PMID- 30545793
OWN - NLM
STAT- MEDLINE
DCOM- 20190813
LR  - 20190813
IS  - 1878-0210 (Electronic)
IS  - 1878-0210 (Linking)
VI  - 13
IP  - 2
DP  - 2019 Apr
TI  - Associations between quality of work features in primary health care and 
      glycaemic control in people with Type 2 diabetes mellitus: A nationwide survey.
PG  - 176-186
LID - S1751-9918(18)30277-8 [pii]
LID - 10.1016/j.pcd.2018.11.005 [doi]
AB  - AIMS: To describe and analyse the associations between primary health care 
      centres' (PHCCs') quality of work (QOW) and individual HbA1c levels in people 
      with Type 2 diabetes mellitus (T2DM). METHODS: This cross-sectional study invited 
      all 1152 Swedish PHCCs to answer a questionnaire addressing QOW conditions. 
      Clinical, socio-economic and comorbidity data for 230,958 people with T2DM were 
      linked to data on QOW conditions for 846 (73.4%) PHCCs. RESULTS: Of the 
      participants, 56% had controlled (</=52mmol/mol), 31.9% intermediate 
      (53-69mmol/mol), and 12.1% uncontrolled (>/=70mmol/mol) HbA1c. An explanatory 
      factor analysis identified seven QOW features. The features having a call-recall 
      system, having individualized treatment plans, PHCCs' results always on the 
      agenda, and having a follow-up strategy combined with taking responsibility of 
      outcomes/results were associated with lower HbA1c levels in the controlled group 
      (all p<0.05). For people with intermediate or uncontrolled HbA1c, having 
      individualized treatment plans was the only QOW feature that was significantly 
      associated with a lower HbA1c level (p<0.05). CONCLUSIONS: This nationwide study 
      adds important knowledge regarding associations between QOW in real life clinical 
      practice and HbA1c levels. PHCCs' QOW may mainly only benefit people with 
      controlled HbA1c and more effective QOW strategies are needed to support people 
      with uncontrolled HbA1c.
CI  - Copyright (c) 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.
FAU - Husdal, Rebecka
AU  - Husdal R
AD  - Centre for Clinical Research Vastmanland, Uppsala University, Vasteras, Sweden; 
      Department of Medical Sciences, Clinical Diabetology and Metabolism, Uppsala 
      University, Uppsala, Sweden. Electronic address: 
      rebecka.husdal@regionvastmanland.se.
FAU - Thors Adolfsson, Eva
AU  - Thors Adolfsson E
AD  - Centre for Clinical Research Vastmanland, Uppsala University, Vasteras, Sweden.
FAU - Leksell, Janeth
AU  - Leksell J
AD  - Department of Medical Sciences, Clinical Diabetology and Metabolism, Uppsala 
      University, Uppsala, Sweden; School of Education, Health and Social Studies, 
      Dalarna University, Falun, Sweden.
FAU - Eliasson, Bjorn
AU  - Eliasson B
AD  - Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
FAU - Jansson, Stefan
AU  - Jansson S
AD  - School of Medical Sciences, University Health Care Research Centre, Orebro 
      University, Orebro, Sweden.
FAU - Jerden, Lars
AU  - Jerden L
AD  - School of Education, Health and Social Studies, Dalarna University, Falun, 
      Sweden; Centre for Clinical Research Dalarna, Uppsala University, Falun, Sweden.
FAU - Stalhammar, Jan
AU  - Stalhammar J
AD  - Department of Public Health and Caring Sciences, Family Medicine and Preventive 
      Medicine Section, Uppsala University, Uppsala, Sweden.
FAU - Steen, Lars
AU  - Steen L
AD  - Drug and Therapeutics Committee, Sormland County Council, Eskilstuna, Sweden.
FAU - Wallman, Thorne
AU  - Wallman T
AD  - Department of Public Health and Caring Sciences, Family Medicine and Preventive 
      Medicine Section, Uppsala University, Uppsala, Sweden; Centre for Clinical 
      Research Sormland, Uppsala University, Eskilstuna, Sweden.
FAU - Svensson, Ann-Marie
AU  - Svensson AM
AD  - National Diabetes Register, Centre of Registers, Gothenburg, Sweden.
FAU - Rosenblad, Andreas
AU  - Rosenblad A
AD  - Centre for Clinical Research Vastmanland, Uppsala University, Vasteras, Sweden.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20181210
PL  - England
TA  - Prim Care Diabetes
JT  - Primary care diabetes
JID - 101463825
RN  - 0 (Biomarkers)
RN  - 0 (Blood Glucose)
RN  - 0 (Hypoglycemic Agents)
MH  - Aged
MH  - Biomarkers/blood
MH  - Blood Glucose/*drug effects/metabolism
MH  - Cross-Sectional Studies
MH  - Diabetes Mellitus, Type 2/blood/diagnosis/*drug therapy/epidemiology
MH  - Female
MH  - Health Care Surveys
MH  - Humans
MH  - Hypoglycemic Agents/*therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Primary Health Care/*standards
MH  - Quality Improvement/standards
MH  - Quality Indicators, Health Care/*standards
MH  - Sweden/epidemiology
OTO - NOTNLM
OT  - Diabetes mellitus
OT  - National survey
OT  - Primary health care
OT  - Quality of health care
OT  - Type 2
EDAT- 2018/12/14 06:00
MHDA- 2019/08/14 06:00
CRDT- 2018/12/15 06:00
PHST- 2018/08/23 00:00 [received]
PHST- 2018/11/02 00:00 [revised]
PHST- 2018/11/15 00:00 [accepted]
PHST- 2018/12/14 06:00 [pubmed]
PHST- 2019/08/14 06:00 [medline]
PHST- 2018/12/15 06:00 [entrez]
AID - S1751-9918(18)30277-8 [pii]
AID - 10.1016/j.pcd.2018.11.005 [doi]
PST - ppublish
SO  - Prim Care Diabetes. 2019 Apr;13(2):176-186. doi: 10.1016/j.pcd.2018.11.005. Epub 
      2018 Dec 10.