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[Frequency of attendance and degree of control of type-2 diabetic patients]
María Trinidad Ortiz Tobarra1, Domingo Orozco Beltrán, Vicente Gil Guillén
1Medicina de Familia, Centro de Salud Albatera, Alicante, España. triniortiztobarra@hotmail.com
Objective:
To analyse whether the number of doctor's appointments for type-2 diabetes patients is linked to the degree of control of his/her illness.
Setting:
Primary care. Two teaching health centres in the public network (Petrer 1 and Petrer 2, Alicante, Spain).
Design:
Retrospective, observational study. Review of computerised clinical histories and direct interview with patients. Patients with DM2 included in Diabetes Programme (DP); 18-month follow-up (January 2003-June 2004).
Sample Size:
86 patients (mean, 15 visits/year; SD, 7.1; alpha, 0.02; and accuracy to 2%). RANDOMISED SAMPLING: Study factor was number of visits. Evaluation criterion was difference in glycosylated haemoglobin (A(1c)) between start and end. Characteristics of the patients, characteristics of the illness and numbers of changes in treatment done were analysed. Statistical tests were: chi(2), Student t test, confidence intervals, and multivariate analysis.
Results:
Mean age was 65.5 (95% CI, 63.5-67.5); women, 57%; years of disease's evolution, 7.07 (95% CI, 5.6-8.5). Treatment was: diet, 12.8%; ADOs, 61.6%; ADO+insulin, 17.4%; insulin, 8.1%. Number of visits to the HC: total, 28.8 (95% CI, 26.5-31.2); medical, DP 4.7 (95% CI, 4.1-5.2); nursing DP, 11 (95% CI, 9.9-12.1). Changes of treatment were 1.73 (95% CI, 1.3-2.1); initial A1C, 7.0 (95% CI, 6.6-7.3), and final A1C, 6.9 (95% CI, 6.7-7.1). On multivariate analysis, the number of changes in the treatment (beta=-0.430; P=.007) had 0an association, but the number of visits (beta=-0.273; P=.215) and the other variables analysed had no statistical association.
Conclusions:
Improvement in control of glycosylated haemoglobin was not related to the number of visits to the doctor, but was related to changes in treatment.
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