A recent study of a large population of Italian diabetics found that the level and quality of care resulted in better outcomes. While this message is not surprising, specific details in how this is done are not always apparent. This particular study followed over 30,000 individuals in Torino, Italy, yet the lessons learned can be adopted by any healthcare system.
The authors of this study were interested in identifying specific processes that help diabetics minimize complications associated with their chronic disease.
To address the level of care, the investigators looked at diabetics who received care from either a primary care provider (PCP), a specialist (endocrinologist) or both.
For each of these groups, the quality of care was measured as to those who received regular screenings of A1C, and at least two assessments from eye examinations, total serum cholesterol, and microalbuminuria.
Those patients who faired the best had regular visits to providers and specialists as well as consistent adherence to established guidelines for frequent diabetic screening exams. In addition, patients who were referred to a specialist early on, tended to minimize or postpone complications and even mortality associated with diabetes such as heart attack, stroke, cardiovascular disease, amputations and even cancer. Early intervention with lifestyle modifications and patient education were key in this process.
Interestingly, the authors point out that tools are needed to help PCPs and specialists to know “who does what” in treating the patients. This observation is particularly acute for doctors who use different electronic medical records.
Personal health records such as myLifeLog that give patients tools to record their exams and treatments between institutions gives doctors the ability to capture that missing information seamlessly. Ultimately, this results in better treatment outcomes.
The Impact of Adherence to Screening Guidelines and of Diabetes Clinics Referral on Morbidity and Mortality in Diabetes.