Computer feedback helps docs treat diabetes

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A computerized system that tells primary care physicians how well they are managing blood sugar levels in their diabetic patients seems to improve diabetes control, new research suggests.

Proper blood sugar control can improve diabetes outcomes and numerous treatment guidelines drive home this point, yet sugar control among diabetics in the US has been getting worse over the years. This trend may reflect “clinical inertia,” meaning that doctors are not intensifying diabetes therapy when indicated.

In a 3-year study, Dr. Lawrence S. Phillips, from Emory University Hospital in Atlanta, and colleagues evaluated computerized performance feedback as a means of overcoming clinical inertia among 345 young doctors treating a predominantly African American population. A total of 4038 diabetic patients were included in the analysis.

The doctors were randomized to a usual-care group or to groups that received computerized reminders, or feedback on how well their patients were doing, or both. The results are reported in the Archives of Internal Medicine.

The interventions that incorporated performance feedback were better at intensifying diabetes therapy than were the usual-care or reminder-only interventions.

Further analysis confirmed that performance feedback predicted treatment intensification, which in turn led to better blood sugar control.

“To the extent that limitations in healthcare provider behavior—clinical inertia—constitute a major barrier to diabetes management, our model may have broad application to improve patient outcomes and to decrease the clinical and economic impact of diabetes in the primary care setting,” the authors conclude.

SOURCE: Archives of Internal Medicine, March 13, 2006.

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