An evaluation of glycosylated hemoglobin requesting patterns in a primary care setting: a pilot experience in the Valencian Community (Spain)

Abstract Objective To assess the pattern of glycosylated hemoglobin (HbA1c ) requests by clinicians from eight health care departments by calculating indicators of demand appropriateness. Methods A cross-sectional study of the number of HbA1c requests by primary care clinics in 2008 and 2009. The in...

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Published in:Endocrinologia y nutrición (English ed.) 2011, Vol.58 (5), p.219-223
Main Authors: Salinas, María, López-Garrigós, Maite, Carratala, Arturo, Aguado, Cristina, Díaz, Julián, Ortuño, Mario, Rodriguez-Borja, Enrique, Yago, Martín, Chinchilla, Virtudes, Marcaida, Goizane, Esteban, Ángel, Laíz, Begoña, Guaita, Marcos, Lorente, Miguel Ángel, Pomares, Francisco, Uris, Joaquín
Format: Article
Language:English
Subjects:
Biological markers
Diabetes mellitus tipo 2
Endocrinology & Metabolism
Glycemic control
Glycosylated hemoglobin
Hemoglobina glucosilada
Marcadores biológicos
Type 2 diabetes mellitus
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Summary:Abstract Objective To assess the pattern of glycosylated hemoglobin (HbA1c ) requests by clinicians from eight health care departments by calculating indicators of demand appropriateness. Methods A cross-sectional study of the number of HbA1c requests by primary care clinics in 2008 and 2009. The indicator of demand appropriateness was the proportion of HbA1c values lower than 6.5%. Variables were collected and indicators were automatically calculated. The number of HbA1c measurements that should theoretically have been requested according to known diabetes prevalence data was also calculated. Results A progressive increase was seen in the demand for HbA1c measurements. Approximately 54% of HbA1c values obtained in seven of the eight departments studied were lower than 6.5%. The number of theoretical HbA1c requests that would have been expected based on the known prevalence of diabetes was higher than the number of HbA1c requests in all departments. Conclusion The results appear to suggest that HbA1c requests in the health care departments studied were not always appropriate. HbA1c measurements were probably overused in patients without diabetes and underused in patients with diabetes.
ISSN:2173-5093
2173-5093
DOI:10.1016/S2173-5093(11)70050-2