Type 2 diabetes and COPD: treatment in the right healthcare setting? An observational study
Abstract Background Type 2 diabetes (T2DM) and COPD are chronic medical conditions, for which patients need lifelong healthcare. The aim of this study is to examine in which healthcare setting patients with T2DM and COPD receive their care, and if this is the correct healthcare setting according to...
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| Format: | Article |
| Language: | English |
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BMC
2021-04-01
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| Series: | BMC Family Practice |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12875-021-01424-w |
| _version_ | 1828471359572803584 |
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| author | R. P. Willink Rimke C. Vos I. Looijmans-van den Akker Huberta E. Hart |
| author_facet | R. P. Willink Rimke C. Vos I. Looijmans-van den Akker Huberta E. Hart |
| author_sort | R. P. Willink |
| collection | DOAJ |
| description | Abstract Background Type 2 diabetes (T2DM) and COPD are chronic medical conditions, for which patients need lifelong healthcare. The aim of this study is to examine in which healthcare setting patients with T2DM and COPD receive their care, and if this is the correct healthcare setting according to guidelines. Method T2DM and COPD patients from five primary care practices were included. Data concerning healthcare setting and patient- and clinical characteristics were extracted from the electronic medical records. Patient profiles treated in primary care were compared with the profiles of those treated in secondary care. In patients treated in secondary care we evaluated whether treatment allocation was according to the guidelines and if back-referral to primary care should take place. Results Of the T2DM and COPD patients 7.6% and 29.6% respectively, were treated in secondary care, and 72.7% respectively 31.4% of these were according to the guideline. T2DM patients treated in primary care were older (63 versus 57 years, p < 0.01, had a shorter diabetes duration (8 versus 11 years, p < 0.01) and lower HbA1c (53.0 versus 63.5 mmol/l, p < 0.01) than those treated in secondary care. Those with COPD treated in primary care used less inhalation medication (75.2 versus 90.1%, p < 0.01) and had better spirometry results (67.39 versus 57.53 FEV1%pred, p < 0.01). Conclusion The majority of the patients with T2DM and COPD were correctly treated in primary care and on average patients with a better health condition were treated in primary care.. Also, those who were treated in secondary care were most of the time treated in the correct treatment setting according to the guidelines. |
| first_indexed | 2024-12-11T05:11:01Z |
| format | Article |
| id | doaj.art-7a256be34ac34a4db681ab7a1d7c7642 |
| institution | Directory Open Access Journal |
| issn | 1471-2296 |
| language | English |
| last_indexed | 2024-12-11T05:11:01Z |
| publishDate | 2021-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Family Practice |
| spelling | doaj.art-7a256be34ac34a4db681ab7a1d7c76422022-12-22T01:19:56ZengBMCBMC Family Practice1471-22962021-04-012211910.1186/s12875-021-01424-wType 2 diabetes and COPD: treatment in the right healthcare setting? An observational studyR. P. Willink0Rimke C. Vos1I. Looijmans-van den Akker2Huberta E. Hart3Department of General Practice, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht UniversityDepartment of General Practice, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht UniversityLeidsche Rijn Julius Healthcare CentersDepartment of General Practice, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht UniversityAbstract Background Type 2 diabetes (T2DM) and COPD are chronic medical conditions, for which patients need lifelong healthcare. The aim of this study is to examine in which healthcare setting patients with T2DM and COPD receive their care, and if this is the correct healthcare setting according to guidelines. Method T2DM and COPD patients from five primary care practices were included. Data concerning healthcare setting and patient- and clinical characteristics were extracted from the electronic medical records. Patient profiles treated in primary care were compared with the profiles of those treated in secondary care. In patients treated in secondary care we evaluated whether treatment allocation was according to the guidelines and if back-referral to primary care should take place. Results Of the T2DM and COPD patients 7.6% and 29.6% respectively, were treated in secondary care, and 72.7% respectively 31.4% of these were according to the guideline. T2DM patients treated in primary care were older (63 versus 57 years, p < 0.01, had a shorter diabetes duration (8 versus 11 years, p < 0.01) and lower HbA1c (53.0 versus 63.5 mmol/l, p < 0.01) than those treated in secondary care. Those with COPD treated in primary care used less inhalation medication (75.2 versus 90.1%, p < 0.01) and had better spirometry results (67.39 versus 57.53 FEV1%pred, p < 0.01). Conclusion The majority of the patients with T2DM and COPD were correctly treated in primary care and on average patients with a better health condition were treated in primary care.. Also, those who were treated in secondary care were most of the time treated in the correct treatment setting according to the guidelines.https://doi.org/10.1186/s12875-021-01424-wPrimary health careDiabetes mellitusType 2Pulmonary diseaseChronic obstructive |
| spellingShingle | R. P. Willink Rimke C. Vos I. Looijmans-van den Akker Huberta E. Hart Type 2 diabetes and COPD: treatment in the right healthcare setting? An observational study BMC Family Practice Primary health care Diabetes mellitus Type 2 Pulmonary disease Chronic obstructive |
| title | Type 2 diabetes and COPD: treatment in the right healthcare setting? An observational study |
| title_full | Type 2 diabetes and COPD: treatment in the right healthcare setting? An observational study |
| title_fullStr | Type 2 diabetes and COPD: treatment in the right healthcare setting? An observational study |
| title_full_unstemmed | Type 2 diabetes and COPD: treatment in the right healthcare setting? An observational study |
| title_short | Type 2 diabetes and COPD: treatment in the right healthcare setting? An observational study |
| title_sort | type 2 diabetes and copd treatment in the right healthcare setting an observational study |
| topic | Primary health care Diabetes mellitus Type 2 Pulmonary disease Chronic obstructive |
| url | https://doi.org/10.1186/s12875-021-01424-w |
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