PMID- 30187860
OWN - NLM
STAT- MEDLINE
DCOM- 20181224
LR  - 20181224
IS  - 2245-1919 (Electronic)
IS  - 2245-1919 (Linking)
VI  - 65
IP  - 9
DP  - 2018 Sep
TI  - Optimisation of quality indicators for lipid-lowering treatment of type 2 
      diabetes mellitus.
LID - A5501 [pii]
AB  - INTRODUCTION: The Danish Adult Diabetes Database (DADD) annually reports a 
      quality indicator for lipid-lowering treatment of type 2 diabetes mellitus (T2DM) 
      patients. This retrospective cohort study aims to A) investigate the reasons for 
      inadequate or lacking lipid-lowering treatment and to B) assess the validity of 
      the DADD indicator as a measure of quality of care. METHODS: A) A pop-up 
      questionnaire enquiring about reasons for lack of treatment was added to the 
      clinicians' data entry tool in the Central Denmark Region. B) The DADD indicator 
      was compared on a per-clinic basis with the achieved median low-density 
      lipoprotein (LDL) cholesterol level and with an internationally widely used 
      indicator of lipid-lowering treatment quality. RESULTS: A) A total of 3,491 
      patients were registered from 1 January 2013 to 28 February 2015. For 170 (62%) 
      of 309 patients with an LDL level > 2.5 mmol/l who were not receiving 
      lipid-lowering treatment, there was no "good" explanation for lacking treatment. 
      Among 518 patients with an LDL level > 2.5 mmol/l despite lipid-lowering 
      treatment, 259 (50%) did not receive high-intensity treatment. B) The DADD 
      quality indicator was neither associated with the international quality indicator 
      nor with the median per-clinic LDL level for T2DM patients. CONCLUSIONS: A) We 
      found substantial potential for improvement of lipid management among T2DM 
      patients in Denmark by initiating and/or intensifying lipid-lowering treatment. 
      B) The current DADD indicator is not a valid measure of lipid-lowering quality of 
      care. FUNDING: supported by the Rosa and Asta Jensen Foundation. TRIAL 
      REGISTRATION: not relevant.
CI  - Articles published in the DMJ are "open access". This means that the articles are 
      distributed under the terms of the Creative Commons Attribution Non-commercial 
      License, which permits any non-commercial use, distribution, and reproduction in 
      any medium, provided the original author(s) and source are credited.
FAU - Madsen, Michael Moesmann
AU  - Madsen MM
AD  - moesmann@gmail.com.
FAU - Kaersvang, Lone
AU  - Kaersvang L
FAU - Hansen, Anders Wurgler
AU  - Hansen AW
FAU - Flink, Morten
AU  - Flink M
FAU - Nielsen, Henning K
AU  - Nielsen HK
FAU - Hansen, Klavs Wurgler
AU  - Hansen KW
LA  - eng
PT  - Journal Article
PL  - Denmark
TA  - Dan Med J
JT  - Danish medical journal
JID - 101576205
RN  - 0 (Cholesterol, LDL)
RN  - 0 (Hypolipidemic Agents)
SB  - IM
MH  - Aged
MH  - Cholesterol, LDL/*blood
MH  - Denmark
MH  - Diabetes Mellitus, Type 2/*complications
MH  - Female
MH  - Humans
MH  - Hypercholesterolemia/*drug therapy
MH  - Hypolipidemic Agents/*therapeutic use
MH  - Male
MH  - Middle Aged
MH  - *Quality Indicators, Health Care
MH  - Retrospective Studies
EDAT- 2018/09/07 06:00
MHDA- 2018/12/26 06:00
CRDT- 2018/09/07 06:00
PHST- 2018/09/07 06:00 [entrez]
PHST- 2018/09/07 06:00 [pubmed]
PHST- 2018/12/26 06:00 [medline]
AID - A5501 [pii]
PST - ppublish
SO  - Dan Med J. 2018 Sep;65(9):A5501.