Improving diabetes care in general practice using a nurse-led, GP supported clinic: A cohort study

Abstract

Diabetes is becoming an increasingly common problem, and those in primary care are being encouraged to provide efficient, effective patient-centred care for people with diabetes. In this study we aimed to see if re-organising diabetes care and introducing a nurse-led clinic would improve parameters of care for patients with diabetes. We compared parameters of care in adult patients with type 2 diabetes provided in a twice-yearly GP-led clinic, with a subsequent 15-month period of a weekly nurse-led clinic. We found a 27% increase in patients with BP <140/80mmHg (inclusive) p<0.001, and an 18% improvement in patients with HbA1c <7.4% (inclusive) p<0.05. Control of cholesterol improved in the nurse-led clinic: 65% of patients having a cholesterol <5.0mmol/L and 75% receiving a statin (p<0.001) appropriately, compared to 60% and 55% respectively in the GP-led clinic. At the same time we saw an 84% reduction in patients testing blood glucose (p<0.001) and a 99% reduction in those testing their urine (p<0.001). Diabetes care can be improved by the appropriate reorganisation of care provision and is not dependent on glucose self-monitoring. Copyright © 2005 John Wiley & Sons, Ltd.