1. Statement of the problem Conclusion/recommendations
Will frequent provisions of physicians’ hemoglobin A1c profiles improve glycemic control?
Yar Pye MD, Liming Yang MD MS, Randy Wang BA, and Myint Tin, MD
Lutheran Family Medicine, Brooklyn, NY
Statement of the problem
The effectiveness of primary care physicians in diabetic care is frequently sub-optimal
Different interventions improved diabetic control
Ongoing monitoring of key variables with yearly feedback system found effective 1
Methods: continued
Profiling on physicians’ HbA1c yearly in 2004, 2x a year in 2005, quarterly in 2006 (till 6/06)
Patients without HbA1c for the last 6 months, or uncontrolled group (HbA1c 9.5 or above) - recalled
Average HbA1c, % of patients with known HbA1c and % of uncontrolled patients -recorded 4
Percent of uncontrolled group and % of diabetic patients with known hemoglobin A1c 6
Objectives
To gauge improvement in glycemic control by accelerating provisions of physicians’ hemoglobin A1c (HbA1c) profiles from yearly to semi-annually, then quarterly 2
Average Hemoglobin A1c
Conclusion/recommendations
A semi-annual feedback system helped reduction of average HbA1c and % of uncontrolled diabetes
Quarterly profiling improved % of patients with known HbA1c further
A longer study - required to determine other merits of quarterly feedback of HbA1c 7
Methods
30 months-long observational study
An urban-setting clinic: 9 attendings and 22 residents
All diabetic adults non-pregnant aged 20 and above (n=300 to over 400)
Age range ( median 61, average 65), 1/3 male and 2/3 female 3