%0 Journal Article
%T Care for Patients with Type 2 Diabetes in a Random Sample of Community Family Practices in Ontario, Canada
%A Gina Agarwal
%A Janusz Kaczorowski
%A Steve Hanna
%J International Journal of Family Medicine
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/734202
%X Objective. Diabetes care is an important part of family practice. Previous work indicates that diabetes management is variable. This study aimed to examine diabetes care according to best practices in one part of Ontario. Design and Participants. A retrospective chart audit of 96 charts from 18 physicians was conducted to examine charts regarding diabetes care during a one-year period. Setting. Grimsby, Ontario. Main Outcome Measures. Glycemic screening, control and management strategies, documentation and counselling for lifestyle habits, prevalence of comorbidities, screening for hypertension, hyperlipidemia, and use of appropriate recommended preventive medications in the charts were examined. Results. Mean A1c was within target (less than or equal to 7.00) in 76% of patients (ICC = £¿0.02), at least 4 readings per annum were taken in 75% of patients (ICC = 0.006). Nearly 2/3 of patients had been counselled about diet, more than 1/2 on exercise, and nearly all (90%) were on medication. Nearly all patients had a documented blood pressure reading and lipid profile. Over half (60%) had a record of their weight and/or BMI. Conclusion. Although room for improvement exists, diabetes targets were mainly reached according to recognized best practices, in keeping with international data on attainment of diabetes targets. 1. Introduction Routine diabetes care remains a family practice activity for which the Canadian Diabetes Association (CDA) has set standards since 1999 [1]. Previous work in 7 Canadian provinces [2] examining the management of T2DM patients between 1998 and 1999 found family physicians were falling short of best practice guidelines, particularly in screening for microvascular disease, managing hypertension, hyperlipidemia, and prescribing antiplatelet medication. Currently, family physicians¡¯ performance levels in their regular patients in Ontario are unknown. This knowledge could help family physicians target certain areas of diabetes care, in service planning for the future. The goals of this study were to examine a small group of actual family physicians¡¯ management practices in following best practices and achieving targets in actual clinical care following on from the widespread dissemination of best practice documents, in the following areas: glycemic screening, control and management strategies, documentation and counselling for lifestyle habits, prevalence of comorbidities, screening for hypertension, hyperlipidemia, and use of appropriate recommended preventive medications (see the appendix). Specific outcomes are described in Table
%U http://www.hindawi.com/journals/ijfm/2012/734202/