Glycated hemoglobin: A powerful tool not used enough in primary care. Issue 3 (30th August 2017)

• Record Type: Journal Article
• Authors: Salinas, Maria; López‐Garrigós, Maite; Flores, Emilio; Leiva‐Salinas, Carlos
• Other Names: Valero Vidal Pérez investigator.; Gascón Félix investigator.; Contreras Isidoro Herrera investigator.; Bailen García Maria Ángeles investigator.; Oyonarte Cristóbal Avivar investigator.; Fontana Esther Roldán investigator.; Cantalejo Fernando Rodríguez investigator.; Noval Padillo José Ángel investigator.; González García M Ángela investigator.; Rico Ignacio Vázquez investigator.; Santos Cristina investigator.; Marín Ángeles Giménez investigator.; del Señor López Vélez Maria investigator.; García Larios José Vicente investigator.; Luque Federico Navajas investigator.; Tapia Amado investigator.; Solé LLop Maria Esther investigator.; Puente Juan José investigator.; Esteve Patricia investigator.; Avello López Maria Teresa investigator.; Noguero Emilia Moreno investigator.; Follana Vázquez Ana Maria investigator.; Ribes Valles Jose Luis investigator.; de Lis Alonso Mª Luisa Fernández investigator.; Muros Mercedes investigator.; Martin Leopoldo Martin investigator.; Pico Picos Miguel Ángel investigator.; Cabrera Casimira Domínguez investigator.; Ruiz Marta Riaño investigator.; Molinos Juan Ignacio investigator.; Colomo Luis Fernando investigator.; Hoyos Marcos López investigator.; de Medio Enrique Prada investigator.; Chico Pilar García investigator.; Gómez‐Biedma Simón investigator.; Domínguez Vicente Granizo investigator.; Ruiz Guadalupe investigator.; Navarro Laura investigator.; Pena Fidel Velasco investigator.; Fernández Carolina Andrés investigator.; Carrera Oscar Herráez investigator.; Lorenzo Lozano Mª Carmen investigator.; Martínez Joaquín Domínguez investigator.; Carrera Oscar Herráez investigator.; Gil Maria Teresa investigator.; Rodríguez Rodríguez Mª Ángeles investigator.; Poncela García M. Victoria investigator.; Rabadán Luis investigator.; Villamandos Vicente investigator.; García Nuria Fernández investigator.; González Redondo José Miguel investigator.; García Cesáreo investigator.; Menéndez Luis García investigator.; Sastre Pilar Álvarez investigator.; Gómez Ovidio investigator.; LLovet Mabel investigator.; Serrat Nuria investigator.; Baz Mª José investigator.; Zaro Maria José investigator.; Plata M Carmen investigator.; Yun Pura García investigator.; Sánchez Milagrosa Macías investigator.; Martin Javier investigator.; Suarez Lola Máiz investigator.; Ponce Berta González investigator.; Magadan Concepcion investigator.; Andrade Olivie M. Amalia investigator.; Rodríguez Pastora investigator.; Herranz Puebla M. Mercedes investigator.; Soto Antonio Buño investigator.; Cava Fernando investigator.; Santos Raquel Guillén investigator.; Pascual Tomas investigator.; de Larramendi Carmen Hernando investigator.; Sánchez Raquel Blázquez investigator.; Díaz Pilar investigator.; Díaz Ana investigator.; Collía Marta García investigator.; Cuadrado Cenzual Maria Ángeles investigator.; Menchero Santiago Prieto investigator.; del Carmen Gallego Ramírez María investigator.; Quilez Fernández José Luis investigator.; Albaladejo Maria Dolores investigator.; López Yepes Maria Luisa investigator.; Martínez Alfonso Pérez investigator.; Urrutia Antonio López investigator.; Chércoles Adolfo Garrido investigator.; Medina Carmen Mar investigator.; Zugaza M Carmen investigator.; de Eguileor Manuel investigator.; Pesudo Silvia investigator.; Vinuesa Carmen investigator.; Díaz Julián investigator.; Graells Marisa investigator.; Benítez Diego Benítez investigator.; Carratalá Arturo investigator.; Tormo Consuelo investigator.; Miralles Francisco investigator.; Miralles Amparo investigator.; Barberà José Luis investigator.; Molina Juan investigator.; Yago Martin investigator.; Ortuño Mario investigator.; Martínez Llopis Maria José investigator.; Estañ Nuria investigator.; Molina Ricardo investigator.; Ferrero Juan Antonio investigator.; Marro Begoña Laiz investigator.; Marcaida Goitzane investigator.;
• Is Part Of: Journal of clinical laboratory analysis. Volume 32:Issue 3(2018)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2017-08-30
• Subjects: appropriateness -- diabetes -- glycated haemoglobin -- laboratory tests utilization; Diagnosis, Laboratory -- Periodicals; Medical laboratory technology -- Periodicals; 616
• DOI: 10.1002/jcla.22310
• Languages: English
• ISSNs: 0887-8013

Abstract

Abstract : Background: Glycated haemoglobin (HbA1c) is one of the most useful and relevant laboratory tests currently available. The aim of the actual research was to study the variability and appropriateness in the request of HbA1c in primary care, and differences between regions, to assess if there would be an opportunity to improve the request. Methods: A cross‐sectional study was conducted enrolling clinical Spanish laboratories. The number of HbA1c requested in 2014 by all general practitioners was reported by each participant. Test‐utilization rate was expressed as tests per 1000 inhabitants. The index of variability was calculated, as the top decile divided by the bottom decile. HbA1c per 1000 inhabitants was compared between the different regions. To investigate whether HbA1c was appropriately requested to manage patients with diabetes, the real request was compared to the theoretically ideal number, according to prevalence of known diabetes mellitus in Spain and guideline recommendations. Results: A total of 110 laboratories participated in the study, corresponding to a catchment area of 27 798 262 inhabitants (59.8% of the Spanish population) from 15 different autonomous communities (AACCs). 2 655 547 HbA1c were requested, a median of 93.9 (interquartile range (IQR): 33.4) per 1000 inhabitants. The variability index was 1.97. The HbA1c/1000 inhabitants was significantly different among the AACCs, ranging from 73.4 to 126.3. A total of 4 336 529 additional HbA1c would have been necessary to manage patients with diabetes according to guidelines, and 3 861 769 for diagnosis in asymptomatic patients. Conclusions: There was a high variability and significant differences between Spanish AACCs. Also a significant under‐request of HbA1c was observed in Primary Care in Spain.