Table 1 Results from evaluation of candidate indicators
Indicator | Validity | Feasibility | Result of the validation process | Programmable in the EHR |
|---|---|---|---|---|
I. Process indicators | Average | |||
A. Timely detection of T2D complications and comorbidity in the last year | ||||
1. At least one measurement of HbA1c | 8.7 | 7.8 | Accepted | Programmable |
2. Comprehensive foot evaluation | 8.7 | 8.2 | Accepted | Programmable |
3. Referral to the ophthalmologist | 8.3 | 7.7 | Accepted | Programmable |
4. Screening for microalbuminuria through the ratio albumin/creatinine | 8.5 | 5.7 | Discarded | |
5. Measurement of creatinine and rate of glomerular filtration | 8.7 | 5.3 | Discarded | |
6. Screening for dyslipidemia by measuring total cholesterol in patients without previous diagnosis of dyslipidemia | 8.5 | 7.8 | Accepted | Programmable |
B. Non pharmacological treatment in the last year | ||||
7. Smoking cessation counseling for current smokers | 8.2 | 8 | Accepted | Not Programmable |
8. Advise to moderate alcohol consumption | 6.0 | 5.8 | Discarded | |
9. Nutritional counseling provided by the nutrition service | 7.8 | 7.8 | Accepted | Programmable |
10. Advise to practice aerobic physical exercise of moderate intensity, at least 150 minutes per week, unless contraindicated | 8.2 | 8.0 | Accepted | Not Programmable |
11. Registration of adherence to dietary recommendations | 8.5 | 7.0 | Accepted | Not Programmable |
12. Registration of adherence to aerobic physical exercise | 8.5 | 7.0 | Accepted | Not Programmable |
C. Pharmacological treatment in the last three visits | ||||
13. Overweight/obese (BMI ≥ 25 kg/m2) patients who received metformin, unless contraindicated* | 8.7 | 8.5 | Accepted | Programmable |
14. Patients with HbA1c ≥ 8, or with an average fasting blood glucose of ≥140 mg/dl in the last 3 months, who had registered: a) recommendations to modify their diet and physical exercise, b) referral to a social work group; c) modification in their scheme of treatment. | 8.7 | 6.3 | Discarded | |
15. Patients with HbA1c ≥ 8, or with an average fasting blood glucose of ≥140 mg/dl in the last 3 months, who had registered adherence to the pharmacological treatment. | 8.5 | 6.8 | Discarded | |
16. Patients with hypertension receiving inhibitors of angiotensin converting enzyme or angiotensin-receptor blocker, otherwise contraindicated** | 8.5 | 8.5 | Accepted | Programmable |
17. Patients > 40 years of age with one or more of the following risk factors: smoking, hypertension, dyslipidemia, receiving 75-150 mg/day of acetylsalicylic acid, unless contraindicated*** | 8.5 | 8.2 | Accepted | Programmable |
18. Patient with total cholesterol >200 mg/dl and were prescribed statins, unless contraindicated**** | 8.2 | 8.3 | Accepted | Programmable |
II. Health outcomes indicators | ||||
19. HbA1c <7% or fasting glucose ≤130 mg/dl in the last 3 measurements | 8. 7 | 8.3 | Accepted | Programmable |
20. Total cholesterol levels < 200 mg/dl in the last measurement | 8. 7 | 8.2 | Accepted | Programmable |
21. Blood pressure <130/80 mmHg in the last 3 measurements | 8. 7 | 8.5 | Accepted | Programmable |
22. Overweight/obese (BMI ≥ 25 kg/m2) patients who lost ≥5% body weight in the last year | 8.0 | 7. 7 | Accepted | Programmable |
Composed indicator of health outcomes | ||||
23. Patients with HbA1c <7%, or fasting glucose ≤130 mg/dl, total cholesterol levels < 200 mg/dl and blood pressure <130/80 mmHg in the last 3 measurements | 8.5 | 7.5 | Accepted | Programmable |