Table 3.
Quality of care indicators of T2DM management by type of consultation.
| Quality of care indicators | Face to face consultation | Telemedicine consultation | P value |
|---|---|---|---|
| Process indicatorsa | |||
| HbA1c | 94.7 | 82.0 | <0.0001 |
| Blood pressure | 80.4 | 30.9 | <0.0001 |
| Lipid profile | 75.7 | 61.0 | <0.0001 |
| Albuminuria | 64.9 | 53.0 | <0.0001 |
| Serum creatinine | 88.3 | 76.3 | <0.0001 |
| Eye examination | 25.1 | 11.5 | <0.0001 |
| Foot examination | 14.3 | 4.3 | <0.0001 |
| Favorable outcome indicators | |||
| HbA1c ≤ 7.0 % (≤53 mmol/mol) | 48.8 | 56.0 | <0.0001 |
| Blood pressure < 140/90 mmHg | 50.3 | 60.7 | <0.0001 |
| LDL cholesterol < 100 mg/dl | 66.5 | 64.4 | <0.0001 |
| Unfavorable outcome indicators | |||
| HbA1c > 8.0 % (>64 mmol/mol) | 21.8 | 16.1 | <0.0001 |
| Blood pressure ≥ 140/90 mmHg | 49.7 | 39.3 | <0.0001 |
| LDL cholesterol ≥ 130 mg/dl | 11.4 | 12.1 | 0.001 |
| Albuminuria | 33.6 | 32.7 | 0.006 |
| eGFR < 60 ml/min | 29.6 | 33.6 | <0.0001 |
| Indicators of treatment intensity/appropriateness | |||
| No insulin despite HbA1c ≥ 9.0 % (>75 mmol/mol)* | 29.4 | 23.3 | <0.0001 |
| No antihypertensive treatment despite BP ≥ 140/90 mmHg** | 27.0 | 29.6 | <0.0001 |
| No lipid-lowering agents despite ldl-cholesterol ≥ 130 mg/dl*** | 45.3 | 52.7 | <0.0001 |
| No ACE-I and/or ARBs despite albuminuria£ | 38.4 | 40.3 | <0.0001 |
| HbA1c ≥ 9.0 % (≥75 mmol/mol) in spite of insulin treatment§ | 19.3 | 14.8 | <0.0001 |
| BP ≥ 140/90 mmHg in spite of antihypertensive treatment¤ | 51.6 | 40.4 | <0.0001 |
| ldl-cholesterol ≥ 130 mg/dl in spite of lipid lowering treatmentƚ | 9.5 | 9.7 | 0.42 |
| Overall quality of care | |||
| Q score > 25 | 56.4 | 49.5 | <0.0001 |
a
Process indicators, percentages of patients monitored at least once during the index year for the following parameters. Data are n (%).
*
The denominator is represented by all patients with HbA1c ≥ 9.0 %.
**
The denominator is represented by all patients with BP ≥ 140/90 mmHg.
***
The denominator is represented by all patients with LDL- cholesterol ≥ 130 mg/dl.
£
The denominator is represented by all patients with albuminuria.
§
The denominator is represented by all patients treated with insulin.
¤
The denominator is represented by all patients treated with antihypertensive drugs.
ƚ
The denominator is represented by all patients treated with lipid-lowering drugs.