Effectiveness of disease-management programs for improving diabetes care: a meta-analysis

Pimouguet, Clément; Goff, Mélanie Le; Thiébaut, Rodolphe; Jf, Dartigues; Helmer, Catherine

doi:10.1503/cmaj.091786

Cited by 223 publications

(202 citation statements)

References 66 publications

(35 reference statements)

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“…Results of meta-analysis performed through clinical trials showed that construction of shared care between professional and patient is a much more effective strategy to control glycemic levels and for the disease self-management, when compared with traditional strategies, guided only by professional orientations (18) . The 1.5% average and significant reduction of HbA1c, presented by individuals of the intervention group, is consistent with results presented by meta-analysis of randomized studies used to evaluate the effectiveness of interventions in the disease management by individuals themselves (19) . Although the mean of HbA1c for the intervention group has not evolved to indicative levels of good glycemic control, we highlight the consolidated fact in the literature, that for each 1% absolute reduction in the HbA1c mean, there is a 37% reduction of risk of microvascular complications and a 32% reduction of risk of any complication related to DM2 (20) .…”

Section: Discussionsupporting

confidence: 86%

Nursing appointment and cardiometabolic control of diabetics: a randomized clinical trial

et al. 2017

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Objective: to verify the effect of nursing appointment on cardiometabolic profi le of people with Diabetes Mellitus type 2. Method: randomized controlled trial, developed with 134 individuals chosen for two groups: intervention and control. The intervention consisted of three nursing appointments alternated bimonthly, with two phone calls, over fi ve months. The control group received usual care offered by the Health Unit. Data were collected through semi-structured interviews before and after the intervention, in addition to conducting laboratory tests. Results: after the intervention, a signifi cant difference was shown in the amount of glycated hemoglobin (p = 0.006) and in the systolic blood pressure (p = 0.031), which were higher in the control group. Conclusion: besides being low-cost and easy to develop on the monitoring routine of people with diabetes, the intervention performed infl uenced positively the biochemical profi le. Descriptors: Diabetes Mellitus; Nursing; Self-Care. Chronic Disease; Clinical Trial. RESUMO Objetivo: verifi car o efeito da consulta de enfermagem sobre o perfi l cardiometabólico de pessoas com Diabetes Mellitus tipo 2. Método: ensaio clínico controlado e randomizado, desenvolvido com 134 indivíduos sorteados para dois grupos: intervenção e controle. A intervenção consistiu em três consultas de enfermagem bimensais alternadas, com duas ligações telefônicas, ao longo de cinco meses. O grupo-controle recebeu os cuidados habituais oferecidos pela Unidade de Saúde. Os dados foram coletados mediante entrevistas semiestruturadas antes e após a intervenção, além da realização de exames laboratoriais. Resultados: após a intervenção, foi evidenciada diferença signifi cativa no valor da hemoglobina glicada (p=0,006) e da pressão arterial sistólica (p=0,031), que se mostraram mais elevadas no grupo-controle. Conclusão: a intervenção realizada, além de ser de baixo custo e de fácil desenvolvimento na rotina de acompanhamento da pessoa com diabetes, infl uenciou positivamente a melhora do perfi l bioquímico. Descritores: Diabetes Mellitus; Enfermagem; Autocuidado. Doença Crônica; Ensaio Clínico. RESUMEN Objetivo: comprobar el resultado de la consulta de enfermería sobre el perfi l cardiometabólico en personas con Diabetes mellitus tipo 2. Método: ensayo clínico controlado y aleatorizado, en el cual participaron 134 sujetos. Se los dividieron de forma aleatoria en dos grupos: intervención y control. La intervención consistió en tres consultas de enfermería cada dos meses alternados, con dos llamadas, a lo largo de cinco meses. El grupo control recibió los cuidados usuales de la Unidad de Salud. Se recolectaron los datos a través de entrevistas semiestructuradas, antes y después de la intervención, y de análisis de laboratorio. Resultados: después de la intervención, se observaron diferencias signifi cativas en el valor de la hemoglobina glicosilada (p=0,006) y de la presión arterial sistólica (p=0,031), que fueron más elevados en el grupo control. Conclusión: la intervención realizada...

