Improving diabetes care in The Netherlands

Two reports from The Netherlands explore strategies for advancing improvement of care for patients with diabetes. To develop diabetes prescribing guidelines, 31 prescribing quality indicators were assessed by a panel of experts that used the RAND/UCLA Appropriateness Method. General practitioners and diabetes specialists tested the resulting guidelines in over 3200 patients. Fourteen of the quality indicators appear to have validity and deserve further analysis in practice. In a separate report, patient-focused interventions demonstrated added benefit when compared with standard evidence-based management. An accompanying commentary elaborates on methodological considerations for prescribing quality indicators and particularly addresses the use of dichotomous measures and the Delphi technique for guideline development. See pages 315 …