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International Journal for Quality in Health Care Advance Access originally published online on November 16, 2007
International Journal for Quality in Health Care 2008 20(1):72-77; doi:10.1093/intqhc/mzm051
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© The Author 2007. Published by Oxford University Press on behalf of International Society for Quality in Health Care; all rights reserved

Implementing diabetes passports to focus practice reorganization on improving diabetes care

Rob Dijkstra, Joze Braspenning and Richard Grol

Centre for Quality of Care Research, University Medical Centre St Radboud Nijmegen, The Netherlands

Objective. Although an active role of the patient is often stressed in diabetes care, it is not easily implemented in daily practice. The aim of the study was to measure the effects of introducing a diabetes passport to patients after embedding the passport in the organization of care.

Design. Randomized controlled trial.

Setting. Forty general practice in The Netherlands.

Participants. Pre- and post-intervention data were obtained from 993 patients with type 2 diabetes mellitus. Patients treated in secondary care and patients over 80 years of age were excluded.

Intervention. The intervention consisted of clarifying the diabetes care tasks for all practice staff and embedding the diabetes passports in the structured care.

Main outcome measure. Self-reported use of the diabetes passport.

Results. Diabetes passports were issued to 87% of the patients. After 15 months, 76% of the patients reported that the passport was being used during clinic visits. The process indicators of care improved by 10% on average in the intervention group. However, there were no changes in the outcome measures.

Conclusion. Diabetes passports can be introduced successfully in structured primary care and they lead to improved effect measures for medical behaviour.

Keywords: delivery of health care, diabetes mellitus, guidelines, intervention studies, patient participation, physician–patient relations

Address reprint requests to: Rob Dijkstra, Centre for Quality of Care Research-114, UMC St Radboud, PO Box 9101, 6500 HB Nijmegen, The Netherlands. Tel: +31 24 3619640; Fax: +31 24 3540166; E-mail: r.dijkstra{at}kwazo.umcn.nl

Accepted for publication October 9, 2007.


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