Diabetes Collaborative Registry releases baseline, quality of care data

Clinicians submitting data to the Diabetes Collaborative Registry regularly adhere to 4 out of 7 diabetes quality metrics when treating patients with diabetes, according to the first presented results from the registry. Registry data will be presented and published in two abstracts at the American Diabetes Association's 76th Scientific Sessions, June 10-14 in New Orleans.

In the first quarter of 2016, the Diabetes Collaborative Registry reached the milestone of 1 million unique patients with diabetes in its database. The rapid growth of the registry since its launch in 2014 will allow for an increasingly detailed view into how patients with diabetes are managed in real world clinical settings.

"Highlighting variability in diabetes care is one of the key objectives of the registry," said Mikhail N. Kosiborod, M.D., FACC, senior author of the study, cardiologist and professor of medicine at Saint Luke's Mid America Heart Institute, and steering committee chair of the Diabetes Collaborative Registry. "Our hope is that over time the lessons we learn will foster more of a team-based approach to diabetes management, which may ultimately result in better quality and outcomes for patients with diabetes."

"Achieving the important milestone of 1 million patients enrolled defines the Diabetes Collaborative Registry as a benchmarking registry that can inform research initiatives focusing on unique opportunities to improve patients' quality of care in the U.S. and beyond," said Niklas Hammar, Ph.D., Senior Director, Global Medical Affairs at AstraZeneca and member of the Registry's Stakeholder Advisory Panel. Dr. Hammar is also an adjunct professor of epidemiology at Karolinska Institutet.

Patients with diabetes often receive treatments across multiple medical specialties for a multitude of related conditions. The Diabetes Collaborative Registry was established to allow for a longitudinal study of diabetes across all stages of the disease—including presentation, progression, management and outcomes—even as patients receive treatment from multidisciplinary care teams. The abstracts presented at the ADA Scientific Sessions include the growing number of patients with diabetes in the ACC's PINNACLE Registry, which is the nation's largest ambulatory cardiovascular registry.

In the first research presented from the registry, researchers looked at adherence to seven quality metrics at 236 practices with 861,699 patients. Practices checked if patients are on high blood pressure medication 73 percent of the time; screened for kidney disease 70 percent of the time; checked if patients had a blood pressure less than 140/90 mm Hg and were prescribed at least two antihypertensive medications 89 percent of the time; and screened for smoking and counseled smokers to quit 85 percent of the time. The lowest performance levels were seen when checking blood glucose levels and performing an eye or foot exam at 20 percent, 11 percent and 1.2 percent, respectively.

The low rates of performance on some performance measures may be attributable to lack of documentation, true gaps in care or a combination of these factors, all of which indicate opportunities for providers, including cardiology practices, to improve chronic disease management for patients with diabetes. Researchers also acknowledged that lower adherence to some measures may be because a majority of patients in the initial registry cohort were managed by cardiology providers. These providers typically would not conduct a blood glucose test or eye and foot exams.

The registry also released baseline data showing a high burden of cardiovascular risk factors and complications among patients. This reflects both the cardiovascular risk associated with Type 2 Diabetes and the large number of cardiology practices contributing patients to the first cohort in the registry. Researchers said the picture of diabetes care will likely evolve as additional specialty sites and primary care centers continue to join the registry and the patient cohort grows beyond the first 1 million patients.