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Med."],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>To assess population, general practitioner (<jats:styled-content style=\"fixed-case\">GP<\/jats:styled-content>) and practice characteristics associated with the performance of microvascular screening procedures and to propose strategies to improve Type 2 diabetes care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cross\u2010sectional survey in Norway (281 <jats:styled-content style=\"fixed-case\">GP<\/jats:styled-content>s from 77 practices) identified 8246 people with a Type 2 diabetes duration of 1\u00a0year or more. We used multilevel regression models with either the recording of at least two of three recommended screening procedures (albuminuria, monofilament, eye examination) or each procedure separately as dependent variable (yes\/no), and characteristics related to the person with diabetes, <jats:styled-content style=\"fixed-case\">GP<\/jats:styled-content> or practice as independent variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The performance of recommended screening procedures was recorded in the following percentages: albuminuria 31.5%, monofilament 27.5% and eye examination 60.0%. There was substantial heterogeneity between practices, and between <jats:styled-content style=\"fixed-case\">GP<\/jats:styled-content>s within practices for all procedures. Compared with people aged 60\u201369\u00a0years, those aged &lt;\u00a050\u00a0years were less likely to have an albuminuria test performed [odds ratio (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>) 0.75, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.61 to 0.93] and eye\u00a0examination (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 0.79, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.66 to 0.95). People with macrovascular disease had fewer screening procedures recorded (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 0.68, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.59 to 0.78). Use of an electronic diabetes form was associated with improved screening\u00a0\u00a0(<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 2.65, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.86 to 3.78). <jats:styled-content style=\"fixed-case\">GP<\/jats:styled-content>s with high workload recorded fewer procedures (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 0.59, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.39 to 0.90).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Performance of screening procedures was suboptimal overall, and in people who should be prioritized. Performance varied substantially between <jats:styled-content style=\"fixed-case\">GP<\/jats:styled-content>s and practices. The use of a structured diabetes form should be mandatory.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.13842","type":"journal-article","created":{"date-parts":[[2018,10,21]],"date-time":"2018-10-21T09:36:21Z","timestamp":1540114581000},"page":"1431-1443","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Population, general practitioner and practice characteristics are associated with screening procedures for microvascular complications in Type 2 diabetes care in Norway"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7069-6870","authenticated-orcid":false,"given":"\u00c5.","family":"Bakke","sequence":"first","affiliation":[{"name":"Department of Medicine Stavanger University Hospital Stavanger"},{"name":"Department of Global Public Health and Primary Care University of Bergen Bergen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. T.","family":"Tran","sequence":"additional","affiliation":[{"name":"Department of General Practice Institute of Health and Society University of Oslo Oslo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Dalen","sequence":"additional","affiliation":[{"name":"Department of Research Section\u00a0of Biostatistics Stavanger University Hospital Stavanger"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. G.","family":"Cooper","sequence":"additional","affiliation":[{"name":"Department of Medicine Stavanger University Hospital Stavanger"},{"name":"Norwegian Quality Improvement of Laboratory Examinations Haraldsplass Deaconess Hospital Bergen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. F.","family":"L\u00f8vaas","sequence":"additional","affiliation":[{"name":"Norwegian Quality Improvement of Laboratory Examinations Haraldsplass Deaconess Hospital Bergen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. K.","family":"Jenum","sequence":"additional","affiliation":[{"name":"General Practice Research Unit (AFE) Department of General Practice Institute of Health and Society University of Oslo Oslo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. J.","family":"Berg","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine University of Oslo Oslo"},{"name":"Department of Endocrinology, Morbid Obesity and Preventive Medicine Oslo University Hospital Oslo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. V.","family":"Madsen","sequence":"additional","affiliation":[{"name":"Norwegian Quality Improvement of Laboratory Examinations Haraldsplass Deaconess Hospital Bergen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"N\u00f8kleby","sequence":"additional","affiliation":[{"name":"Department of General Practice Institute of Health and Society University of Oslo Oslo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Gjelsvik","sequence":"additional","affiliation":[{"name":"Department of General Practice Institute of Health and Society University of Oslo Oslo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Claudi","sequence":"additional","affiliation":[{"name":"Nordland Hospital Department of Medicine Bod\u00f8"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Skeie","sequence":"additional","affiliation":[{"name":"Department of Medicine Stavanger University Hospital Stavanger"},{"name":"Department of Clinical Science University of Bergen Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Carlsen","sequence":"additional","affiliation":[{"name":"Department of Medicine Stavanger University Hospital Stavanger"},{"name":"Norwegian Quality Improvement of Laboratory Examinations Haraldsplass Deaconess Hospital Bergen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Sandberg","sequence":"additional","affiliation":[{"name":"Department of Global Public Health and Primary Care University of Bergen Bergen"},{"name":"Norwegian Quality Improvement of Laboratory Examinations Haraldsplass Deaconess Hospital Bergen"},{"name":"Laboratory of Clinical Biochemistry Haukeland University Hospital Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Thue","sequence":"additional","affiliation":[{"name":"Department of Global Public Health and Primary Care University of Bergen Bergen"},{"name":"Norwegian Quality Improvement of Laboratory Examinations Haraldsplass Deaconess Hospital Bergen"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,11,27]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc18-S010"},{"key":"e_1_2_11_3_1","unstructured":"Helsedirektoratet. 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