Patients’ experiences with patient-centred care are associated with documented outcome of care indicators for diabetes: findings from the Leuven Diabetes Project — Borgermans et al. 15 (3): 65 — International Journal of Care Pathways.
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Summary: Assessment of diabetes care quality increasingly integratesmeasurements of patient perceptions. With escalating demandfor diabetic services, it is critical to evaluate patients’experiences with patient-centred care and their associationwith outcome of care indicators. Global satisfaction and experienceswith patient-centred care were evaluated in patients with type2 diabetes. Patients participated in a quality improvement programmeset-up as a two-arm clustered randomized trial. The Usual QualityImprovement Programme (UQIP) targeted clinical inertia in primarycare physicians. The Advanced Quality Improvement Programme(AQIP) aimed to reduce the rate of clinical inertia and improvethe provision of patient-centred care. Objective measures ofpatient-centred care, including overall satisfaction with careand measures related to health promotion, were associated withmean levels of glycosylated haemoglobin (HbA1c), low-densitylipoprotein cholesterol (LDLc) and systolic blood pressure (SBP),measured after 18 months of intervention. The patient responserate was 55.4%. Fifty-nine per cent of patients were very satisfiedwith quality of care. Overall satisfaction scores and patients’experiences with patient-centred care, did not significantlydiffer between AQIP and UQIP. The association between overallsatisfaction with care and HbA1c levels significantly differedbetween AQIP and UQIP (P = 0.048). Overall satisfaction withcare and LDLc levels did not significantly differ between AQIPand UQIP, or among all patients. The association between overallsatisfaction with care and SBP levels, significantly differedbetween AQIP and UQIP (P = 0.004). Positive experiences withsupport in the use of oral antidiabetic agents were associatedwith significantly lower levels of HbA1c in all patients (P= 0.006). Positive experiences with information provision ondiabetes mellitus were associated with significantly lower levelsof LDLc and SBP (P = 0.036 and 0.010, respectively), as wereexperiences with information provision on medical treatment(LDLc, P = 0.005; SBP, P = 0.003). In conclusion, results showrelatively good performance in both overall satisfaction withquality of care and in all patient-centredness measures examined.Overall satisfaction and measures of patient-centred care areassociated with improved outcomes of care, although not consistently.