Registry of people with diabetes in three Latin American countries: a suitable approach to evaluate the quality of health care provided to people with type 2 diabetes

Abstract

Aims: To implement a patient registry and collect data related to the care provided to people with type 2 diabetes in six specialized centers of three Latin American countries, measure the quality of such care using a standardized form (QUALIDIAB) that collects information on different quality of care indicators, and analyze the potential of collecting this information for improving quality of care and conducting clinical research. Methods: We collected data on clinical, metabolic and therapeutic indicators, micro-and macrovascular complications, rate of use of diagnostic and therapeutic elements and hospitalization of patients with type 2 diabetes in six diabetes centers, four in Argentina and one each in Colombia and Peru. Results: We analyzed 1157 records from patients with type 2 diabetes (Argentina, 668; Colombia, 220; Peru, 269); 39 records were discarded because of data entry errors or inconsistencies. The data demonstrated frequency performance deficiencies in several procedures, including foot and ocular fundus examination and various cardiovascular screening tests. In contrast, HbA 1c and cardiovascular risk factor assessments were performed with a greater frequency than recommended by international guidelines. Management of insulin therapy was sub-optimal, and deficiencies were also noted among diabetes education indicators. Conclusions: Patient registry was successfully implemented in these clinics following an interactive educational program. The data obtained provide useful information as to deficiencies in care and may be used to guide quality of care improvement efforts. What′s knownWhile many reports describe the quality of care provided to people with diabetes in Europe and the USA, scarce information is available on this issue in Latin America. What′s newThe article provides detailed information regarding the quality of care provided to people with type 2 diabetes in diabetes centers of three Latin American countries.

Drug treatment of type 2 diabetes: Its cost is significantly associated with HbA1c levels

“…This observational study utilised data from the QUALIDIAB database, which includes patients attended at public and privateDiabetes Service Centers in Argentina. QUALIDIAB is a program that records clinical, metabolic and therapeutic indicators of the quality of care provided to people with diabetes in Latin America as well as on micro and macrovascular complications, the rate of use of diagnostic and therapeutic elements and annual patient hospitalisation . The development of the QUALIDIAB net was promoted by the Declaration of the Americas (DOTA) and based on the benefits of a common data registry in Latin American countries to enable comparison of data to correct mistakes and strengthen successful strategies.…”

“…Although available evidence support the concept that appropriate control of blood glucose and associated cardiovascular risk factors (CVRF) can reduce diabetes complications, attainment of such control is rarely observed in real world clinical practice . In fact, care received by people with diabetes is frequently far from optimal …”

“…[6][7][8][9] In fact, care received by people with diabetes is frequently far from optimal. [10][11][12][13] On line with this situation, data in the literature dealing with decreasing cost of T2D mainly focus on the long-term complications of the disease that negatively impact on life quality and economical costs. However, it is likely that drug therapy for diabetes could also significantly affect the use of costly resources.…”

HbA1c measurement in diabetes diagnosis and management of diabetes in latin: proceedings of the San Pablo Symposium

“…Diabetes prevalence in Argentina rose from 8.4 to 9.8% in the 2005-2013 period, being higher in the elderly, women with obesity and people with lower incomes and low educational levels 27 . The number of undiagnosed and untreated people is high and, despite the available evidence that good control of glycemic and associated cardiovascular risk factors can delay the onset/progression of microvascular and macrovascular complications, most people with diabetes do not achieve treatment goals to reach this prevention 28 .…”

Control metabólico en pacientes diabéticos ambulatorios de un hospital general

“…Así, en América Latina se han encontrado cifras muy altas, hasta de un 70% de pacientes diabéticos con control metabólico inadecuado (16)(17)(18)(19). En nuestro país hay reportes que cifran el control metabólico adecuado en 50% de pacientes diabéticos, tomando en cuenta sólo glucosa y hemoglobina glicosilada (HbA1C) (20).…”