Implementing diabetes passports to focus practice reorganization on improving diabetes care

Objective. Although an active role of the patient is often stressed in diabetes care, it is not easily implemented in daily practice. The aim of the study was to measure the effects of introducing a diabetes passport to patients after embedding the passport in the organization of care. Design. Randomized controlled trial. Setting. Forty general practice in The Netherlands. Participants. Pre- and post-intervention data were obtained from 993 patients with type 2 diabetes mellitus. Patients treated in secondary care and patients over 80 years of age were excluded. Intervention. The intervention consisted of clarifying the diabetes care tasks for all practice staff and embedding the diabetes passports in the structured care. Main outcome measure. Self-reported use of the diabetes passport. Results. Diabetes passports were issued to 87% of the patients. After 15 months, 76% of the patients reported that the passport was being used during clinic visits. The process indicators of care improved by 10% on average in the intervention group. However, there were no changes in the outcome measures. Conclusion. Diabetes passports can be introduced successfully in structured primary care and they lead to improved effect measures for medical behaviour.