Identifying people at risk for undiagnosed type 2 diabetes using the GP's electronic medical record.
| Autor: | Klein Woolthuis EP; Department of General Practice, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands. e.kleinwoolthuis@hag.umcn.nl, de Grauw WJ, van Gerwen WH, van den Hoogen HJ, van de Lisdonk EH, Metsemakers JF, van Weel C |
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| Jazyk: | angličtina |
| Zdroj: | Family practice [Fam Pract] 2007 Jun; Vol. 24 (3), pp. 230-6. Date of Electronic Publication: 2007 May 16. |
| DOI: | 10.1093/fampra/cmm018 |
| Abstrakt: | Background: Screening for type 2 diabetes is recommended in at-risk patients. The GP's electronic medical record (EMR) might be an attractive tool for identifying them. Objective: To assess the value of the GP's EMR in identifying patients at risk for undiagnosed type 2 diabetes and the feasibility to use this information in usual care to initiate screening. Methods: In 11 Dutch general practices (25 GPs), we performed an EMR-derived risk assessment in all patients aged > or =45 and < or =75 years, without known diabetes, identifying those at risk according to the American Diabetes Association recommendations. Patients with an EMR-derived risk or risk after additional risk assessment during regular consultation were invited for capillary fasting plasma glucose (FPG) measurement. Results: Of 13 581 patients, 3858 (28%) had an EMR-based risk (hypertension, cardiovascular disease, lipid metabolism disorders and/or obesity). Additional risk assessment in those without an EMR-based risk showed that in 51%, greater than one risk factor was present, mainly family history (51.2%) and obesity (59%). Ninety per cent returned for the FPG measurement. In both groups, we found patients with an FPG exceeding the cut point for diabetes (5.9% versus 4.1%). Conclusions: With additional risk assessment during consultation, the GP's EMR was valuable in identifying patients at risk for undiagnosed type 2 diabetes. It was feasible to use this information to initiate screening. At-risk patients were willing to take part in screening. Better registration of family history and obesity will improve the EMR as a tool for identifying at-risk patients in opportunistic screening in general practice. |
| Databáze: | MEDLINE |
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