Table 1

Summary of a series of studies in a project on the quality of cardiovascular and diabetes care in general practice (n=124 practices)

TopicFindingsReference
Quality assessment
Practice organisationTeamwork 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 makingGPs frequently provide information and advice in cardiovascular care. For several medical conditions, 25% of the GPs perform less favourably.12
Clinical decision makingGPs target at a diastolic blood pressure (DBP) of <100 mm Hg, whereas guidelines recommend targeting at a DBP of <90 mm Hg.13
Risk perceptionsPatients 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 organisationThe 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 makingThe 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 makingThe 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 lifeThe intervention has a positive impact on several domains of the health related quality of life among patients with diabetes or cardiovascular disease.18