@article{f9c33700221543bfa81e133484e938d1,
title = "Quality of care of the initial patient cohort of the diabetes collaborative registry{\textregistered}",
abstract = "Background-Although guidelines and performance measures exist for patients with diabetes mellitus, achievement of these metrics is not well known. The Diabetes Collaborative Registry{\textregistered} (DCR) was formed to understand the quality of diabetes mellitus care across the primary and specialty care continuum in the United States. Methods and Results-We assessed the frequency of achievement of 7 diabetes mellitus-related quality metrics and variability across the Diabetes Collaborative Registry{\textregistered} sites. Among 574 972 patients with diabetes mellitus from 259 US practices, median (interquartile range) achievement of the quality metrics across the practices was the following: (1) glycemic control: 19% (5-47); (2) blood pressure control: 80% (67-88); (3) angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers in patients with coronary artery disease: 62% (51-69); (4) nephropathy screening: 62% (53-71); (5) eye examination: 0.7% (0.0-79); (6) foot examination: 0.0% (0.0-2.3); and (7) tobacco screening/cessation counseling: 86% (80-94). In hierarchical, modified Poisson regression models, there was substantial variability in meeting these metrics across sites, particularly with documentation of glycemic control and eye and foot examinations. There was also notable variation across specialties, with endocrinology practices performing better on glycemic control and diabetes mellitus foot examinations and cardiology practices succeeding more in blood pressure control and use of angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers. Conclusions-The Diabetes Collaborative Registry{\textregistered} was established to document and improve the quality of outpatient diabetes mellitus care. While target achievement of some metrics of cardiovascular risk modification was high, achievement of others was suboptimal and highly variable. This may be attributable to fragmentation of care, lack of ownership among various specialists concerning certain domains of care, incomplete documentation, true gaps in care, or a combination of these factors.",
keywords = "Diabetes mellitus, Quality of care, Registry",
author = "Arnold, {Suzanne V.} and Abhinav Goyal and Inzucchi, {Silvio E.} and McGuire, {Darren K} and Fengming Tang and Mehta, {Sanjeev N.} and Sperling, {Laurence S.} and Maddox, {Thomas M.} and Daniel Einhorn and Wong, {Nathan D.} and Niklas Hammar and Peter Fenici and Kamlesh Khunti and Lam, {Carolyn S.P.} and Mikhail Kosiborod",
note = "Funding Information: support from Boston Scientific, Bayer, Thermofisher, Med-tronic, and Vifor Pharma; and has consulted for Bayer, Novartis, Takeda, Merck, Astra Zeneca, Janssen Research & Development, LLC, Menarini, Boehringer Ingelheim and Abbott Diagnostics; Kosiborod reports research grants from AstraZeneca and Boehringer Ingelheim; consulting honoraria from AstraZeneca, Sanofi, GSK, Boehringer Ingelheim, Merck (Diabetes), Novo Nordisk, Eisai, Glytec and ZS Pharma. The remaining authors report no relevant disclosures to the current article. Funding Information: The Diabetes Collaborative Registry{\^a} is funded by AstraZe-neca (founding sponsor) and Boehringer Ingelheim. AstraZe-neca has contributed scientific expertise to the design of the registry. Several co-authors from AstraZeneca have reviewed and edited the manuscript for intellectual content; however, the sponsors of the registry had no role in the final review and approval of the manuscript for submission. Funding Information: Inzucchi reports honoraria for trial leadership from AstraZe-neca, Boehringer Ingelheim, Daichii Sankyo, Janssen, Lexicon, Merck, and Sanofi and data monitoring committees for Novo Nordisk and Intarcia. McGuire reports honoraria for trial leadership from Boehringer Ingelheim, Janssen Research and Development LLC, Merck Sharp and Dohme Corp, Lilly USA, Novo Nordisk, GlaxoSmithKline, Takeda Pharmaceuticals North America, AstraZeneca, Lexicon; honoraria for consultancy from Janssen Research and Development LLC, Sanofi Aventis Groupe, Merck Sharp and Dohme Corp, Novo Nordisk and Regeneron; Einhorn: honoraria for consultancy from Eli Lilly, Novo Nordisk, Sanofi, Aztra Zeneca, Janssen, Takeda, Halozyme; clinical research honoraria from Novartis, Eli Lilly, Novo Nordisk, Mylan, Janssen, Bristol Myers Squibb, Eisai; speaker for Takeda; equity in Halozyme; Hammar is an employee of and holds equity in AstraZeneca; Fenici is an employee of and holds equity in AstraZeneca; Lam is supported by a Clinician Scientist Award from the National Medical Research Council of Singapore; has received research Publisher Copyright: {\textcopyright} 2017 The Authors and Medtronic.",
year = "2017",
month = aug,
day = "1",
doi = "10.1161/JAHA.117.005999",
language = "English (US)",
volume = "6",
journal = "Journal of the American Heart Association",
issn = "2047-9980",
publisher = "Wiley-Blackwell",
number = "8",
}