Grant: Operating Grant: Population Health Intervention Research

Diabetes is a common and serious chronic disease. However, there is a large gap between the level of care that people should receive (based on research and guidelines) and the level of care they actually receive. With the release of their 2008 Clinical Practice Guidelines, the Canadian Diabetes Association has a strategy to improve heart disease screening and treatment for people with diabetes. This study will evaluate whether the strategy works. The CDA¿s strategy will begin in 2009. The focus of the strategy is to give all family physicians in Canada two tools to help them delivery better care for their diabetic patients: one is a short checklist on how to test for and treat heart disease; the other is a four-page synopsis of the Clinical Practice Guidelines. We will do three studies to measure the effectiveness of this strategy: 1) We will look at the quality of care received by patients by examining the charts of people with diabetes in family doctors¿ offices. 2) We will look at health care system data from the Ministry of Health to see if there were changes in the use heart tests, referrals to cardiologists, and heart disease medications by people with diabetes over time. 3) We will gather focus groups of family doctors to discover whether or not the CDA¿s tools are acceptable and useable. Diabetes is associated with very high rates of heart disease, but risk factors are not treated aggressively enough. Therefore, the potential impact of improved detection and treatment of heart disease is enormous.