Effectiveness of diabetes flow sheet in controlling blood pressure: should family medicine teams in Zenica use recommended guidelines?

BACKGROUND

Blood pressure (BP) is one of the important parameters for controlling Diabetes Mellitus (DM). European Society of Cardiology recommended optimal level for DM BP < 130/80 mmHg.

AIM

We wanted to assess the level of BP for our DM patients after using specific guidelines for DM.

METHODOLOGY

Retrospective medical record (audit) has been conducted among 853 DM patients older then 18 years. We checked patient charts among 19 FM teams two years before (May 2003-May 2005) and two years after (May 2005-May 2007) implementation of the DM guidelines in Family Medicine (FM) clinic in Zenica. We divided FM teams based on their patients BP values; optimal level of BP < 130/80 mmHg; suboptimal level when systolic BP 130-140mmHg and diastolic 85-90 mmHg and that with inadequate level with BP>140/90mmHg.

RESULTS

853 DM patient charts were analysed, 46 per FM team. Average age of DM patients was greater than 60 years and average age of doctors was 46.6. Percentage of BP inadequate level was smaller after implementation of DM guidelines in most of FM teams. For optimal level BP < 130/80 mmHg, significant improvement was seen after implementation of DM guidelines for: 6/19 teams (p < 0.0001), 2/19 teams (p < 0.001) and 2/19 teams (p < 0.01).

CONCLUSION

After implementation of BP guidelines for DM patients, BP can be improved in patients treated by FM teams and guidelines should be used.