Measuring Quality of Healthcare Outcomes in Type 2 Diabetes from Routine Data: a Seven-nation Survey Conducted by the IMIA Primary Health Care Working Group

Abstract

SummaryBackground: The Institute of Medicine framework defines six dimensions of quality for healthcare systems: (1) safety, (2) effectiveness, (3) patient centeredness, (4) timeliness of care, (5) efficiency, and (6) equity. Large health datasets provide an opportunity to assess quality in these areas. Objective: To perform an international comparison of the measurability of the delivery of these aims, in people with type 2 diabetes mellitus (T2DM) from large datasets. Method: We conducted a survey to assess healthcare outcomes data quality of existing databases and disseminated this through professional networks. We examined the data sources used to collect the data, frequency of data uploads, and data types used for identifying people with T2DM. We compared data completeness across the six areas of healthcare quality, using selected measures pertinent to T2DM management. Results: We received 14 responses from seven countries (Australia, Canada, Italy, the Netherlands, Norway, Portugal, Turkey and the UK). Most databases reported frequent data uploads and would be capable of near real time analysis of healthcare quality.

Intervenções farmacêuticas e o cuidado em pacientes portadores de Diabetes mellitus

“…Kitsiou et al (2017), relatam a efetividade da telemedicina no controle do diabetes, onde destacam que essa intervenção, seja por meio de mensagem de textos, ligações telefônicas ou uso de aplicativos, pode facilitar a o autocuidado e/ou autogestão do diabetes, ao fornecer informações sobre a doença, lembretes do horário das medicações, informações sobre alimentação e sobre estilo de vida; além de melhorar a comunicação do paciente com a equipe multidisciplinar (Faruque et al, 2017). Hinton et al, (2017), destacam que os lembretes por meio de SMS e o monitoramento da glicemia em tempo real, demonstraram melhorar a adesão a terapia farmacoterapêutica, destacando-se, como um apoio a autogestão e/ou autocuidado do diabetes. Ademais, os estudos em relação a telemedicina, tem relatado efeitos benéficos sobre a aceitabilidade dos pacientes em relação a sua doença.…”

Treatment effects may remain the same even when trial participants differed from the target population

“…general practice data, disease specific registries, claim databases) appropriately represent the wider population. The quality of such data is a further concern with high levels of miscoding, misclassification and misdiagnosis reported for patients with diabetes in routinely collected data across several western countries [63][64][65]. The impact of this is difficult to quantify, but there appears inherent inaccuracy in the characterisation (and indeed identification) of the wider disease populations.…”