Reduction in self-monitoring of blood glucose in type 2 diabetes: an observational controlled study in east London
| Autor: | John Robson, Jack Dunne, Isabel Dostal, Kambiz Boomla, Tahseen A Chowdhury, Rohini Mathur, Philip Bennett-Richards, David Keene, Hannah Smithers, Sally Hull |
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| Rok vydání: | 2015 |
| Předmět: |
Blood Glucose
Glycated Hemoglobin Pediatrics medicine.medical_specialty business.industry Research Guideline Type 2 diabetes medicine.disease Metformin Treatment and control groups Diabetes Mellitus Type 1 Diabetes Mellitus Type 2 Quality of life Diabetes mellitus Blood Glucose Self-Monitoring Emergency medicine medicine Humans Hypoglycemic Agents Observational study Family Practice business medicine.drug |
| Zdroj: | British Journal of General Practice. 65:e256-e263 |
| ISSN: | 1478-5242 0960-1643 |
| DOI: | 10.3399/bjgp15x684421 |
| Popis: | Background Self-monitoring of blood glucose (SMBG) confers no benefit for many people with type 2 diabetes not being treated with insulin. It accounts for 21% of diabetes prescribing costs. Aim To improve care quality at reduced cost for type 2 diabetes by reducing unnecessary SMBG. Design and setting Non-randomised, observational controlled study in two intervention clinical commissioning groups (CCGs) and one control CCG in east London. Method In total, 19 602 people with type 2 diabetes not being treated with insulin were recruited from two intervention CCGs; 16 033 were recruited from a control CCG. The intervention (from 2010 to 2013) comprised implementation of a locally developed guideline, including IT support and peer feedback of performance. Data on practice prescribing SMBG testing strips were gathered using GP electronic health records. Information on costs were obtained via the ePACT electronic database. Results Over 4 years, in all non-insulin type 2 diabetes treatment groups, use of SMBG was reduced in the two intervention CCGs from 42.8% to 16.5%, and in the control CCG from 56.4% to 47.2%. In people on metformin alone or no treatment, intervention CCGs reduced SMBG use from 29.6% to 6.0%, and in the control CCG use dropped from 47.1% to 38.7% (P Conclusion This low-cost programme demonstrated a major reduction in unnecessary prescribing of SMBG, along with cost savings. If replicated nationally, this would avoid unnecessary testing in 340 000 people and prescribing costs that total £21.8 million. |
| Databáze: | OpenAIRE |
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