Diabetes care: reasons for missing HbA1c measurements in general practice

Glycated haemoglobin (HbA1c) is often used as one of the indicators to measure the quality of diabetes care. Complete registration is difficult to obtain. This study investigated the reasons for missing HbA1c measurements. HbA1c measurements for 1485 patients with diabetes mellitus type 2 who were attended by 19 general practitioners at 4 primary care health centres in south-east Amsterdam were studied. HbA1c measurements were missing for 356 (23.9%) of the patients. The main reason stated in 50% of the cases was that the patient was under specialized care. The general practitioners provided multiple reasons for the missing HbA1c measurements. This study provides insight into why HbA1c measurements were not present in the patients' electronic medical record.