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The article presents a survey of medication prescriptions and blood pressure control among patients with hypertension using electronic medical records in southwest London, England. According to the survey, black patients with hypertension were less likely to achieve an established treatment target for blood pressure control than white or South Asian patients. Researchers found that ethnic disparities in the management of hypertension have persisted across the country.

This article offers an overview of the life and work of Leonhard Euler (1707-83). During 2007 Euler's tercentenary was celebrated by mathematicians around the world. The Open University Centre for the History of the Mathematical Sciences and the BSHM marked the occasion with a meeting in Oxford in June 2007 on Euler's mathematical legacy. Three of the lectures from that meeting have been reproduced in this issue of the Bulletin, beginning here with the opening talk from Jeremy Gray. [ABSTRACT FROM AUTHOR]

Background The aims of this study were to develop ischaemic heart disease (IHD) registers in three primary care groups (PCGs) in SW London; to determine what proportion of patients with IHD were already identified; and to estimate the workload in producing an IHD disease register. [ABSTRACT FROM PUBLISHER]

Abstract Objective To establish current practice in the use of Read codes for diabetes. Design Cross sectional study. Setting 17 practices in the Battersea primary care group in southwest London. Data sources Computerised medical records. Main outcome measures Number of codes in use in all practices; variation in the use of codes between practices; and prevalence of Read code use in diabetic patients. Results At least 9 separate Read code groupings and 25 individual diabetes codes were in use in the 17 general practices. Only one Read code (C10, diabetes mellitus) and its subcodes was being used in all 17 practices, but its use varied from 14% to 98% of patients with diabetes. The use of other key Read codes for monitoring the care of patients with diabetes also varied widely between practices; for example, < 20% of practices used the code for the location of care. Less than half of patients (45%) with diabetes had their type of diabetes coded, and even fewer (21%) had measures such as the examination of the retina coded. Conclusions The use of Read codes for diabetes needs to be standardised and coding levels improved if valid diabetic registers are to be constructed and the quality of care is to be monitored effectively. Until all patients with diabetes have the C 10 Read code recorded, clinicians will have to use a wide range of Read codes and prescribing data to ensure that diabetes registers are complete. [ABSTRACT FROM AUTHOR]

Background: Pay-for-performance rewards health-care providers by paying them more if they succeed in meeting performance targets. A new contract for general practitioners in the United Kingdom represents the most radical shift towards pay-for-performance seen in any health-care system. The contract provides an important opportunity to address disparities in chronic disease management between ethnic and socioeconomic groups. We examined disparities in management of people with diabetes and intermediate clinical outcomes within a multiethnic population in primary care before and after the introduction of the new contract in April 2004.Methods and Findings: We conducted a population-based longitudinal survey, using electronic general practice records, in an ethnically diverse part of southwest London. Outcome measures were prescribing levels and achievement of national treatment targets (HbA1c < or = 7.0%; blood pressure [BP] < 140/80 mm Hg; total cholesterol < or = 5 mmol/l or 193 mg/dl). The proportion of patients reaching treatment targets for HbA1c, BP, and total cholesterol increased significantly after the implementation of the new contract. The extents of these increases were broadly uniform across ethnic groups, with the exception of the black Caribbean patient group, which had a significantly lower improvement in HbA1c (adjusted odds ratio [AOR] 0.75, 95% confidence interval [CI] 0.57-0.97) and BP control (AOR 0.65, 95% CI 0.53-0.81) relative to the white British patient group. Variations in prescribing and achievement of treatment targets between ethnic groups present in 2003 were not attenuated in 2005.Conclusions: Pay-for-performance incentives have not addressed disparities in the management and control of diabetes between ethnic groups. Quality improvement initiatives must place greater emphasis on minority communities to avoid continued disparities in mortality from cardiovascular disease and the other major complications of diabetes. [ABSTRACT FROM AUTHOR]

Objectives: To determine the quality of diabetes management in primary care after the publication of the National Service Framework and examine the impact of age, gender and deprivation on the achievement of established quality indicators., Design: Population-based cross sectional survey using electronic general practice records carried out between June-October 2003., Setting: Thirty-four practices in Wandsworth, South-West London, UK., Participants: 6035 adult patients (> or =18 years) with diabetes from a total registered population of 201,572 patients., Interventions: None., Main Outcome Measures: Success rates for the diabetes quality indicators within the General Medical Services contract for general practitioners., Results: We identified large variations in diabetes management between general practitioner practices with poorer recording of quality care in younger patients (18-44 years). In addition, younger patients had a worse cholesterol and glycaemia profile, although hypertension was more common in older patients. Gender and deprivation did not appear to be important determinants of the quality of care received., Conclusions: There are large variations in diabetes management between general practitioner practices, with care seemingly worse for younger adults. Longitudinal studies are required to determine whether current UK quality improvement initiatives have been successful in attenuating existing variations in care and treatment outcomes.