Adherence to diabetes clinical practice guidelines to improve prevention and treatment of cardiovascular disease in Quebec: A retrospective cohort 2017-2020

Diabetes epidemiology and management(2022)

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摘要
• Identification and selection of quality indicators in Primary Care Health. • Retrospective cohort was used with patients with diabetes and/or cardiovascular disease between 2017 and 2020. • The prescriptions for statins, antiplatelet in secondary prevention and nephroprotective treatment (ACE/ARB) appear in accordance with the Diabetes Canada's 2018- Clinical Practice Guidelines (CPG) and stable from 2017 to 2020. • The prescriptions of antiplatelet medications in primary prevention is declining and the prescribing of new therapies (SGLT-2 / GLP-1) is increasing between 2017 and 2020, which is consistent with Diabetes Canada's 2018 CPG. Objective Assess adherence to the Diabetes Clinical Practice Guidelines (CPG) for the Prevention and Treatment of Cardiovascular Disease (CVD) in Family Medicine Groups (FMG) in Quebec. Methodology A retrospective cohort was used with patients with diabetes (PWD) and/or CVD, enrolled in a FMG and the Public Prescription Drug Plan (PPDP) between 2017 and 2020. Results Six adjusted indicators (gender and age) for the management of CVD in PWD aged 50 and over and enrolled in a FMG and the PPDP were calculated. In 2019-2020, among PWD with CVD, 82.0% were taking a statin, 71.9% were taking an antiplatelet, 66.5% were taking an angiotensin receptor (ARB) blocker or angiotensin-converting enzyme (ACE) inhibitor, and 25.5% were taking cardiac-protection therapies [ sodium/glucose cotransporter 2 (SGLT-2), Glucagon like peptide antagonist (GLP-1)]. Among PWD for 15 years, 50.4% take a statin, while in the absence of CVD, 36.1% take an antiplatelet. Conclusion The prescriptions for statin, antiplatelet and ACE/ARB appear in accordance with the CPG and stable from 2017 to 2020. Prescription of antiplatelet in primary prevention was declining between and SGLT-2/GLP-1 were increasing from 2017 to 2020, which is consistent with the recommendations from Diabetes Canada CPG.[ 1 ]
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adherence,clinical practice guidelines,diabetes,cardiovascular disease,retrospective cohort
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