Agarwal Gina, Kaczorowski Janusz, Hanna Steve
Department of Family Medicine, McMaster University, 175 Longwood Road South, Hamilton, Ontario, Canada L8P 0A1.
Int J Family Med. 2012;2012:734202. doi: 10.1155/2012/734202. Epub 2012 Jul 18.
Objective. Diabetes care is an important part of family practice. Previous work indicates that diabetes management is variable. This study aimed to examine diabetes care according to best practices in one part of Ontario. Design and Participants. A retrospective chart audit of 96 charts from 18 physicians was conducted to examine charts regarding diabetes care during a one-year period. Setting. Grimsby, Ontario. Main Outcome Measures. Glycemic screening, control and management strategies, documentation and counselling for lifestyle habits, prevalence of comorbidities, screening for hypertension, hyperlipidemia, and use of appropriate recommended preventive medications in the charts were examined. Results. Mean A1c was within target (less than or equal to 7.00) in 76% of patients (ICC = -0.02), at least 4 readings per annum were taken in 75% of patients (ICC = 0.006). Nearly 2/3 of patients had been counselled about diet, more than 1/2 on exercise, and nearly all (90%) were on medication. Nearly all patients had a documented blood pressure reading and lipid profile. Over half (60%) had a record of their weight and/or BMI. Conclusion. Although room for improvement exists, diabetes targets were mainly reached according to recognized best practices, in keeping with international data on attainment of diabetes targets.
目的。糖尿病护理是家庭医疗的重要组成部分。先前的研究表明糖尿病管理存在差异。本研究旨在根据安大略省某一地区的最佳实践来审视糖尿病护理情况。
设计与参与者。对来自18位医生的96份病历进行回顾性图表审核，以检查一年期间有关糖尿病护理的图表。
地点。安大略省格里姆斯比。
主要观察指标。检查图表中的血糖筛查、控制和管理策略、生活习惯的记录与咨询、合并症患病率、高血压筛查、高脂血症筛查以及适当推荐预防药物的使用情况。
结果。76%的患者平均糖化血红蛋白（A1c）处于目标范围内（小于或等于7.00）（组内相关系数[ICC]= -0.02），75%的患者每年至少进行4次读数（ICC = 0.006）。近三分之二的患者接受过饮食咨询，超过二分之一的患者接受过运动咨询，几乎所有患者（90%）正在接受药物治疗。几乎所有患者都有记录的血压读数和血脂谱。超过一半（60%）的患者有体重和/或体重指数（BMI）记录。
结论。尽管仍有改进空间，但根据公认的最佳实践主要达到了糖尿病目标，这与关于实现糖尿病目标的国际数据一致。
