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Glucose test provenance recording in UK primary care: was that fasted or random?

McGovern, AP, Fieldhouse, H, Tippu, Z, Jones, S, Munro, N and de Lusignan, S (2016) Glucose test provenance recording in UK primary care: was that fasted or random? Diabet Med.

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AIMS: To describe the proportion of glucose tests with unrecorded provenance in routine primary care data and identify the impact on clinical practice. METHODS: A cross-sectional analysis was conducted of blood glucose measurements from the Royal College of General Practitioner Research and Surveillance Centre database, which includes primary care records from >100 practices across England and Wales. All blood glucose results recorded during 2013 were identified. Tests were grouped by provenance (fasting, oral glucose tolerance test, random, none specified and other). A clinical audit in a single primary care practice was also performed to identify the impact of failing to record glucose provenance on diabetes diagnosis. RESULTS: A total of 2 137 098 people were included in the cross-sectional analysis. Of 203 350 recorded glucose measurements the majority (117 893; 58%) did not have any provenance information. The most commonly reported provenance was fasting glucose (75 044; 37%). The distribution of glucose values where provenance was not recorded was most similar to that of fasting samples. The glucose measurements of 256 people with diabetes in the audit practice (size 11 514 people) were analysed. The initial glucose measurement had no provenance information in 164 cases (64.1%). A clinician questioned the provenance of a result in 41 cases (16.0%); of these, 14 (34.1%) required repeating. Lack of provenance led to delays in the diagnosis of diabetes [median (range) 30 (3-614) days]. CONCLUSIONS: The recording of glucose provenance in UK primary care could be improved. Failure to record provenance causes unnecessary repeated testing, delayed diagnosis and wasted clinician time. This article is protected by copyright. All rights reserved.

Item Type: Article
Subjects : Health Care Management
Divisions : Faculty of Arts and Social Sciences > Surrey Business School
Authors :
Date : 16 January 2016
Identification Number : 10.1111/dme.13067
Copyright Disclaimer : Copyright 2016 The Authors. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes
Related URLs :
Depositing User : Symplectic Elements
Date Deposited : 08 Jun 2016 16:40
Last Modified : 26 Jul 2016 10:09

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