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Determining rate of compliance with the American diabetes association recommendations in hospitalized patients
Stuckey, Lisa
Stuckey, Lisa
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Research project
Adobe PDF, 597.39 KB
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2007-05
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Research project
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Keywords
Diabetes mellitus,Blood cholesterol,Hydroxymethylglutaryl-CoA reductase inhibitor,Platelet aggregation inhibitors,Hypertension,Angiotensin-converting enzyme inhibitors,Antagonist of angiotensin type 1 receptor,Diabetic nephropathies,Practice guidelines,Health care evaluation mechanisms
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Abstract
Diabetes mellitus is a growing epidemic in the United States associated with significant economic costs, reduced quality of life, long-term complications, and high rates of morbidity and mortality.
Purpose: This study determined the rate of compliance in hospitalized patients with the ADA treatment recommendations for diabetes management with regards to: blood glucose management, cholesterol management, stroke prevention, ACE-I/ARB utilization, and pneumococcal vaccination (PPV).
Methodology: This retrospective, non-interventional, chart review took place at a 760 bed, tertiary care, teaching hospital. A computer-generated list of patients with diabetes ICD-9 codes 250.0 through 250.9 was obtained. All adult patients, ≥ 18 years old, consecutively discharged from a general medical unit, beginning April 1, 2006 were included until data on 100 patients were collected. Exclusion criteria included gestational diabetes, hospital admission < 3days, and death prior to discharge. The following measurements related to the study objectives were collected: blood glucose, cholesterol management, stroke prevention, ACE-I/ARB utilization, and PPV immunization.
Results: Of the 100 patients reviewed, 96% had Type II DM; 24% had contraindications to at least one of their prescribed oral DM medications. Only 57% had HgA1c documented; of these, 56% were at goal. Only 42% had LDL cholesterol documented; of these, 76% were at goal. Appropriate stroke prevention was prescribed for 75% of patients; 69% were receiving appropriate ACE-I therapy; and 38% of eligible patients received PPV.
Conclusions: A high percentage of hospitalized patients are not in full compliance with the ADA treatment guidelines.
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Description
A project presented to the Department of Physician Assistant of Wichita State University in partial fulfillment of the requirements for the degree of Master of Physician Assistant.
Publisher
Wichita State University. Graduate School