Academic Journal
A cross-regional initiative for improving type 2 diabetes mellitus care quality measurement in Spain - The Diabetes Lighthouse project.
| Τίτλος: | A cross-regional initiative for improving type 2 diabetes mellitus care quality measurement in Spain - The Diabetes Lighthouse project. |
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| Συγγραφείς: | Arzuaga A; Novo Nordisk Pharma SA, Madrid, Spain. Electronic address: IAZA@novonordisk.com., García-Casanovas A; Hospital del Mar Research Institute, Barceloa, Spain. Electronic address: agarcia8@researchmar.net., Mas-Morán A; University and Polytechnic Hospital La Fe, Valencia, Spain. Electronic address: mas_alf@gva.es., Megia-Colet A; University Hospital Joan XXIII, Institut Catala de La Salut, Tarragona, Spain. Electronic address: amegia.hj23.ics@gencat.cat., Adam-Ruiz D; Primary Health Care Service Salvador Allende, Departament of Health La Fe, Valencia, Spain. Electronic address: adam_amp@gva.es., Barbazán-García E; IQVIA Spain, Madrid, Spain. Electronic address: elena.barbazan@iqvia.com., Daoud E; IQVIA Spain, Madrid, Spain. Electronic address: elza.daoud@iqvia.com., Bronchalo-Bautista H; IQVIA Spain, Madrid, Spain. Electronic address: hugo.bronchalo@iqvia.com., Roel-Conde J; Primary Health Care Service Guayaba, Madrid Health Service (SERMAS), Madrid, Spain. Electronic address: jaime.roelconde@salud.madrid.org., Merino-Torres JF; Department of Endocrinology and Nutrition, University and Polytechnic Hospital La Fe, Valencia, Spain; Departament of Medicina, Universidad de Valencia, Valencia, Spain. Electronic address: merino_jfr@gva.es., Conejos-Miquel MD; Quality and Safety Unit, Primary Care Management, Madrid Health Service (SERMAS), Madrid, Spain. Electronic address: cervera_inm@gva.es., Cervera-Pérez MI; Primary Health Care Service Campanar II, Departament of Health La Fe, Valencia, Spain. Electronic address: mdolores.conejos@salud.madrid.org., Leon-Sanz M; Department of Endocrinology and Nutrition, University Hospital 12 de Octubre, Madrid, Spain; Departament of Medicina, Universidad Complutense de Madrid, Madrid, Spain. Electronic address: miguel.leon@salud.madrid.org., García-Barrio N; University Hospital 12 de Octubre, Madrid, Spain. Electronic address: ngbarrio@salud.madrid.org., Ochoa-Gondar O; Primary Health Care Service Camp de Tarragona, Institut Catala de La Salut, Tarragona, Spain. Electronic address: oochoa.tgn.ics@gencat.cat., Alonso-Safont T; Information Systems Unit, Primary Care Management, Madrid Health Service (SERMAS), Madrid, Spain. Electronic address: mtamara.alonso@salud.madrid.org., Pascual V; Novo Nordisk Pharma SA, Madrid, Spain. Electronic address: VGPL@novonordisk.com. |
| Πηγή: | Primary care diabetes [Prim Care Diabetes] 2026 Oct; Vol. 20 (5), pp. 620-628. Date of Electronic Publication: 2026 Aug 10. |
| Τύπος έκδοσης: | Journal Article; Multicenter Study; Observational Study; Research Support, Non-U.S. Gov't |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Elsevier Country of Publication: England NLM ID: 101463825 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1878-0210 (Electronic) Linking ISSN: 18780210 NLM ISO Abbreviation: Prim Care Diabetes Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Kidlington, Oxford : Elsevier |
| Ιατρικοί όροι (MeSH): | Diabetes Mellitus, Type 2*/drug therapy , Diabetes Mellitus, Type 2*/diagnosis , Diabetes Mellitus, Type 2*/blood , Diabetes Mellitus, Type 2*/epidemiology , Glycemic Control*/standards , Glycemic Control*/adverse effects , Hypoglycemic Agents*/therapeutic use , Practice Patterns, Physicians'*/standards , Primary Health Care*/standards , Quality Improvement*/standards , Quality Indicators, Health Care*/standards, Biomarkers/blood ; Blood Glucose/metabolism ; Blood Glucose/drug effects ; Glycated Hemoglobin/metabolism ; Guideline Adherence/standards ; Practice Guidelines as Topic/standards ; Spain/epidemiology ; Aged ; Female ; Humans ; Male ; Middle Aged ; Electronic Health Records ; Retrospective Studies ; Time Factors ; Treatment Outcome ; Undertreatment ; Value-Based Health Care |
| Περίληψη: | Aims: To evaluate the quality of type 2 diabetes mellitus (T2DM) care and variability across three Spanish healthcare areas using a standardized set of quality indicators (QIs) applied to routine clinical data. Methods: This retrospective cohort study included 30,111 adults with T2DM drawn from electronic health records across three areas. Fifteen QIs, including nine process and six outcome indicators, were used to evaluate adherence to guideline-recommended monitoring and treatment. Results: For most QIs, adherence to process indicators was below 70%. Only 20.4% of patients had timely 6-month glycosylated hemoglobin (HbA1c) follow-up, and just 3.9% of those out-of-target received quarterly checks. Sixty percent of patients with cardiovascular or chronic kidney disease received sodium-glucose cotransporter type 2 inhibitors (SGLT2i) or glucagon-like peptide type 1 receptor agonists (GLP1ras) treatment, yet only 15% received combination therapy. GLP1ras were used by 1.5% of patients with obesity. Among out-of-target patients, 41% achieved a ≥ 1% HbA1c reduction. Insulin initiation was delayed a median of 7.7 years. Conclusions: In summary, applying a common set of indicators across three healthcare areas proved feasible and helped identify relevant gaps in T2DM care. The Diabetes Lighthouse initiative may support quality monitoring and benchmarking, and help guide targeted improvement strategies. (Copyright © 2026 The Authors. Published by Elsevier Ltd.. All rights reserved.) |
| Competing Interests: | Declaration of Competing Interest Elena Barbazán, Elza Daoud and Hugo Bronchalo are employees of IQVIA Spain. IQVIA Spain has received consulting fees from Novo Nordisk Pharma SA to support the project. Alazne Arzuaga and Virginia Pascual are employees of Novo Nordisk Pharma SA. The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. |
| Contributed Indexing: | Keywords: Benchmarking; Primary care; Quality indicators; Real-world data; Spain; Type 2 diabetes mellitus |
| Substance Nomenclature: | 0 (Biomarkers) 0 (Blood Glucose) 0 (Glycated Hemoglobin) 0 (hemoglobin A1c protein, human) 0 (Hypoglycemic Agents) |
| Entry Date(s): | Date Created: 20260810 Date Completed: 20260907 Latest Revision: 20261015 |
| Update Code: | 20261015 |
| DOI: | 10.1016/j.pcd.2026.07.013 |
| PMID: | 42575755 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1878-0210 |
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| DOI: | 10.1016/j.pcd.2026.07.013 |