Long-term quality-of-care score for predicting the occurrence of acute myocardial infarction in patients with type 2 diabetes mellitus

doi:10.4239/wjd.v14.i7.1091

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Title:	Long-term quality-of-care score for predicting the occurrence of acute myocardial infarction in patients with type 2 diabetes mellitus
Authors:	Li, Pi-, I Guo, How-Ran
Contributors:	Chi Mei Med Ctr, Dept Family Med Chia Nan Univ Pharm & Sci, Dept Pharm Natl Cheng Kung Univ, Coll Med, Dept Environm & Occupat Hlth Natl Cheng Kung Univ Hosp, Dept Occupat & Environm Med Natl Cheng Kung Univ, Coll Med, Dept Environm & Occupat Hlth
Keywords:	Acute myocardial infarction Cardiovascular disease Diabetes mellitus Quality-of-care Score
Date:	2023
Issue Date:	2024-12-25 11:05:32 (UTC+8)
Publisher:	BAISHIDENG PUBLISHING GROUP INC
Abstract:	BACKGROUNDCardiovascular disease (CVD) is the leading cause of death globally, and diabetes mellitus (DM) is a well-established risk factor. Among the risk factors for CVD, DM is a major modifiable factor. In the fatal CVD outcomes, acute myocardial infarction (AMI) is the most common cause of death.AIMTo develop a long-term quality-of-care score for predicting the occurrence of AMI among patients with type 2 DM on the basis of the hypothesis that good quality of care can reduce the risk of AMI in patients with DM.METHODSUsing Taiwan's Longitudinal Cohort of Diabetes Patient Database and the medical charts of a medical center, we identified incident patients diagnosed with type 2 DM from 1999 to 2003 and followed them until 2011. We constructed a summary quality-of-care score (with values ranging from 0 to 8) with process indicators (frequencies of HbA(1c) and lipid profile testing and urine, foot and retinal examinations), intermediate outcome indicators (low-density lipoprotein, blood pressure and HbA(1c)), and co-morbidity of hypertension. The associations between the score and the incidence of AMI were evaluated using Cox regression models.RESULTSA total of 7351 patients who had sufficient information to calculate the score were enrolled. In comparison with participants who had scores = 1, those with scores between 2 and 4 had a lower risk of developing AMI [adjusted hazard ratio (AHR) = 0.71; 95% confidence interval (95%CI): 0.55-0.90], and those with scores = 5 had an even lower risk (AHR = 0.37; 95%CI: 0.21-0.66).CONCLUSIONGood quality of care can reduce the risk of AMI in patients with type 2 DM. The quality-of-care score developed in this study had a significant association with the risk of AMI and thus can be applied to guiding the care for these patients.
Relation:	World Journal of Diabetes, v.14, n.7, pp.1091-1102
Appears in Collections:	[Dept. of Pharmacy] Periodical Articles

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