Programme no. 425-OP
Improvement of diabetes care in the Faroe Islands by Means of APO audit
Anders Munck1, Annelli Sandbæk*2, Annika Olsen*3
1Audit Project Odense,Research Unit of General Practice,5000 Odense,Denmark, 2Department of General Practice,Aarhus University,Aarhus,Denmark, 3Gereral Practice,General Practice,Thorshavn ,Faroe Islands
* = Presenting author
Objectives: To improve general practitioners’ diabetes care in the Faroe Islands.
The most important steps in the treatment of diabetes are lifestyle changes, diet, physical activity and smoking cessation, which in addition to adequate treatment/management of hypertension and hypercholesterolemia plus lowering of blood sugar reduce the risk of long-term complications in diabetes.
Diabetes care in general practice should focus on these and other items important for reducing complications and mortality from the disease.
Results: In the winter 2011/2012 322 cases were registered, in 2013/2014 the number was 600. From the first to the second registration there was a significant increase (p < 0.05) in the frequency of planned consultations and examinations for micro albuminuria. Examinations by ophthalmologists and chiropodists as well as treatment by oral antidiabetics and statins increased significantly. However, the mean level of HbA1c remained unchanged.
Based on the APO method 14 GPs in the Faroe Islands performed a prospective registration of all their consultations with persons with diabetes within three months during the winter 2011/2012 and repeated the registration in a similar period in the winter 2013/2014. Between the two registrations educational activities took place.
At each consultation clinical examinations, laboratory tests, risk factors, specific treatment for diabetes plus other pharmacological treatment and information about the consultation were registered.
Conclusion: The audit resulted in a desired increase in several important process indicators for good diabetes care. However, the overall regulation judged by the mean HbA1c level in the population registered remained unchanged.
Points for discussion:
What should general practice focus mostly on in order to provide better diabetes care?
Why did we not succeed in changing the HbA1c level?
What should be done in collaboration between the community and general practice in diabetes care?