Outcomes of audit-enhanced monitoring of patients with type 2 diabetes

The electronic Research Registration System played an important role in the audit-enhanced monitoring. In the pilot phase of the project, paper records were used. Although using paper records had clear disadvantages, one could expect to achieve similar results using such records in combination with a central electronic data bank.

Conclusions

Outcomes of diabetes care in our family research setting were comparable with those reported in randomized controlled trials. Therefore, it is possible for the management of diabetes in family practice to be efficacious. This finding should encourage more efforts by physicians in family practice to bridge the gap between efficacy and effectiveness.

Important differences remained in achieved process measures between the academic family practices. While the outcome of diabetes care in the network was favorable, the outcome of treatment was unsatisfactory in a substantial number of patients. Further implementation strategies must be developed. The differences in achieved process measures were probably unrelated to socioeconomic differences between the practice populations, since the practice pairs 1/3 and 7/10 served comparable communities and had different levels of compliance.

Our study demonstrated that a high quality of diabetes care in family practice can be achieved. Audit-enhanced monitoring, which will provide the greatest benefit to the most patients with type 2 diabetes mellitus, should be implemented as part of a quality improvement system.

ACKNOWLEDGMENTS

The authors wish to thank the family physicians and practice nurses for their continuing support and data collection.