Quality of Care for Patients With Type 2 Diabetes in Primary Care in Norway Is Improving

Quality of Care for Patients With Type 2 Diabetes in Primary Care in Norway Is Improving Results of cross-sectional surveys of 33 general practices in 1995 and 2005 John Graham Cooper , MBBS, MRCP 1 , Tor Claudi , MD 2 , Anne Karen Jenum , PHD 3 , Geir Thue , PHD 4 , Marie Fjelde Hausken , RN 1 , Wibeche Ingskog , RN 3 and Sverre Sandberg , PHD 4 1 Department of Medicine, Stavanger University Hospital, Stavanger, Norway 2 Department of Medicine, Nordland Hospital, Bodø, Norway 3 Oslo Diabetes Research Centre, Aker University Hospital, University of Oslo, Norway 4 Norwegian Quality Improvement of Laboratory Services in Primary Care, Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway Corresponding author: John G. Cooper, john.cooper{at}isf.uib.no Abstract OBJECTIVE —To assess changes in the quality of care in Norway for patients with type 2 diabetes. RESEARCH DESIGN AND METHODS —Two cross-sectional surveys were examined that identified all patients ( n = 1,470 in 1995 and n = 2,699 in 2005) with type 2 diabetes attending 33 general practices in 1995 and 2005. RESULTS —Between 1995 and 2005, there were significant improvements in the proportion of patients for whom important laboratory analyses, smoking habits, height, weight, and referral to eye examination were recorded. Mean A1C declined from 7.74 to 7.15%, systolic blood pressure from 150.0 to 140.4 mmHg, and cholesterol from 6.28 to 5.0 mmol/l ( P < 0.001, age and sex adjusted). The 10-year risk of coronary heart disease for an average male patient declined from 42 to 29%. CONCLUSIONS —There have been substantial improvements in type 2 diabetes primary care in Norway that are potentially related to major improvements in health outcomes. Footnotes Published ahead of print at http://care.diabetesjournals.org on 13 October 2008. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details. The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact. Accepted September 30, 2008. Received March 25, 2008. DIABETES CARE