Inclusion of Hypoglycemia in Clinical Practice Guidelines and Performance Measures in the Care of Patients With Diabetes

HEALTH CARE POLICY AND LAW

Rene Rodriguez-Gutierrez, MD, MSc1,2,3; Naykky Singh Ospina, MD, MSc1,2; Rozalina G. McCoy, MD, MS4,5; Kasia J. Lipska, MD6; Nilay D. Shah, PhD5; Victor M. Montori, MD, MSc1,2 ; for the Hypoglycemia as a Quality Measure in Diabetes Study Group

This study assesses the inclusion and prioritization of hypoglycemia in contemporary clinical guidelines and performance measures for patients with diabetes.

Health care organizations use publicly reported performance measures for quality measurement and improvement and pay-for-performance initiatives.1 These measures should ideally promote high-quality care that is evidence based and congruent with clinical practice guidelines. However, they should also reward patient-centered care that yields optimal outcomes with the lowest risk of harm.2 For patients with both type 1 and type 2 diabetes, high-quality care should therefore minimize the risk of hypoglycemia.2 The degree to which existing performance measures are aligned with guidelines, particularly in regard to hypoglycemia avoidance, is uncertain. We therefore conducted an environmental scan to assess the inclusion and prioritization of hypoglycemia in contemporary clinical guidelines and performance measures for patients with diabetes.