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Quality statement

People with diabetes agree with their healthcare professional to start, review and stop medications to lower blood glucose, blood pressure and blood lipids in accordance with NICE guidance.

Quality measure

Structure

Evidence of local arrangements to ensure that people with diabetes agree with their healthcare professional to start, review and stop medications to lower blood glucose, blood pressure and blood lipids in accordance with NICE guidance.

Process

a) Proportion of people with diabetes who have received a medication review in the past 12 months.

Numerator - the number of people in the denominator receiving a review of medication in the past 12 months.

Denominator - the number of people with diabetes.

b) Proportion of people with diabetes whose blood glucose, blood pressure and blood lipids are managed in accordance with NICE guidance.

Numerator - the number of people in the denominator whose blood glucose, blood pressure and blood lipids are managed in accordance with NICE guidance.

Denominator - the number of people with diabetes.

c) Proportion of people with diabetes whose medications are not managed according to NICE guidance who have medical notes documenting clinical reasons for exception.

Numerator - the number of people in the denominator who have medical notes documenting clinical reasons for exception.

Denominator- the number of people with diabetes whose medications are not managed according to NICE guidance.

Outcome

Proportion of people with diabetes with a documented HbA1c between 48 mmol/mol and 58 mmol/mol (6.5% and 7.5%).

Numerator - the number of people in the denominator with a documented HbA1c between 48 mmol/mol and 58 mmol/mol (6.5% and 7.5%).

Denominator - the number of people with diabetes.

Description of what the quality statement means for each audience

Service providers ensure that people with diabetes are able to agree with their healthcare professional to start, review and stop medications to lower blood glucose, blood pressure and blood lipids in accordance with NICE guidance.

Healthcare professionals ensure the person with diabetes understands and agrees with them to start, review and stop medication to lower blood glucose, blood pressure and blood lipids in accordance with NICE guidance.

Commissioners ensure they commission services that enable the person with diabetes to agree with their healthcare professional to start, stop and review blood glucose, blood pressure and blood lipid lowering medications in accordance with NICE guidance.

People with diabetes agree with their healthcare professional to start, review and stop medications to lower blood glucose, blood pressure, and blood lipids (blood fats).

Source clinical guideline references

NICE clinical guideline 87 recommendations 1.5-1.8.

NICE clinical guideline 15 recommendation sections 1.9 and 1.10.

Data source

Structure

Local data collection. DiabetesE collects data on medication.

Process

a) Local data collection. Quality and Outcomes Framework (QOF) indicator DM 15 The percentage of patients with diabetes with a diagnosis of proteinuria or micro-albuminuria who are treated with angiotensin-converting enzyme inhibitors (or A2 antagonists).

b) Local data collection. QOF DM 26 The percentage of patients with diabetes in whom the last IFCC-HbA1c is 59 mmol/mol (equivalent to HbA1c of 7.5% in DCCT values) or less (or equivalent test/reference range depending on local laboratory) in the preceding 15 months. QOF DM 31 The percentage of patients with diabetes in whom the last blood pressure is 140/80 or less in the preceding 15 months. QOF indicator DM 17 The percentage of patients with diabetes whose last measured total cholesterol within the previous 15 months is 5mmol/l or less. NICE clinical guideline 87 Audit support clinical criteria, criteria 6-21, 23-27, 30 and 34.

Process measure a) and b) will be measured by the next phase of the National Diabetes Audit in which all diabetes medications will be collected at patient level.

c) Local data collection.

Outcome

DiabetesE and The National Diabetes Audit collect data on HbA1c levels. Quality and Outcomes Framework indicator (QOF) DM 26 The percentage of patients with diabetes in whom the last IFCC-HbA1c is 59 mmol/mol (equivalent to HbA1c of 7.5% in DCCT values) or less (or equivalent test/reference range depending on local laboratory) in the preceding 15 months.

Definitions

People with diabetes will start, review and stop medications in accordance with NICE clinical guidance 87 recommendations 1.5 -1.8. and NICE clinical guideline 15 recommendation sections 1.9 and 1.10.

Healthcare professionals managing medications for people with diabetes should document the clinical reasons why NICE guidance is not followed for starting and stopping medications to lower blood glucose, blood pressure and blood lipids.

This page was last updated: 25 March 2011

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Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.

Selected, reliable information for health and social care in one place

Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.

Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.