Evidence map›Paper›PMID 32709758›Full record

ArticleBMJ open diabetes research & care2020

Assessing guideline adherence in the management of type 1 diabetes mellitus in Australian children: a population-based sample survey.

Richard G McGee, Chris T Cowell, Gaston Arnolda, Hsuen P Ting, Peter Hibbert, S Bruce Dowton, Jeffrey Braithwaite

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Article in BMJ open diabetes research & care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

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4citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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4 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Richard G McGeeCentral Coast Clinical School, The University of Newcastle Faculty of Health and Medicine, Callaghan, New South Wales, Australia richard.mcgee@health.nsw.gov.au.ORCID 0000-0002-3125-8253
Chris T CowellThe University of Sydney Children's Hospital Westmead Clinical School, Sydney, New South Wales, Australia.
Gaston ArnoldaAustralian Institute of Health Innovation, Faculty of Medicine and Health Sciences, Macquarie University, New South Wales, Australia.
Hsuen P TingAustralian Institute of Health Innovation, Faculty of Medicine and Health Sciences, Macquarie University, New South Wales, Australia.
Peter HibbertAustralian Institute of Health Innovation, Faculty of Medicine and Health Sciences, Macquarie University, New South Wales, Australia.
S Bruce DowtonAustralian Institute of Health Innovation, Faculty of Medicine and Health Sciences, Macquarie University, New South Wales, Australia.
Jeffrey BraithwaiteAustralian Institute of Health Innovation, Faculty of Medicine and Health Sciences, Macquarie University, New South Wales, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionTo estimate adherence to clinical practice guidelines in selected settings at a population level for Australian children with type 1 diabetes mellitus. RESEARCH DESIGN AND

methodsMedical records of children with type 1 diabetes mellitus aged 0-15 years in 2012-2013 were targeted for sampling across inpatient, emergency department and community visits with specialist pediatricians in regional and metropolitan areas and tertiary pediatric hospitals in three states where approximately 60% of Australian children reside. Clinical recommendations extracted from two clinical practice guidelines were used to audit adherence. Results were aggregated across types of care (diagnosis, routine care, emergency care).

resultsSurveyors conducted 6346 indicator assessments from an audit of 539 healthcare visits by 251 children. Average adherence across all indicators was estimated at 79.9% (95% CI 69.5 to 88.0). Children with type 1 diabetes mellitus have higher rates of behavioral and psychological disorders, but only a third of children (37.9%; 95% CI 11.7 to 70.7) with suboptimal glycemic control (eg, hemoglobin A1c >10% or 86 mmol/mol) were screened for psychological disorders using a validated tool; this was the only indicator with <50% estimated adherence. Adherence by care type was: 86.1% for diagnosis (95% CI 76.7 to 92.7); 78.8% for routine care (95% CI 65.4 to 88.9) and 83.9% for emergency care (95% CI 78.4 to 88.5).

conclusionsMost indicators for care of children with type 1 diabetes mellitus were adhered to. However, there remains room to improve adherence to guidelines for optimization of practice consistency and minimization of future disease burden.

Indexed as

Diabetes Mellitus, Type 1Guideline AdherenceAustraliaChildDelivery of Health CareEmergency Service, HospitalHumanschildren's quality of careclinical practice guidelinespediatric type 1 diabetes

Identifiers

PMID32709758
PMCPMC7380831

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