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Family practices' achievement of diabetes quality of care targets and risk of screen-detected diabetic retinopathy

Gulliford, MC; Dodhia, H; Sivaprasad, S; Ashworth, M; (2010) Family practices' achievement of diabetes quality of care targets and risk of screen-detected diabetic retinopathy. PLOS ONE , 5 (4) , Article e10424. 10.1371/journal.pone.0010424. Green open access

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Abstract

Background: We aimed to determine whether family practices' achievement of diabetes quality of care targets is associated with diabetic retinal disease in registered patients. Methods: Data for achievement of diabetes quality of care targets, including the proportion of patients with HbA1c≤7.5%, for 144 family practices in London UK, for the years 2004/5 to 2007/8, were linked to data from a population-based diabetes eye screening programme collected from September 2007 to February 2009. Analyses were adjusted for age, sex, duration and type of diabetes, unadjusted diabetes prevalence, ethnicity and deprivation category. Results: Data were analysed for 24,458 participants with one or more eye screening results in the period. There were 9,332 (38%) with any diabetic retinopathy and 2,819 (11.5%) with sight threatening diabetic retinopathy (STDR), including 2,654 (10.9%) with maculopathy. Among participants registered at 13 family practices that were in the highest quartile for achievement of the HbA1c quality of care target for all four years of study, the relative odds of any diabetic retinopathy were 0.78 (0.69 to 0.88) P<0.001. For participants at 12 practices consistently in the lowest quartile of HbA1c achievement, the relative odds of any diabetic retinopathy were 1.16 (1.03 to 1.30), P = 0.015. In the highest achieving practices, the relative odds of maculopathy were 0.74 (0.62 to 0.89), P = 0.001 and STDR 0.77 (0.65 to 0.92), P = 0.004. Conclusions: The risk of diabetic retinopathy might be lower at family practices that consistently achieve highly on diabetes quality of care targets for HbA1c.

Type: Article
Title: Family practices' achievement of diabetes quality of care targets and risk of screen-detected diabetic retinopathy
Open access status: An open access version is available from UCL Discovery
DOI: 10.1371/journal.pone.0010424
Publisher version: http://dx.doi.org/10.1371/journal.pone.0010424
Language: English
Additional information: © 2010 Gulliford et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. The study was supported by Lambeth, Southwark and Lewisham NHS Primary Care Trusts, London UK. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Ophthalmology
URI: https://discovery.ucl.ac.uk/id/eprint/1334125
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