Decision Support for Diabetes in Scotland: Implementation and Evaluation of a Clinical Decision Support System.

Background: Automated clinical decision support systems (CDSS) are associated with improvements in health care delivery to those with long-term conditions, including diabetes. A CDSS was introduced to two Scottish regions (combined diabetes population ~30 000) via a national diabetes electronic health record. This study aims to describe users' reactions to the CDSS and to quantify impact on clinical processes and outcomes over two improvement cycles: December 2013 to February 2014 and August 2014 to November 2014.

Self-monitoring of blood glucose in type 2 diabetes: patients' perceptions of 'high' readings.

Among 207 non-insulin using patients with type 2 diabetes in Tayside, Scotland, who self-monitored blood glucose, we present evidence that many are tolerant of higher blood glucose levels than are clinically advisable; this may explain the lack of empirical evidence for the clinical benefits of self-monitoring in this group.

Self-monitoring among non-insulin treated patients with type 2 diabetes mellitus: Patients' behavioural responses to readings and associations with glycaemic control.

Aim: To investigate self-monitoring of blood glucose (SMBG) behaviour among non-insulin treated patients with type 2 diabetes mellitus, and to evaluate associations with glycaemic control.

Methods: Eligible patients in 23 GP practices in Tayside, Scotland, were identified (18-75 years, no insulin treatment, SMBG reagent strips dispensed in 2009). Consenting patients were administered questionnaires addressing SMBG behaviour: these primary data were record-linked to clinical data (including HbA1c) from a validated population-based diabetes clinical information system, then anonymised.

Using web technology to support population-based diabetes care.

Background: Managed clinical networks have been used to coordinate chronic disease management across geographical regions in the United Kingdom. Our objective was to review how clinical networks and multidisciplinary team-working can be supported by Web-based information technology while clinical requirements continually change.

Methods: A Web-based population information system was developed and implemented in November 2000.

Screening uptake in a well-established diabetic retinopathy screening program: the role of geographical access and deprivation.

Objective: To identify criteria that affect uptake of diabetes retinal screening in a community screening program using mobile retinal digital photography units.

Research Design And Methods: Data from the regional diabetes population-based retinal screening program and regional ophthalmology laser database were linked to patient postal code (zip code) data. We used distance from retinal screening event, social deprivation scores, and demographic information to identify risk factors for nonattendance at a diabetes retinal screening event.

Quality measurement of care for people with type 2 diabetes in Tayside, Scotland: implications for the new UK general practice contract.

Background: The new United Kingdom general practice contract proposes that up to a third of general practitioners' income will come from achieving quality targets.

Aim: To examine selected quality markers in terms of their robustness to case-mix variation and chance effects, and in the attribution of quality to practices.

Study Design And Methods: Data were extracted from a population-based diabetes clinical information system in Tayside, Scotland, for patients with type 2 diabetes registered in 67 practices with complete ascertainment.

A population study of first exposure to community antibacterials in children and the suitability of routine urine samples for study of the acquisition of drug resistance.

The study objectives were to measure time from birth to first exposure to antibacterials in children and compare the characteristics of children who submit urine samples with the general population. Antibacterials were dispensed to 63% of children within 1 year of birth, increasing to 75% within 2 years after birth. Boys had earlier exposure to antibacterials than girls.

Considerations on blood glucose management in Type 2 diabetes mellitus.

In recent years the benefits of more intensive management in preventing or delaying the development and progression of diabetic complications have been well documented. What is not as well documented is how to motivate the person with diabetes to manage the condition, how to set, assess and quantify glucose goals, and the glucose variables that should be routinely measured. This review discusses the importance of setting targets and communicating them in a way that the patient understands.