Accessing CDRC resources on SystmOne
To access the below resources you will need to be a member of the DCS group on SystmOne. To do this, please follow the instructions on the CDRC SystmOne Access webpage.
Reports
Missed ACR and Foot Checks
The following searches identify patients who have had an annual diabetes review (at least a month ago) who haven’t submitted a urine for ACR or haven’t had a foot check. Foot checks and ACR are the areas of worst performance w.r.t. key care processes nationally.
Setting these reports to batch report at regular intervals to your admin staff allows these patients to be prompted to arrange these tests. Information about automatic reporting can be found here Automated Reporting.
These reports can be found in the folder CDRC Quality > Diabetes IGR
Diabetes Drug Reports
These reports have been created using the County Durham and Darlington integrated diabetes model.
These reports can be found in the folder CDRC Quality > Diabetes IGR
Reports to identify possible overtreatment:
| Report Name | Returns | |
| DIABREVIEW001 | Housebound, care home resident, palliative care register, moderate/severe frailty | |
| DIABREVIEW002 | Overtreatment: On any glucose lowering treatment and last Hba1c < 42 | |
| DIABREVIEW003 | Overtreatment: On monotherapy with any agent capable of causing hypoglycaemia and last Hba1c <48 | |
| DIABREVIEW004 | Overtreatment: On two or more glucose lowering drugs and Hba1c <48 | |
| DIABREVIEW005 | Overtreatment: Over 70 or mild frailty, on sulfonylurea or insulin and Hba1c <53 | |
| DIABREVIEW006 | Overtreatment: Moderate frailty, on sulfonylurea or insulin and Hba1c <59 | |
| DIABREVIEW007 | Overtreatment: Severe frailty/palliative care, on sulfonylurea or insulin and Hba1c <59 | |
| DIABREVIEW008 | Overtreatment: Severe frailty/palliative care on third line agent | |
| DIABREVIEW009 | Low engagement – On treatment but no Hba1c in the last 8 months | Excludes GSF green/amber/red, end of life and moderate and severe frailty |
| DIABREVIEW010 | Low engagement – On repeat diabetes medication but no recent issue |
Reports to identify patients who might be eligible for drug switches:
| Report Name | Returns |
| DIABSWITCHCDD001 | DPP4 (not alogliptin) and Hba1c <58 ? switch to alogliptin |
| DIABSWITCHCDD002 | DPP4 and HbA1c >58 ?Stop DPP4 |
| DIABSWITCHCDD003 | Type 2 on analogue insulin Hba1c <70 ? Switch to human insulin |
| DIABSWITCHCDD004 | Type 2 on analogue insulin no recent Hba1c <70 ? Switch to human insulin |
| DIABSWITCHCDD005 | Type 1 on Lantus. ?Switch to abasaglar |
| DIABSWITCHCDD006 | On GLP1 more than 6 months and no recent Hba1c <70 ?Is GLP1 still appropriate |
| DIABSWITCHCDD007* | Type 2 (no insulin pump) but non-formulary strip ? Change to formulary strip |
| DIABSWITCHCDD008* | Diabetes (not type 2, no insulin pump) but non-formulary strip ? Change to formulary strip |
| DIABSWITCHCDD009* | Insulin pump but non-formulary strip ? Change to formulary strip |
Diabetes Performance
The following reports can give you an overview of the HbA1c management at your unit.
These reports can be found in the folder CDRC Quality > Diabetes IGR
The reports are subdivided into different treatment regimens and HbA1c achievement.
The following algorithm is used to highlight patients for review.
Patients who are not on the frailty or palliative care registers
| No treatment | Oral Monotherapy Metformin | Oral Monotherapy Other | Oral Dual Therapy with Metformin | Oral Dual Therapy w/o Metformin | Oral >=3 Therapy with Metformin | Oral >=3 Therapy with Metformin | GLP1 no insulin | Insulin | |
| >=75 | NPR | NPR | NPR | NPR | NPR | NPR(S) | NPR(S) | NPR(S) | NPR(S) |
| 58-74 | NR | NR | NR | NR | NR | NR | NR | NR | NR(S) |
| 53-57 | NR | NA | NA | NA | NA | NA | NA | NA | NA |
| 48-52 | NUR | NA | NA | NA | NA | NA | NA | NA | CDPR |
| <48 | NA | NA | NA* | CDPR* | CDPR* | CDPR* | CDPR* | CDPR* | SA |
NA – No action
SA – safety alert
CDPR – Consider deprescribing/dose reduction review
NUR – Non-urgent review
NR – Needs review
NPR – Needs prompt review
(S) – indicates that specialist input may be needed depending on local expertise
* – upgraded to safety alert if the patient is taking a sulfonylurea
The algorithm looks for the last HbA1C result when that result in at least 15 weeks old.