Intensified follow-up of patients with type 1 diabetes and poor glycaemic control: A multicentre quality improvement collaborative based on data from the Norwegian Diabetes Register for Adults

• Main Authors: Madsen, Tone Vonheim, Cooper, John Graham, Carlsen, Siri, Loevaas, Karianne, Rekdal, Magne, Igland, Jannicke, Sandberg, Sverre, Ueland, Grethe Åstrøm, Iversen, Marjolein M, Sølvik, Una Ørvim
• Format: Article
• Language: English

Background Patients with type 1 diabetes mellitus (T1DM) and poor glycaemic control are at high risk of developing microvascular and macrovascular complications. The aim of this study was to determine if a quality improvement collaborative (QIC) initiated by the Norwegian Diabetes Register for adults (NDR-A) could reduce the proportion of patients with T1DM with poor glycaemic control (defined as glycated haemoglobin (HbA1c)≥75 mmol/mol) and reduce mean HbA1c at participating clinics compared with 14 control clinics. Method Multicentre study with controlled before and after design. Representatives of 13 diabetes outpatient clinics (n=5145 patients with T1DM) in the intervention group attended four project meetings during an 18-month QIC. They were required to identify areas requiring improvement at their clinic and make action plans. Continuous feedback on HbA1c outcomes was provided by NDR-A during the project. In total 4084 patients with type 1 diabetes attended the control clinics. Results Between 2016 and 2019, the overall proportion of patients with T1DM and HbA1c≥75 mmol/mol in the intervention group were reduced from 19.3% to 14.1% (p