PMID- 18842968
OWN - NLM
STAT- MEDLINE
DCOM- 20090310
LR  - 20191210
IS  - 1475-3901 (Electronic)
IS  - 1475-3898 (Linking)
VI  - 17
IP  - 5
DP  - 2008 Oct
TI  - Prescribing quality indicators of type 2 diabetes mellitus ambulatory care.
PG  - 318-23
LID - 10.1136/qshc.2007.024224 [doi]
AB  - BACKGROUND: Existing performance indicators for assessing quality of care in type 
      2 diabetes mellitus (T2DM) focus mostly on registration of measurements and 
      clinical outcomes, and not on quality of prescribing. OBJECTIVE: To develop a set 
      of valid prescribing quality indicators (PQI) for internal use in T2DM, and 
      assess the operational validity of the PQI using electronic medical records. 
      METHODS: Potential PQI for hypertension, hyperglycaemia, dyslipidaemia and 
      antiplatelet treatment in T2DM were based on clinical guidelines, and assessed on 
      face and content validity in an expert panel followed by a panel of GPs and 
      diabetologists. Analysis of ratings was performed using the RAND/UCLA 
      Appropriateness Method. The operational validity of selected indicators was 
      assessed in a dataset of 3214 T2DM patients registered with 70 GPs. RESULTS: Out 
      of 31 potential prescribing indicators, the expert panel considered 18 indicators 
      as sufficiently valid, of which 14 indicators remained valid after assessment by 
      the panel of GPs and diabetologists. Of these 14 indicators, one could not be 
      calculated because of an absence of eligible patients. For the remaining 
      indicators, outcomes varied from 10% for timely prescribing of insulin to 96% for 
      prescribing of any antihyperglycemic medication in patients with elevated HbA1c 
      levels. CONCLUSIONS: This study provides a set of face- and content-valid PQI for 
      pharmacological management of patients with T2DM. While outcomes of some PQI were 
      limited to patients with registration of clinical values, the selected PQI had 
      good operational validity to be used in practice for assessment of prescribing 
      quality.
FAU - Martirosyan, L
AU  - Martirosyan L
AD  - Department of Clinical Pharmacology, University Medical Centre Groningen, 
      University of Groningen, The Netherlands. l.martirosyan@med.umcg.nl
FAU - Braspenning, J
AU  - Braspenning J
FAU - Denig, P
AU  - Denig P
FAU - de Grauw, W J C
AU  - de Grauw WJ
FAU - Bouma, M
AU  - Bouma M
FAU - Storms, F
AU  - Storms F
FAU - Haaijer-Ruskamp, F M
AU  - Haaijer-Ruskamp FM
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Validation Study
PL  - England
TA  - Qual Saf Health Care
JT  - Quality & safety in health care
JID - 101136980
RN  - 0 (Hypoglycemic Agents)
CIN - Qual Saf Health Care. 2008 Oct;17(5):315-7. PMID: 18842967
MH  - *Ambulatory Care
MH  - Diabetes Mellitus, Type 2/complications/*drug therapy
MH  - Humans
MH  - Hypoglycemic Agents/therapeutic use
MH  - Outcome Assessment, Health Care/methods
MH  - Practice Guidelines as Topic
MH  - *Quality Indicators, Health Care
EDAT- 2008/10/10 09:00
MHDA- 2009/03/11 09:00
CRDT- 2008/10/10 09:00
PHST- 2008/10/10 09:00 [pubmed]
PHST- 2009/03/11 09:00 [medline]
PHST- 2008/10/10 09:00 [entrez]
AID - 17/5/318 [pii]
AID - 10.1136/qshc.2007.024224 [doi]
PST - ppublish
SO  - Qual Saf Health Care. 2008 Oct;17(5):318-23. doi: 10.1136/qshc.2007.024224.