Long-term conditions and the National Diabetes Audit

Heald, Adrian; Stedman, Mike; Farman, Sanam; Fryer, Anthony; Bailey, Sue; Gadsby, Roger

Abstract

The management of long-term conditions1 in primary care has hit the headlines thanks to a report from the Academy of Medical Sciences,2 which highlighted the clustering of different physical and mental health conditions in a single patient, and estimated that millions of Britons suffer from multimorbidity.

Diabetes is acknowledged as a condition where primary care clinicians should be well used to managing multimorbidity, and lessons may be learnt from this area. The National Diabetes Audit data3 provide practice-level measures of diabetes outcomes including the numbers achieving target HbA1c and those at elevated risk of complications. We have recently published4 multivariate analysis linking variation in these outcomes to the organisation of diabetes care.

There was a univariate relation between a higher percentage of ‘No’ responses to ‘satisfaction with level of support for all LTC’ and a lower proportion of T2DM patients hitting target glycaemic control (TGC). Practices in the highest decile of patient rating with 3.0% ‘No’ response to this question had 68% TGC versus the lowest decile of ratings with 27.3% ‘No’ response associated with only 64% TGC. Interpolation gave a 1% increase in the TGC proportion at GP practice level associated with a 5.9% decrease in ‘No’ response.

We have shown how ensuring that patients with LTC feel listened to, involved, and cared for is a key way to make a difference to their clinical outcomes. Patients’ perception of clinical care may be a significant determinant of clinical outcomes.

Citation

Heald, A., Stedman, M., Farman, S., Fryer, A., Bailey, S., & Gadsby, R. (2018). Long-term conditions and the National Diabetes Audit. British Journal of General Practice (BJGP), 68(672), 320.2-320. https://doi.org/10.3399/bjgp18x697637

• Journal Article Type: Letter
• Online Publication Date: Jun 28, 2018
• Publication Date: 2018-07
• Deposit Date: Jun 23, 2023
• Journal: British Journal of General Practice
• Print ISSN: 0960-1643
• Electronic ISSN: 1478-5242
• Publisher: Royal College of General Practitioners
• Peer Reviewed: Peer Reviewed
• Volume: 68
• Issue: 672
• Pages: 320.2-320
• DOI: https://doi.org/10.3399/bjgp18x697637
• Keywords: Family Practice
• Public URL: https://keele-repository.worktribe.com/output/504114
• PMID: 29954795