ArticleBMJ open2022
Primary care service utilisation and outcomes in type 2 diabetes: a longitudinal cohort analysis.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
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Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 26 citations in OpenAlex.
- What are the consequences of over and undertreatment of type 2 diabetes mellitus in a frail population? A systematic review.Endocrinology, diabetes & metabolism · 2024Pooled it
- Effectiveness of the chronic care model for adults with type 2 diabetes in primary care: a systematic review and meta-analysis.Systematic reviews · 2022Pooled it
- Impact of 12-Month mHealth Home Telemonitoring on Clinical Outcomes in Older Individuals With Hypertension and Type 2 Diabetes: Multicenter Randomized Controlled Trial.JMIR mHealth and uHealth · 2025Trial
- Implementing SGLT2 Inhibitor Therapy in Line with the New NICE Guidelines for Type 2 Diabetes Management.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2026Review
- Association of kidney function impairment with healthcare service utilisation in individuals with type 2 diabetes: an observational follow-up study in primary care.BMC health services research · 2025Observational
- Modifiable and Non-Modifiable Risk Factors and Vascular Damage Progression in Type 2 Diabetes: A Primary Care Analysis.Journal of clinical medicine · 2025Article
- SGLT2 Inhibitors - The New Standard of Care for Cardiovascular, Renal and Metabolic Protection in Type 2 Diabetes: A Narrative Review.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2024Review
- Use of primary health care services and mortality in older patients with type 2 diabetes with or without comorbidities.Scandinavian journal of primary health care · 2023Article
- Effect of physical activity counselling on the number of contacts in primary healthcare, specialised healthcare and the related healthcare costs among patients with type 2 diabetes: a register-based evaluation study.BMJ public health · 2023Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo describe primary care utilisation patterns among adults with type 2 diabetes and to quantify the association between utilisation and long-term health outcomes.
designRetrospective cohort study.
setting168 primary care practices in Southern England within the Electronic Care and Health Information Analytics database between 2013 and 2020.
participants110 240 adults with Quality and Outcomes Framework read code of type 2 diabetes diagnosis; age greater than 18 years; linked and continuous records available from April 2013 until April 2020 (or death). PRIMARY AND SECONDARY OUTCOME MEASURES: (1) Rates of service utilisation (total number of primary care contacts per quarter) across the study period; (2) participant characteristics associated with higher and lower rates of service utilisation; and (3) associations between service utilisation and (A) cardiovascular disease (CVD events) and (B) all-cause mortality.
resultsMean (SD) number of primary care attendances per quarter in the cohort of 110 240 went from 2.49 (2.01) in 2013 to 2.78 (2.06) in 2020. Patients in the highest usage tertile were more likely to be female, older, more frail, white, from the least deprived quintile and to have five or more comorbidities. In adjusted models, higher rates of service utilisation (per consultation) were associated with higher rates of CVD events (OR 1.0058; 95% CI 1.0053 to 1.0062; p<0.001) and mortality (OR 1.0057; 95% CI 1.0051 to 1.0064; p<0.001).
conclusionsPeople with type 2 diabetes are using primary care services more frequently, but increased volume of clinical care does not correlate with better outcomes, although this finding may be driven by more unwell patients contacting services more frequently. Further research on the nature and content of contacts is required to understand how to tailor services to deliver effective care to those at greatest risk of complications.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.