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Can Fam Physician
Vol. 53, No. 1, January 2007, pp.73 - 77
Copyright © 2007 by The College of Family Physicians of Canada
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Clinical Review

Improving diabetes management

Structured clinic program for Canadian primary care

Daren Lin
Medical student in the Schulich School of Medicine and Dentistry at the University of Western Ontario in London

Shirley Hale, RN(EC)
Nurse practitioner at the Wawa Medical Centre in Wawa, Ont

Erle Kirby, MD, MSC, FCFP
General practitioner at the Wawa Medical Centre and an Associate Professor at McMaster University in Hamilton, Ont

Correspondence to: Dr Erle Kirby, Wawa Medical Centre, 17 Government Rd, Wawa, ON P0S 1K0; telephone 705 856-1313; fax 705 856-1330; e-mail erlkirby{at}xplornet.com

PROBLEM BEING ADDRESSED Adherence to diabetes treatment guidelines is often poor in primary care.

OBJECTIVE OF PROGRAM To introduce simple accessible interventions in our clinic to improve both physicians’ adherence to diabetes treatment guidelines and patient outcomes.

PROGRAM DESCRIPTION A physician and a nurse practitioner used 3 interventions for diabetes care: 30-minute appointments, reminder telephone calls to patients, and standardized flow sheets. Evaluation of this structured program found that, after 3 years, these interventions had improved primary caregivers’ adherence to diabetes care guidelines and several physiologic parameters in patients with diabetes (compared with outcomes of patients managed with the usual less structured approach).

CONCLUSION This program improved delivery of diabetes care in our clinic. We believe a similar approach could help other physicians and nurse practitioners in primary care practices increase their adherence to guidelines and improve the clinical outcomes of their patients.


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Copyright © 2007 by The College of Family Physicians of Canada.