Quantifying the link between long-term condition (LTC) patient experience in primary care and their clinical outcomes as measured by the National Diabetes Audit

The costs of drug prescriptions for diabetes in the NHS

“…Among the questions raised by the public is whether this money is actually spent wisely, given the appearance of new classes of drugs over the past decade still mostly on patent-and, therefore, more expensive than older generic preparations. In recent studies, [2][3][4] we have identified a range of therapeutic factors independently associated with high performance (ie, in glycaemic control) in the management of people with type 2 diabetes in general practice in the UK, on the basis of data from the National Diabetes Audit and National Primary Care Prescribing database. We found that taking into account specific factors, such as the way the follow-up of people with diabetes is organised and access to expert patient education, associated with improved glycaemic outcome changes in primary care, changes in diabetes services could result in significant increases in patients in the target glycaemic control group (glycated haemoglobin [HbA 1c ] ≤58 mmol/mol) and substantial reductions in those in the high glycaemic risk group (HbA 1c >86 mmol/mol).…”

“…Ultimately, the guidelines surrounding the management of MINS are based on one prospective trial 3 that did not address MINS directly and one relatively small retrospective trial. 4 The scarcity of studies regarding management of MINS allows plenty of room to question recommendations and to investigate new approaches, and the authors of the MANAGE trial should be applauded for doing so.…”

Patient perception of support within primary care is as important as medication and services in achieving good glycaemic control

“…Following on from our recent paper in this journal, we have now considered at a GP practice level how T2DM HbA1C target achievement in the 2017 NDA varies with the patient's own reported experience of practice performance as provided in the March 2017 National GP Patient Survey (GPPS) while also taking into account other potential determinants of glycaemic outcome as reported by the National Diabetes Audit (NDA).…”

General practice (GP) level analysis shows that patients’ own perceptions of support within primary care as reported in the GP patient survey (GPPS) are as important as medication and services in improving glycaemic control

“…Following on from our recent paper [5], we have now considered at a GP practice level how T2DM HbA1C target achievement in the 2017 NDA varies with the patient's own reported experience of practice performance as provided in the March 2017 National GP patient survey (GPPS) [6] now taking into account the potential determinants of glycaemic outcome as reported by the National Diabetes Audit (NDA).…”