Trends over 8 years in quality of diabetes care: results of the AMD Annals continuous quality improvement initiative

Maria Chiara Rossi, Riccardo Candido, Antonio Ceriello, Antonino Cimino, Paolo Di Bartolo, Carlo Giorda, Katherine Esposito, Giuseppe Lucisano, Marina Maggini, Edoardo Mannucci, Illidio Meloncelli, Antonio Nicolucci, Fabio Pellegrini, Marco Scardapane, Giacomo Vespasiani

Research output: Contribution to journalArticlepeer-review


Objective: Quality of care monitoring is a key strategy for health policy. In Italy, the AMD Annals continuous monitoring and quality improvement initiative has been in place since 2006. Results after 8 years are now available. Research design and methods: Quality of diabetes care indicators during the years 2004–2011 were extracted from electronic medical records of 300 diabetes clinics. From 200,000 to 500,000 patients with type 2 diabetes were analyzed per year. Six process indicators, eight intermediate outcome indicators, seven indicators of treatment intensity/appropriateness, and a quality of care summary score (Q score) were evaluated. Previous studies documented that the risk of developing a new cardiovascular event was 80 % higher in patients with a Q score 25. Results: The proportion of patients with HbA1c ≤7 %, LDL cholesterol 25 increased from 22.9 to 38.5 %. Conclusions: AMD Annals document the progress in quality of diabetes care. Longitudinal improvements in Q score can translate into less cardiovascular events, with evident clinical and economic implications. AMD Annals represent a physician-led effort not requiring allocation of extra-economic resources, which is easy to implement and deeply rooted in routine clinical practice. They are a potential case model for other healthcare systems.

Original languageEnglish
Pages (from-to)557-571
Number of pages15
JournalActa Diabetologica
Issue number3
Publication statusPublished - Dec 21 2014


  • Diabetes mellitus
  • Electronic medical records
  • Outcome measures
  • Process measures
  • Quality of care
  • Treatment intensity/appropriateness

ASJC Scopus subject areas

  • Endocrinology
  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism


Dive into the research topics of 'Trends over 8 years in quality of diabetes care: results of the AMD Annals continuous quality improvement initiative'. Together they form a unique fingerprint.

Cite this