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SCOTTISH DIABETES SURVEY 2002
DISCUSSION
The 2002 Survey
The 2002 Survey demonstrates that NHS Boards have made significant progress in recording information that may be used to measure and understand the quality of diabetes care in Scotland. It is clear that considerable work is still required to capture information for all people with diabetes in each area. It is perhaps a little disappointing that the number of registered patients is slightly reduced in this survey compared to the provisional survey of 2001, but the reasons for this are understood and it is anticipated that numbers will increase as NHS Boards provide information for all the patients in their area rather than for subgroups of patients.
The Scottish Diabetes Survey Monitoring Group believe the quality of information has improved significantly compared to that of the provisional survey. There is increased recording of CHI, diabetes retinopathy screening and recorded myocardial infarction. Information about modifiable vascular risk factors (blood pressure and cholesterol) is now available for many patients.
The introduction of the SCI-DC Clinical and Network systems will enable timely collection of information and greatly ease analysis of data in each NHS Board. As these systems become fully integrated into diabetes services, data quality should improve, thereby creating an increasingly valuable resource.
Future developments
In order to provide information which can be more easily compared across different NHS Boards, it is proposed that in the 2003 Survey report some (and perhaps all) of the data items will be presented in relation to the estimated prevalence. It is acknowledged that at present such estimates are rather crude. However, it is hoped that by next year it will be possible to improve upon the estimates included in this year's report.
In addition to improving the estimate of current prevalence, there is a need to produce a more accurate prediction of future trends. The suggestion that the prevalence of diabetes will double in the next 10-15 years is frequently repeated, but to date no work has been carried out to confirm the relevance of this projected increase to the Scottish context. The Monitoring Group will bring forward plans to produce figures for the estimated future prevalence of diabetes in Scotland.
The Monitoring Group suggest that a number of additional data items should be added to the Survey in 2003. These will be confirmed before the end of June 2003. We welcome comment on the relevance and practicality of these items.
Incident data. Number of patients newly diagnosed in 2000, 2001 and 2002.
Number of patients with
Type 2 aged under 35 years.
Number and percentage of patients
aged 45-64 achieving a
Blood Pressure target of 140/80.
Number and percentage of patients achieving
cholesterol target of <5.
Number and percentage of patients falling within different
BMI ranges- >18; 18-25; 25-30; 30-35; 35-40, 40+; not recorded.
Deprivation. Depcat scores of the registered diabetes population in comparison to the total NHS Board population.
In the absence of effective clinical management systems the collection of data for the Survey is time-consuming and difficult. Nevertheless, it should be possible for NHS Boards to submit data by the requested date. Starting in the 2003 report, the date when data are submitted will be published.
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