News
26 May 2010
Decision supports improves physician diabetes care
Diabetes patients are better served when their physician uses specialized diabetes management software and works with a specialized diabetes nurse. This is the conclusion drawn in a dissertation by family medicine physician Frits Cleveringa of the University Medical Center Utrecht in the Netherlands. His graduation is set for May 27th.
This is the first time that clinical decision support software has been used for a trial study in the Netherlands. Cleveringa spent a year analyzing the health status of 3391 diabetes patients that were being treated by their family medicine physician. Half of the 55 involved physicians used specialized diabetes management software; the other half used existing means of treatment. Besides providing decision support, the diabetes management software generates a report every three month indicating which patients could benefit from treatment changes. It also compares local practice outcomes to dozens of other practices around the country.
Reduced risk of cardio vascular complications
At the end of the year, patients treated by a practice using the specialized software proved to be better off; their cholesterol levels and blood pressure improved over time, which translates to lower risk for cardio vascular complications. The calculated 10-year risk reduced by an extra 1.4 percent compared to the control group. Blood glucose levels – the most important indicator in diabetes treatment – was already at target levels and equal in both groups at the start of the trial study.
High standard of care
The use of a software solution is not necessarily cost effective for all groups of diabetes patients, concluded Cleveringa. For the average diabetes patient, the relative health improvement does not justify the extra cost. “Existing diabetes care in the Netherlands already operates at a high level of quality”, says Cleveringa. “But the system does benefit patients with a high risk for developing cardio vascular complications.”
Decision support
The Vital for Diabetes software (formerly known as the Diabetes Care Protocol) from VitalHealth Software supports the physician in making treatment decisions. For instance, for patients with foot complications it will generate a foot exam reminder every 3 months. Typical physician information systems may already capture data to support such a clinical decision, but do not generate practical decision support in the form of an alert or reminder. Furthermore, the software generates a report for all diabetes patients every quarter listing the latest blood glucose and blood pressure levels, enabling the physician to quickly identify those patients in need of additional treatment. The trial study showed that comparing practice outcomes with other practices is essential to identifying potential improvements. It also showed that involving specialized diabetes nurses in the care process positively influences outcomes, providing patients with an easily accessible point of care during office visits.
Cleveringa’s research study was partly made possibly though the financial support of the pharmaceutical company Pfizer.
About Cleveringa
Since 2009, F.G.W. Cleveringa is a fulltime family medicine physician and coordinator at the Gezondheidshuis Stadshagen in Zwolle (NL). Cleveringa combined his research study with his work as a physician.
This is the first time that clinical decision support software has been used for a trial study in the Netherlands. Cleveringa spent a year analyzing the health status of 3391 diabetes patients that were being treated by their family medicine physician. Half of the 55 involved physicians used specialized diabetes management software; the other half used existing means of treatment. Besides providing decision support, the diabetes management software generates a report every three month indicating which patients could benefit from treatment changes. It also compares local practice outcomes to dozens of other practices around the country.
Reduced risk of cardio vascular complications
At the end of the year, patients treated by a practice using the specialized software proved to be better off; their cholesterol levels and blood pressure improved over time, which translates to lower risk for cardio vascular complications. The calculated 10-year risk reduced by an extra 1.4 percent compared to the control group. Blood glucose levels – the most important indicator in diabetes treatment – was already at target levels and equal in both groups at the start of the trial study.
High standard of care
The use of a software solution is not necessarily cost effective for all groups of diabetes patients, concluded Cleveringa. For the average diabetes patient, the relative health improvement does not justify the extra cost. “Existing diabetes care in the Netherlands already operates at a high level of quality”, says Cleveringa. “But the system does benefit patients with a high risk for developing cardio vascular complications.”
Decision support
The Vital for Diabetes software (formerly known as the Diabetes Care Protocol) from VitalHealth Software supports the physician in making treatment decisions. For instance, for patients with foot complications it will generate a foot exam reminder every 3 months. Typical physician information systems may already capture data to support such a clinical decision, but do not generate practical decision support in the form of an alert or reminder. Furthermore, the software generates a report for all diabetes patients every quarter listing the latest blood glucose and blood pressure levels, enabling the physician to quickly identify those patients in need of additional treatment. The trial study showed that comparing practice outcomes with other practices is essential to identifying potential improvements. It also showed that involving specialized diabetes nurses in the care process positively influences outcomes, providing patients with an easily accessible point of care during office visits.
Cleveringa’s research study was partly made possibly though the financial support of the pharmaceutical company Pfizer.
About Cleveringa
Since 2009, F.G.W. Cleveringa is a fulltime family medicine physician and coordinator at the Gezondheidshuis Stadshagen in Zwolle (NL). Cleveringa combined his research study with his work as a physician.
