A pilot quality improvement intervention in patients with diabetes and hypertension in primary care settings of Cyprus

George A. Samoutis, Elpidoforos S. Soteriades, Henri E. Stoffers, Anastasios Philalithis, Eumorphia M. Delicha, Christos Lionis

Research output: Contribution to journalArticlepeer-review


Background: The achievement of quality of care constitutes a priority for modern health care systems. The objective of our study was to evaluate a quality improvement intervention in primary care of Cyprus. Methods: In a two-arm non-randomized controlled study in primary care centres in Cyprus, all patients with hypertension (HTN) and diabetes (n = 539) were invited. In one urban and one rural centre, a quality improvement programme was implemented; two other centres (one urban and one rural) served as control practices. The intervention mainly consisted of the introduction of clinical disease management guidelines and an electronic medical record system. The primary outcome measurement was improvement of specific clinical indicators for HTN and diabetes. Patients' satisfaction was evaluated using the European Task Force on Patient Evaluations of General Practice (EUROPEP) questionnaire over an 18-month follow-up period. Results. Five hundred and four patients completed the study, 278 patients in the intervention practices and 226 patients in the control practices. Mean results for blood pressure, total cholesterol and low density lipoprotein-cholesterol and three annual performance measures (urine protein testing, dilated eye and foot examination) had improved at 18-month follow-up in the intervention as compared to the control group. There was no improvement of HbA1c levels. Patients' satisfaction improved in the intervention practices (improvement of 10/23 EUROPEP items) but decreased in the control group (decline of 20/23 items). Conclusions. A pilot multifaceted quality improvement intervention programme for patients with diabetes and HTN implemented in primary care settings in Cyprus showed promising results. Future studies need to involve a broader number of practices and patient populations.

Original languageEnglish
Pages (from-to)263-270
Number of pages8
JournalFamily Practice
Issue number3
Publication statusPublished - 26 Mar 2010


  • Cyprus
  • Diabetes mellitus
  • Hypertension
  • Patient satisfaction
  • Primary care
  • Quality improvement
  • Quality indicators


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