The Effect of a Primary Care Intervention on Management of Patients with Diabetes and Hypertension: A Pre-Post Intervention Chart Audit

摘要: BACKGROUND A principal goal in enhancing primary care Canada is to increase emphasis on health promotion, disease prevention and the management of chronic diseases setting. To achieve this Nova Scotia, collaborative practice teams with a nurse practitioner at least one physician were established, both alternative funding arrangements for physicians an information system implemented. This study reports impact healthcare reform initiative quality process-of-care, self-care proxy measures specific outcomes patients diabetes hypertension. METHODS pre- (April 1, 1999-March 31, 2000) post- 2001-March 2002) intervention audit consenting was conducted four sites participating Strengthening Primary Care Initiative. Two hundred eleven charts 541 hypertension audited. Process-of-care, targeted outcomes, patient education items measured diabetes. Process-of-care outcome related clinical management, blood pressure, lifestyle modifications laboratory investigations Frequencies proportions calculated. McNemar's test used compare paired data postintervention. RESULTS The percentage who achieved target pressure control rose from 20.4 28.5%. Annual screening retinopathy increased 33.8 41.9% nephropathy 61.7 71.3%. monitoring glucose levels home 61.5% 69.1%. HYPERTENSION had their checked twice year dropped 89.1% 85.0%; however, more systolic (rising 40.6 55.3%) diastolic (from 77.9 85.3%) readings. Body mass index recorded moderate exercise prescribed patients. fasting 37.7 67.1%) lipid profiles 62.6 69.1%) markedly higher. CONCLUSION Overall either maintained or improved over course initiative.