Defining quality in type 2 diabetes primary care: A multistakeholder modified Delphi consensus indicator set

Area of Science:

• Public Health
• Healthcare Quality Improvement
• Endocrinology

Background:

• Type 2 diabetes mellitus (T2DM) poses a significant public health challenge in Greece.
• Existing validated tools for assessing T2DM care quality in primary care settings are lacking.
• There is a need for context-specific indicators to evaluate and enhance T2DM management.

Purpose of the Study:

• To develop a context-specific set of consensus-based quality indicators (QIs) for T2DM in Greek primary care.
• To create a framework applicable to comparable European and low- and middle-income country (LMIC) systems.
• To establish a foundation for improving T2DM care quality.

Main Methods:

• A two-phase approach was employed, starting with a bibliographic search for existing T2DM QI sets.
• A three-round modified Delphi survey involving 10 diverse stakeholders was conducted.
• Candidate indicators were adapted for European relevance before consensus building.

Main Results:

• The literature search yielded limited eligible studies, identifying 43 candidate QIs.
• The Delphi process resulted in a consensus set of 39 QIs across nine domains.
• These domains include access, monitoring, health counseling, treatment, patient safety, records, health status, patient satisfaction, and self-management.

Conclusions:

• The study presents the first context-adapted, consensus-based T2DM QI set for Greek primary care.
• The developed QIs encompass clinical, organizational, and patient-reported aspects of care.
• This framework supports wider implementation, electronic health record integration, and international benchmarking.