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A computerized model for home glucose monitoring proficiency testing: efficacy of an innovative testing program
R J Schrot1, P R Foulis2, A D Morrison3
1Department of Family Medicine, James A. Haley Veterans Administration Hospital, University of South Florida College of Medicine, Tampa, Florida (Dr Schrot)
Purpose:
A newly instituted computerized system for proficiency testing of home glucose monitoring was evaluated comparing accuracy of patient determination of glucose with serum values measured in the laboratory.
Methods:
Patients returning for routine blood glucose testing ordered by their care provider brought their glucose monitoring equipment to the laboratory. They performed a finger-stick glucose check in the laboratory while the laboratory phlebotomist drew blood for glucose determination; both results were computer analyzed. Patients with a 25% or less variation from the laboratory were considered proficient, while those with greater than 25% variation were defined as nonproficient.
Results:
Over a 19-month period, 300 of the 3208 patients notified about the study completed proficiency testing at least once. Using the defined proficiency of 25% variation or less, 12% of the participants were nonproficient. Using a variation of 15% or less, 31% of patients were nonproficient.
Conclusions:
An annual methodology evaluation such as the one in this study should become a standard of care to identify patients for remedial classes to correct the source of error. The goal must be to meet or exceed the American Diabetes Association standard of 15% total error in home glucose monitoring.