Auditing of Medical Chart Among Type 2 Diabetic Patient Done by Primary Care Physicians - Zdravlje, medicina, lijecenje, zdravstveni portal

Auditing of Medical Chart Among Type 2 Diabetic Patient Done by Primary Care Physicians

Auditing of Medical Chart Among Type 2 Diabetic Patient Done by Primary Care Physicians
Larisa Gavran, Muharem Zildzic, Olivera Batic-Mujanovic, Alma Alic, Ibrahim Gledo, Subhija Prasko
Med Arh. 2012; 66(6): 388-390

View PDF Fulltext


Aim: To analyse the difference in documentation of standard parameters for monitoring DM type 2 between Family Medicine Teams (FMT) and Teams on Program Additional Training (PAT). Methods: Study was conducted as 20 medical chart audits of diabetic type 2 patients randomly selected per 3 FMT from Zenica and 3 PAT from Kakanj. According to the chart, we assess sex, age, glucose in blood-GB, blood pressure-BP, total cholesterol-TC, body mass index-BMI, HbA1c, foot exam, eye exam and urinoanalisis and have any of the tests been done in the past year. Results: 60 medical chart from FMT and 60 medical charts from PAT teams were reviewed. FMT vs. PAT teams recorded: BG 58% vs. 30% (X2=8.651, p=0.003); BP 70% vs.33% (X2=14.716, p=0.0001); TC 35% vs.22% (X2=2.011, p=0.156); BMI 48% vs.28% (X2=4.266, p=0.038); HbA1c 41% vs.75% (X2=12.377, p=0.0004); foot exam 26% vs. 78% (X2=28.158, p<0.0001); eye exam 48% vs. 65% (X2=2.749, p=0.097) and urinoanalisis 38% vs.88% (X2=30.179, p<0.0001). Conclusion: FMT recorded a higher number of metabolic parameters for macrovascular risk factors (BG, BP and BMI) than microvascular risk factors (HbA1c, foot exam and urinoanalisis) which are were better controlling by PAT teams.


1. National Institute for Clinical Excellence. Principles for Best Practice in Clinical Audit. Int J Qual Health Care. 2003; 15 (1): 87 .

2. Bilic-Komarica E, Beciragfic A, Junuzovic Dz. Effects of Treatment with L-thyroxin on Glucose Regulation in Patients with Subclinical Hypothyroidism. Med Arh. 2012 Dec; 66(6): 364-368:.

3. Ratsep A, Kalda R, Oja I, Lember M Family doctors’ knowledge and self-reported care of type 2 diabetes patients in comparison to the clinical practice guideline: cross-sectional study. BMC Fam Pract 2006; 16: 7-36.

4. Bryant W, Greenfield JR, Chisholm DJ, Campbell LV Diabetes guidelines: easier to preach than to practice? MJA. 2006; 185 (6): 305-309

5. Anonymous. Canadian Diabetes Association Clinical Practice Guidelines Expert Committee. Canadian Diabetes Association. Clinical practice guidelines for the prevention and management of diabetes in Canada. Can J Diabetes. 2003; 27 (2): S1-152. 2003.

6. Anonymous. American Diabetes Association: Standard of medical care in diabetes. Diabetes Care. 2006; 29(1): 4-42.

7. Kirk JK, Huber KR, Clinch CR. Attainment of goals from national guidelines among persons with type 2 diabetes: a cohort study in an academic family medicine setting. NC Med J. 2005; 66(6): 415-419.

8. Worrall G, Freake D, Kelland J, Pickle A, Keenan T. Care of patients with type II diabetes: a study of family physicians’ compliance with clinical practice guidelines. J Fam Pract 44(4): 374-381.

9. Bodenheimer T, Wagner EH, Grumbach K. Improving primary care for patients with chronic illness. JAMA. 1997; 288: 1775-1779.

10. Lawler F, Viviani N. Patient and Physician Perspectives Regarding Treatment of Diabetes: Compliance with Practice Guidelines. J Fam Pract. 1997; 44: 369-373.

11. Harris SB, Meltzer SJ, Zinman B. New guidelines for the of diabetes: a physician’s guide. Canadian Medical Association. 1998; 159 (8): 973-978.

12. Kirkman MS, Williams SR, Caffrey HH, David GM. Impact of a program to Improve Adherence to Diabetes Guidelines by Primary Care Physicians. Diabetes Care. 2002; 25: 1946-1951.

13. Harris SB, Stewart M, Brown JB, Wetmore S, Faulds C, Webster-Bogaert S i sur. Type 2 diabetes in family practice. Room for improvement. Can Fam Physician. 2003; 49: 778-785.

14. Ziemer DC, Miller CD, Rhee MK. Clinical inertia con- tributes to poor diabetes control in a primary care setting. Diabetes Educ. 2005; 31: 564-571.

15. Anonymous. Službene novine Federacije BiH. Zakon o sustavu poboljšanja kvalitete, sigurnosti i o akreditaciji u zdravstvu 2005; 59: 5007-5013.

16. Šabanovic F, Selimbašic I, Pavlovic J, Leovac Lj, Cepo M, Mercvajer M i sur. U: Akreditacijski standardi za timove porodiène/obiteljske medicine- verzija 3.3 (ur.) Riğanovic Z, Nakaš B, Ceric K. Sarajevo. AVICENA 2005; 27-29.

17. Anonymous. Europski vodiè za prevenciju kardiovaskularnih bolesti u klinièkoj praksi. European Heart Journal 2003; 24 (17): 1601-1610 and European Journal of Cardiovascular Prevention and Rehabilitation. 2003; 10 (4):. 1-11.

18. Stevic S. Agencija za akreditaciju i napreğenje kvaliteta zdravstvene zaštite Republike Srpske. Vodiè kroz akreditaciju za ambulante/timove porodiène medicine 2006; 27-29.

19. Rothman AA, Wagner EH. Chronic Illness Management: What is Role of Primary Care? Ann Intern Med. 2003; 138: 256-261.

20. Riğanovic Z, Nakaš B, Ceric K. Klinièke usluge. Standard: Diabetes mellitus. U: Akreditacijski standardi za timove porodiène / obiteljeske medicine Sarajevo. AKAZ, 2008; 109-110.

21. Ornstein S, Nietert PJ, Jenkins GR, Wessell AM, Nemeth LS, Feifer C, Corley ST. Improving Diabetes Care Through a Multicomponent Quality Improvement Model in a Practice-based research Network. American Journal of Medica Quality 2007; 1: 34- 41.

22. Gavran L, Brkic S, Nuhbegovic S, Sivic S, Batic-Mujanovic O, Beganlic A. Improvement in Monitoring of Type 2 Diabetes Mellitus (DM) done by Family Medicine Teams after implementation of DM flowcharts. Acta Informatica Medica. 2009; 17 (1): 15-19.

23. Beciragic A, Bilic-Komarica E, Junuzovic Dz. The Importance of HbA1C Control in Patients with Subclinical Hypothyroidism. Mat Soc Med. 2012 Dec; 24(4): 212-219.

Leave a reply

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <s> <strike> <strong>