Quality indicators for type-2 diabetes care in practice guidelines: An example from six European countries

Wens, Johan; Dirven, Kristien; Mathieu, Chantal; Paulus, Dominique; Van Royen, Paul; On behalf of the Belgian Diabetes Project Group,

doi:10.1016/j.pcd.2006.07.001

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Volume 1, Issue 1 , Pages 17-23, February 2007

Quality indicators for type-2 diabetes care in practice guidelines: An example from six European countries

Johan Wens
- University of Antwerp, Faculty of Medicine, Department of General Practice, Integrated Health Care and Geriatrics, Universiteitsplein 1, 2610 Wilrijk, Antwerp, Belgium
- Corresponding author. Tel.: +32 3 820 25 29; fax: +32 3 820 25 26.
Kristien Dirven
- University of Antwerp, Faculty of Medicine, Department of General Practice, Integrated Health Care and Geriatrics, Universiteitsplein 1, 2610 Wilrijk, Antwerp, Belgium
Chantal Mathieu
- Catholic University of Leuven, Department Experimental Medicine—Endocrinology, Herestraat, 49 Box 902, 3000 Leuven, Belgium
- Flemish Diabetes Association, Ottergemsesteenweg 456, 9000 Gent, Belgium
Dominique Paulus
- Belgian Health Care Knowledge Centre, Résidence Palace Blok A, Wetstraat 155, 1040 Brussel, Belgium
Paul Van Royen
- University of Antwerp, Faculty of Medicine, Department of General Practice, Integrated Health Care and Geriatrics, Universiteitsplein 1, 2610 Wilrijk, Antwerp, Belgium
On behalf of the Belgian Diabetes Project Group
- See Acknowledgements.

Received 21 April 2006; received in revised form 2 June 2006; accepted 14 July 2006. published online 22 December 2006.

Abstract

Introduction

Diabetes mellitus patients need a multidisciplinary management and rigorous follow up. Quality indicators are important to assess and improve the quality of the health-care delivery. Less straightforward, however, is choosing which indicators to use for the assessment of the disease management.

Methods

Review of guidelines. Process and outcome indicators were extracted out of type-2 diabetes guidelines from Belgium and its neighbouring countries. The “most evidence based” indicators were derived after applying a “best evidence” ratio.

Results

Thirty-four indicators were classified in five diabetes management topics: (1) control of glycaemia, (2) early detection of glycaemic complications, (3) treatment of glycaemic complications, (4) cardiovascular disease and, (5) quality of life. Target values to outcome indicators and appropriate specifications to process indicators were not assigned because direct transfer to different countries is not possible without considering contextual information such as typical preconditions of every society and health-care system.

Conclusion

Although not all aspects of care are described in guidelines, five ‘mini’ lists of highly valuable indicators for optimal treatment in the field of type-2 diabetes could be drawn up. The target sets for indicators’ values and specifications are a matter of ongoing concern because evidence changes over time.

Keywords: Type-2 diabetes mellitus, Quality of care, Quality indicators, Guidelines