Clinical evaluation of the implementation of the first pilot Russian integrated program for an integrated approach to the management of diabetes mellitus “NORMA”

Galstyan, Gagik R.; Mayorov, Alexander Yur'evich; Mel'nikova, Olga Georgievna; Holmskaya, N. I.; Hamradjanov, Z. A.; Milyutin, V. I.; Shestakova, Marina Vladimirovna

doi:10.14341/dm13008

Diabetes mellitus

2023

DOI: 10.14341/dm13008

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Clinical evaluation of the implementation of the first pilot Russian integrated program for an integrated approach to the management of diabetes mellitus “NORMA”

Gagik R. Galstyan¹,

Alexander Yur'evich Mayorov²,

Olga Georgievna Mel'nikova

et al.

Abstract: BACKGROUND: Despite progress in the treatment of patients with diabetes mellitus (DM), the problem of achieving target values of glycemic control remains relevant. In this regard, the search for new integrated solutions that could strengthen disease control and improve clinical outcomes becomes relevant.AIM: To assess the impact of the developed integrated approach to disease management on the clinical and metabolic outcomes of patients with type 1 (T1DM) and type 2 diabetes mellitus (T2DM) participating in th… Show more

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Cited by 4 publications

References 15 publications

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Regional peculiarities of hospitalizations and outpatient medical treatment among the adult population with established type 2 diabetes mellitus

Shepel,

Levchenko,

Lusnikov

et al. 2023

jour

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Purpose. To analyze the indicators of hospitalization and outpatient visits of patients aged 18 years and older with type 2 diabetes mellitus (DM) in federal districts (FD) and regions of the Russian Federation from the perspective of the World Health Organization concept of ambulatory care sensitive conditions. Materials and methods. The analysis included data from the annual forms of federal statistics (forms No. 12 and No. 14), on the number of hospitalizations and the outpatient visits of patients aged 18 years and older diagnosed of type 2 diabetes (ICD10: E11) in 2022. Results. We analyzed the data of the federal statistics (forms No. 12 and No. 14) of the Federal District and the regions of the Russian Federation in 2022. It was found that in the North Caucasus Federal District, an increased level of adult hospitalization is associated with an increased ratio of the number of hospitalizations to the number of outpatient visits to the primary health care (PHC) facilities. At the same time, in FDs with adult outpatient visits is higher than the Russian average and adult hospitalization is higher than the Russian average (Ural, Central and Volga FDs). And vice versa, in FDs with adult outpatient visits is lower than the Russian average and adult hospitalization is lower than the Russian average (Southern, Far Eastern, Siberian and North-Western FDs). When analyzing the ratio of the number of hospitalizations to the number of outpatient visits to PHC facilities among the adult population, the highest indicator was recorded in the North Caucasus FD, while the heterogeneity of the indicator within the FD was one of the highest among the other FDs. The lowest indicator of the number of hospitalizations to the number of cases of treatment in PHC facilities among the adult population with type 2 DM was recorded in the Northwestern FD, while the heterogeneity of the indicator within the FD was the lowest among the other FGs. There was a high variability of the ratio both for all subjects of the Russian Federation and FDs. The ratio values ranged from 2,55 in the Novgorod Region to 31,39 in the Chechen Republic. Conclusion. Accounting for diseases that can be treated on an outpatient basis can become one of the tools for assessing the quality of medical care to the adult population in PHC facilities. However, before including this indicator as a criterion for assessing the quality of medical services, a deeper understanding of the reasons influencing its change is required.

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Regional peculiarities of hospitalizations and outpatient medical treatment among the adult population with established type 2 diabetes mellitus

Shepel,

Levchenko,

Lusnikov

et al. 2023

jour

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A smart device for smart self-monitoring of glycemia in patients with diabetes

Zanozina,

Sorokina,

Taradayko

et al. 2024

Medicinskij sovet

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Systemic vascular complications of diabetes mellitus (nephropathy, retinopathy, injuries to the great vessels of the heart, brain, arteries of the lower extremities) have been proven to lead to early disability and premature death of patients. The annual economic costs of T2DM and associated cardiovascular complications account for at least 1% of GDP. According to the principles of therapeutic management of diabetes mellitus, patient education is viewed as an integrated component of the treatment process. It should provide patients with knowledge and skills that contribute to achieving specific therapeutic goals (disease self-management). Self-monitoring of blood glucose training is a priority objective in the treatment of patients with diabetes. It is self-monitoring of glycemia that is the most important criterion for selecting therapy, compared with the glycemia testing in an outpatient clinic or hospital settings. Modern glucometers provide an option for remote monitoring of glycemia and timely delivering of consultations using a mobile application. Thus, Contour Plus One glucometer with the Russian-language application Contour Diabitis records the blood glucose readings following each test. If low or high glycaemic levels are detected, the application will show a notification and offer the patient options for actions. Quick recognizing out-of-range lab results motivates patients and helps them understand why changes in therapy are required. Immediate notifications shown on the smartphone screen improve motivation to act and respond to the situation. The glucometer system with a mobile application allows to promptly manage glycemia, increase patient’s commitment to active disease management, achieve treatment goals using innovative technologies, and therefore actively manage the course of diabetes mellitus.

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Clinical-economic evaluation of distance education and blood glucose level monitoring in adults with diabetes mellitus

Omelyanovskiy,

Fediaeva

2024

GCP

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Background. Health Technology Assessment (HTA) in the Russian Federation has been performed for drugs, not for other medical technologies, which leads to decision making difficulties today. Aim. This study aimed to assess the clinical and economic efficiency of distance education and monitoring of blood glucose levels in patients with diabetes mellitus (DM) of both types. Materials and methods. The HTA was prepared using Markov model with a cost-effectiveness analysis methodology. The number of DM complications depending on glycated hemoglobin level with distance education and blood glucose level and without, that has been used for modeling cost of distance education and blood glucose monitoring as well as cost of drugs’ therapy and hospital admission due to DM complications with methodology and source of Obligatory Medical Insurance Fund on 30-yy horizon of modeling. Results. Distance education and blood glucose monitoring in DM patients leads to decrease in complication level as well as mortality, and acceptable additional financial costs from the 5th year of modeling for DM type 1 and from the 6thyear of modeling for type 2 without insulin dose changing. Conclusion. Clinical-economic reasonability of distance education and DM patients’ monitoring are demonstrated in this work. These results should be considered in the decision-making process for HTA budget financing.

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Clinical evaluation of the implementation of the first pilot Russian integrated program for an integrated approach to the management of diabetes mellitus “NORMA”

Cited by 4 publications

References 15 publications

Regional peculiarities of hospitalizations and outpatient medical treatment among the adult population with established type 2 diabetes mellitus

Regional peculiarities of hospitalizations and outpatient medical treatment among the adult population with established type 2 diabetes mellitus

A smart device for smart self-monitoring of glycemia in patients with diabetes

Clinical-economic evaluation of distance education and blood glucose level monitoring in adults with diabetes mellitus

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