Is guideline-adherent prescribing associated with quality of life in patients with type 2 diabetes?

Background: Guideline-adherent prescribing for treatment of multiple risk factors in type 2 diabetes (T2D) patients is expected to improve clinical outcomes. However, the relationship to Health-Related Quality of Life (HRQoL) is not straightforward since guideline-adherent prescribing can increase medication burden.

Objectives: To test whether guideline-adherent prescribing and disease-specific medication burden are associated with HRQoL in patients with T2D.

Development and validation of prescribing quality indicators for patients with type 2 diabetes.

Aim: Quality indicators are used to measure whether healthcare professionals act according to guidelines, but few indicators focus on the quality of pharmacotherapy for diabetes. The aim of this study was to develop and validate a set of prescribing quality indicators (PQIs) for type 2 diabetes in primary care, and to apply this set in practice. To take into account the stepwise treatment of chronic disease, clinical action indicators were specifically considered.

Reducing antibiotic prescriptions for respiratory tract infections in family practice: results of a cluster randomized controlled trial evaluating a multifaceted peer-group-based intervention.

Irrational antibiotic use for respiratory tract infections (RTI) is a major driver of bacterial resistance. The aim of this study was to evaluate the effect of a multifaceted peer-group based intervention aiming to reduce RTI-related antibiotic prescriptions in family practice. This was a cluster randomized controlled trial with pre- and follow-up measurement.

Dutch diabetes prevalence estimates (DUDE-1).

Background: Recent decades have seen a constant upward projection in the prevalence of diabetes. Attempts to estimate diabetes prevalence rates based on relatively small population samples quite often result in underestimation. The aim of the present study was to investigate whether the Dutch diabetes prevalence estimate of 930 000 for 2013, based on a relatively small sample, still holds true when a larger population is studied using actual prevalence data.

Consultation performance of general practitioners when supported by an asthma/COPDC-service.

Background: General practitioners (GPs) can refer patients to an asthma/COPD service (AC-service) for diagnostic assessment of spirometry and medical history and for asthma or COPD monitoring. The AC-service reports diagnostic results and additional information about disease burden (BORG-score for complaints, MRC-dyspnoea score, exacerbation rate), life style, medication and compliance, to the patient's GP. This study explores how GPs use this additional information when discussing the patient's disease burden and how this influences GPs' information and education provision during consultations with asthma/COPD patients.

Effect of an integrated primary care model on the management of middle-aged and old patients with obstructive lung diseases.

Objective: To investigate the effect of a primary care model for COPD on process of care and patient outcome.

Design: Controlled study with delayed intervention in control group.

Setting: The GP delegates tasks to a COPD support service (CSS) and a practice nurse.

Logistic support service improves processes and outcomes of diabetes care in general practice.

Background: Guidelines for type 2 diabetes care in general practice are well known and accepted, but the implementation falls short.

Objective: To implement these guidelines by introducing a diabetes support service (DSS) to support the care delivered by the GP.

Methods: A controlled, non-randomised study with delayed intervention in the control group; 78 GPs (n=51 for the intervention and n=21 for the control group) in the south of the Netherlands and 613 of their type 2 diabetic patients participated.

The feasibility of a primary care model for the management of COPD.

Aims: To investigate the feasibility of a primary care model to improve the management of COPD.

Methods: An intervention study on 1,497 patients with documented COPD from 22 general practices, involving 11 practice nurses and a COPD Support Service (CSS). Outcome measures included the successful delegation of tasks from general practitioners (GPs) to the CSS and practice nurse, and performance in daily practice according to the model components -- keeping a patient register with a recall system, periodical history taking and lung function measurements, asking diagnostic and therapeutic advice, and performing regular follow-up visits with education and counselling.