[An evaluation of glycosylated hemoglobin requesting patterns in a primary care setting: a pilot experience in the Valencian Community (Spain)].

Abstract Objective To assess the pattern of glycosylated hemoglobin (HbA 1c ) requests by clinicians from eight health care departments by calculating indicators of demand appropriateness. Methods A cross-sectional study of the number of HbA 1c requests by primary care clinics in 2008 and 2009. The indicator of demand appropriateness was the proportion of HbA 1c values lower than 6.5%. Variables were collected and indicators were automatically calculated. The number of HbA 1c measurements that should theoretically have been requested according to known diabetes prevalence data was also calculated. Results A progressive increase was seen in the demand for HbA 1c measurements. Approximately 54% of HbA 1c values obtained in seven of the eight departments studied were lower than 6.5%. The number of theoretical HbA1c requests that would have been expected based on the known prevalence of diabetes was higher than the number of HbA 1c requests in all departments. Conclusion The results appear to suggest that HbA 1c requests in the health care departments studied were not always appropriate. HbA 1c measurements were probably overused in patients without diabetes and underused in patients with diabetes.