Article Text

Download PDFPDF

A prospective observational study of quality of diabetes care in a shared care setting: trends and age differences (ZODIAC-19)
  1. Kornelis J J van Hateren1,
  2. Iefke Drion1,
  3. Nanne Kleefstra1–,3,
  4. Klaas H Groenier4,
  5. Sebastiaan T Houweling1,2,4,
  6. Klaas van der Meer4,
  7. Henk J G Bilo1,3,5
  1. 1Diabetes Centre, Isala Clinics, Zwolle, The Netherlands
  2. 2Langerhans Medical Research Group, Zwolle, The Netherlands
  3. 3Department of Internal Medicine, University Medical Center Groningen, Groningen, The Netherlands
  4. 4Department of General Practice, University Medical Center Groningen, Groningen, The Netherlands
  5. 5Department of Internal Medicine, Isala Clinics, Zwolle, The Netherlands
  1. Correspondence to Kornelis J J van Hateren; k.j.j.van.hateren{at}isala.nl

Abstract

Objective The Zwolle Outpatient Diabetes project Integrating Available Care (ZODIAC) study was initiated in 1998 to investigate the effects of shared care for patients with type 2 diabetes mellitus (T2DM) in the Netherlands, and to reduce the number of diabetes-related complications. Benchmarking the performance of diabetes care was and is an important aspect of this study. We aimed to investigate trends in diabetes care, within the ZODIAC study for a wide variety of quality indicators during a long follow-up period (1998–2008), with special interest for different age groups.

Design Prospective observational cohort study.

Setting Primary care, Zwolle, The Netherlands.

Participants Patients with T2DM.

Methods A dataset of quality measures was collected annually during the patient's visit to the practice nurse or general practitioner. Linear time trends from 1998 to 2008 were estimated using linear mixed models in which we adjusted for age and gender. Age was included in the model as a categorical variable: for each follow-up year all participants were categorised into the categories <60, 60–75 and >75 years. Differences in trends between the age categories were investigated by adding an interaction term to the model.

Results The number of patients who were reported to participate increased in the period 1998–2008 from 1622 to 27 438. All quality indicators improved in this study, except for body mass index. The prevalence albuminuria decreased in an 11-year-period from 42% to 21%. No relevant differences between the trends for the three age categories were observed. During all years of follow-up, mean blood pressure and body mass index were the lowest and highest, respectively, in the group of patients <60 years (data not shown).

Conclusions Quality of diabetes care within the Dutch ZODIAC study, a shared care project, has considerably improved in the period 1998–2008. There were no relevant differences between trends across various age categories.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.