Title: Family physicians RegIstry of chronic disEases in iNDianS (FRIENDS) Study- a prospective observational study in urban family practice.
a) Background:
Family physicians RegIstry of chronic disEases in iNDianS (FRIENDS) Study was a prospective observational study of treatments and outcomes in hypertension and diabetes in an urban family practice in Bangalore.
b) Objective:
A prospective observational study among urban family physicians to document the practice patterns and outcomes of chronic diseases and risk factors; primarily diabetes, hypertension, dyslipidemia, and obesity.
c) Methods:
Consenting patients from 19 clinics were recruited and followed over one year with two interim visits. Patient characteristics, investigations and treatments were recorded at baseline, during interim visits and at one year and compared with standard Guidelines (JNC VII and ADA 2012).
d) Results:
We recruited 1297 patients and 675(52%) completed the one year visit. Mean age (SD) was 55.0 (+13.1), 20.49% were less than 45 years and BMI was 27.10 (+5.2). 969 (80.2%) had hypertension, 693 (56.2%) had diabetes, 394 (34.8%) had dyslipidemia and 159/916(17%) had all three. Cardiovascular complications at enrolment were present in 106 (IHD78, TIA17, and Stroke11). Calcium channel blockers (441, 45%) was the commonest anti-hypertensive and 579 (59.7%) used 2 or more drugs. Among patients who had both hypertension and diabetes, use of aspirin, lipid lowering agent and ACE inhibitors was low, at 27%, 38% and 40% respectively.
During follow-up, physicians reported that 60% patients’ visit to their physicians was as per advice. In between visits, 63% patients with hypertension got their BP recorded and 79% with diabetes got blood sugars checked. Among hypertensive patients, lipid profile, serum creatinine and ECG were done in 61%,57% and 56% respectively, over one year. Among diabetics, fasting blood sugars, HbA1c and urine albuminuria were done in 98%, 71% and 67% respectively.
e) Total recruitment & no. of sites:
We recruited 1297 patients and 675(52%) completed the one-year visit from 19 Clinics.
f) Conclusion:
In conclusion, only about 50% of patients came for the final one-year visit and their management was reasonable. Educational interventions among patients would improve regular follow-up, which in turn will result in better outcomes.
g) Publication status (Name & year):
Not published. Presented at 2nd National Conference of Family Medicine and Primary Care 2015, held in New Delhi, 19-20th November 2015.
Updated as on: 28 April 2022