Structured primary care for type 2 diabetes has positive effects on clinical outcomes.

Abstract

BACKGROUND:

Patients with type 2 diabetes have an increased risk of developing microvascular and macrovascular complications. In routine diabetes care an adequate reduction of risk factors for these complications is often not achieved.

OBJECTIVE:

The aim of the study was to evaluate the effects of structured diabetes care on clinical outcomes of patients with type 2 diabetes in primary care.

METHODS:

We performed a quasi-experimental study on the effects of structured care consisting of organizational and educational components (n = 581) compared with care-as-usual (n = 152). We assessed clinical outcomes of HbA1c, blood pressure, cholesterol, creatinine and body mass index, at baseline and after 1 year. The long-term effects in the structured care group were determined after another 2 years.

RESULTS:

Structured care led to improvement in HbA1c and long-term improvements in blood pressure and cholesterol compared with care-as-usual. After 1 year, the percentage of patients who did not deteriorate was higher in the structured care group, again for HbA1c, diastolic blood pressure, low-density lipoprotein cholesterol and body mass index.

CONCLUSIONS:

Structured diabetes care consisting of multiple components has a positive effect on clinical outcomes compared with care-as-usual. Our findings support its further implementation in order to reduce complications in type 2 diabetes patients.

• Authors: Andrea S Fokkens, P Auke Wiegersma, Frank W Beltman, Sijmen A Reijneveld
• Journal: Journal of evaluation in clinical practice (J Eval Clin Pract) Vol. 17 Issue 6 Pg. 1083-8 (Dec 2011) ISSN: 1365-2753 [Electronic] England
• PMID: 20626538 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2010 Blackwell Publishing Ltd.

Chemical References

• Glycated Hemoglobin A
• Lipids
• Creatinine

Topics

• Aged
• Blood Pressure
• Body Mass Index
• Creatinine (blood)
• Diabetes Mellitus, Type 2 (blood, complications, therapy)
• Female
• Glycated Hemoglobin (analysis)
• Humans
• Inservice Training
• Lipids (blood)
• Male
• Middle Aged
• Outcome Assessment, Health Care
• Patient Care Management (organization & administration)
• Patient Care Team (organization & administration)
• Patient Education as Topic
• Primary Health Care (organization & administration)
• Risk Factors