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Thank you for this insightful mixed-method study assessing strategies of best practices for change management of diabetes care in the primary care setting. We discussed your article with great interest during our recent journal club meeting with our department of Public Health and Primary Care in The Hague, the Netherlands. This study could assist other practices in improving their diabetes care. As stated by the WHO, non-communicable diseases like diabetes are one of the 21st century’s major health challenges. This study highlights the complexity of changing quality of care, demonstrating that there is not one answer or easy solution.
We underscore the importance of standardizing care to improve quality of care. Additionally, we support initiatives for pro-active outreach to patients with inadequately managed disease, which aligns with the Population Health Management approach.
Considering Population Health Management we were particularly curious about whether and how the top-performing practices would stratify their population in low, intermediate and high-risk panels and how appropriate care could look like when taking into account social determinants of health and contextual factors. The percentage of patients receiving optimal diabetes care score might not capture the quality of care provided to high-risk patients. Improvement in the quality of care of these patients could yield the highest impact. However, these patients are often hardest to reach and treat. Therefore, we are especially interested in learning about successful strategies for change management tailored to high-risk patients. How do top-performing practices ensure that high-risk patients receive the care they need while avoiding unnecessary care for those at low risk? Are there specific strategies particularly effective in this subgroup? And were other strategies successful in more deprived areas? Understanding these strategies could provide valuable insights for improving care considering both care gaps as care waste.
We thank you once again for your valuable study.