially in patients with CV disease. Only 42% of patients were on target for LDL-cholesterol and 13% for blood pressure. Therefore, wider implementation of process and outcome indicators, which proved to be related, and continuous evaluation of their result, is needed.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antihypertensive Agents / therapeutic use*
  • Belgium
  • Blood Pressure / drug effects
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / prevention & control*
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Drug Utilization
  • Female
  • General Practice* / statistics & numerical data
  • Glycated Hemoglobin / analysis
  • Guideline Adherence
  • Health Care Surveys
  • Humans
  • Hypercholesterolemia / blood
  • Hypercholesterolemia / complications
  • Hypercholesterolemia / drug therapy*
  • Hypertension / complications
  • Hypertension / drug therapy*
  • Hypertension / physiopathology
  • Hypoglycemic Agents / therapeutic use*
  • Hypolipidemic Agents / therapeutic use*
  • Lipids / blood
  • Male
  • Middle Aged
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians'* / statistics & numerical data
  • Time Factors
  • Treatment Outcome

Substances

  • Antihypertensive Agents
  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Hypolipidemic Agents
  • Lipids
  • hemoglobin A1c protein, human