Do financial incentives improve the treatment of diabetes in Swiss primary care?

Not Applicable

Completed

• Conditions: Diabetes mellitus; Nutritional, Metabolic, Endocrine

• Registration Number: ISRCTN13305645
• Lead Sponsor: Institute of Primary Care

Brief Summary

2018 Protocol article in https://pubmed.ncbi.nlm.nih.gov/29961043/ protocol 2021 Results article in https://pubmed.ncbi.nlm.nih.gov/33904045/ (added 28/04/2021) 2021 Results article in https://doi.org/10.3389/fmed.2021.664510 Follow up analysis (added 19/05/2023)

Detailed Description

Not available

Study Timeline

• Results First Posted: 1900-01-01
• Study Start: 2018-03-20
• Study Completion: 2021-06-30
• Last Update Posted: 29 May 2023

Recruitment & Eligibility

• Status: Completed
• Sex: All
• Target Recruitment: 71

Inclusion Criteria

Up to December 2017, 290 GPs from 14 German speaking cantons of Switzerland participated in the FIRE project. In December 2017, the database contained data of 3,372,343 encounters of 345,811 patients. The FIRE database, consisting of administrative data, vital signs (blood pressure), lab values (Hba1c), diagnostic codes (ICPC-2), and medication data (ATC codes) provides the database for the project. Structural data on participating GP practices (physicians’ age and training, practice type (single-handed, double or group practice) and location, laboratory connection) are collected at individual FIRE project entry.

PCPs are eligible for the current study based on the FIRE database, if the dataset of 2017 is complete and a minimum threshold of 0.1 is achieved for the process indicators HbA1c and blood pressure, to rule out technical problems.

Of the eligible PCPs, primary care patients with diabetes mellitus will be identified from the FIRE database according to the following criteria:
1. Patient with ICPC-2 codes T89 (insulin dependent diabetes mellitus) and T90 (insulin independent diabetes mellitus)
2. Patients with antidiabetic medication (oral antidiabetics and/or insulin) according to the pharmaceutical cost group (PCG) (A10A/A10B)

Exclusion Criteria

Incomplete data set of 2017 and/or a minimum threshold of 0.1 is not achieved for the process indicators HbA1c and blood pressure

Study & Design

• Study Type: Interventional
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Obtained from the FIRE database at baseline, 12 and 24 months:<br>1. Proportion of diabetic patients with last blood pressure measurement < 140/85 mmHg (clinical QI)<br>2. Proportion of diabetic patients with at least one measurement of HbA1c in the preceding 12 months (process QI)

Secondary Outcome Measures

Name	Time	Method
Obtained from the FIRE database at baseline, 12 and 24 months:<br>1. Proportion of diabetic patients with at least one blood pressure measurement in the preceding 12 months (process QI)<br>2. Proportion of diabetic patients with HbA1c levels < 7.5% (clinical QI)<br>3. Proportion of diabetic patients with at least one cholesterol measurement in the preceding 12 months (process QI)<br>4. Proportion of diabetic patients with total cholesterol < 5 mmol/l (clinical QI)