Summary of a series of studies in a project on the quality of cardiovascular and diabetes care in general practice (n=124 practices)
| Topic | Findings | Reference |
|---|---|---|
| Quality assessment | ||
| Practice organisation | Teamwork in the practices has statistically significant relations with follow up and record keeping. A variety of other practice organisational items appears not to be related to such activities. | 11 |
| Clinical decision making | GPs frequently provide information and advice in cardiovascular care. For several medical conditions, 25% of the GPs perform less favourably. | 12 |
| Clinical decision making | GPs target at a diastolic blood pressure (DBP) of <100 mm Hg, whereas guidelines recommend targeting at a DBP of <90 mm Hg. | 13 |
| Risk perceptions | Patients with hypertension or diabetes but no atherosclerotic disease have inadequate perceptions of their absolute risk of cardiovascular events and thus need better risk information. | 14 |
| Randomised controlled trial of multifaceted support from trained non-physicians | ||
| Practice organisation | The intervention improves the organisation of cardiovascular and diabetes care. The duration of exposure to certain aspects of organising such care is a key determinant to success. A variety of other characteristics of the multifaceted support appear not to determine better practice organisation. | 15, 16 |
| Clinical decision making | The intervention improves certain aspects of the clinical decision making of GPs in cardiovascular care. The effect was, however, small and the strategy needs further development. | Present study |
| Clinical decision making | The intervention increases rates of foot examination and eye examination for patients with diabetes but appears not to be effective in improving the pursuit of glycaemic control by GPs. | 17 |
| Quality of life | The intervention has a positive impact on several domains of the health related quality of life among patients with diabetes or cardiovascular disease. | 18 |