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Section: Discussionsupporting

confidence: 86%

Nursing appointment and cardiometabolic control of diabetics: a randomized clinical trial

et al. 2017

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“…Sociodemographic and clinical characteristics, along with this type of association can guide the management of care and educational programs for health professionals to monitor glucose levels of health services patients with diabetes. (7,8) In Brazil, the Ministry of health has created several diseases control programs that impact most of the population, and in the case of diabetes mellitus, the National Program of Hypertension and Diabetes Mellitus -Hiperdia was created in 2002, in an attempt to reorient pharmaceutical assistance for the continuous supply of medicines, as well as monitoring the clinical conditions of the health services patients.…”

Section: Introductionmentioning

confidence: 99%

Complicações e o tempo de diagnóstico do diabetes mellitus na atenção primária

et al. 2015

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Objective: To analyze the association between the time of disease and the onset of diabetes mellitus complications and to describe the characteristics of the diabetics' population of a mid-sized city located in the Midwest of the state of Minas Gerais. Methods: Cross-sectional study conducted with 1320 patients with diabetes mellitus. The data were obtained from the registration system of Hypertensive and diabetic patients and the following variables were evaluated: sociodemographic characteristics, duration of disease and diabetes complications. Results: Among patients who have the diagnosis of the disease for more than 10 years, the percentage of those that present complications 156 (32.2%) is higher than among those with the diagnosis of the disease for less than 10 years 45 (12.1%). Conclusion:The results showed that the onset of diabetes-related complications might be associated with the duration of disease. ResumoObjetivo: Analisar a associação entre o tempo da doença e o aparecimento de complicações do diabetes mellitus e descrever as características da população de diabéticos de um município de médio porte do Centro Oeste mineiro. Métodos: Estudo transversal realizado com 1320 usuários com diabetes mellitus. Os dados foram obtidos do sistema de cadastramento de Hipertensos e Diabéticos e foram avaliadas as variáveis: características sociodemográficas, duração da doença e complicações do diabetes. Resultados: Entre os usuários que possuem o diagnóstico da doença há mais de 10 anos, o percentual daqueles que apresentam complicações 156 (32,2%) é maior do que entre os que possuem o diagnóstico da doença há menos de 10 anos 45 (12,1%). Conclusão: Os resultados apontaram que a presença de complicações relacionadas ao diabetes pôde ser associada ao tempo de duração da doença.

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“…The mean reduction in A1C level in the present study was greater in comparison to the Diabetes Ten City Challenge outcomes, as may be expected for a patient population with higher baseline A1C level. A meta-analysis study supports the significant impact of disease-management programs on A1C levels [21]. However, the above-mentioned study also indicated that only programs with high frequency of pharmacist-patient interactions led to significantly greater reduction compared to programs with low frequency of interaction.…”

Section: Discussionmentioning

confidence: 76%

Community Pharmacist-Based Collaborative Disease Management Program for Patients with Poorly Controlled Diabetes

Sansgiry

Mhatre²,

Patel³

et al. 2015

JHS

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Abstract:Objective: Patients with poorly controlled diabetes have more medical complications and are more difficult to manage. The objective of the present study was to evaluate the clinical outcomes of successful implementation of an employer initiated community pharmacist-based disease management program for diabetic patients with poorly controlled diabetes. Methods: Employees with poorly controlled diabetes (glycosylated hemoglobin (A1C) level ≥ 7.5%) were identified from a large diabetes disease management program, in a rural setting in Texas, US. A longitudinal retrospective study was conducted, analyzing clinical indicators in the diabetes patients following the community pharmacist-based disease management program. The program involved a comprehensive drug therapy assessment and individualized disease management education. Primary outcome measured in the present study was A1C levels, assessed at the baseline visit and at the end of the intervention. Results: A total of 64 patients with poorly controlled diabetes were identified. Significant improvement in mean clinical outcome scores was achieved for A1C levels (p = 0.0011). At the end of the 1 year longitudinal intervention, targeted body mass index and A1C goals were attained by 35.9% (p < 0.001) and 15.6% patients, respectively. The 10 patients reaching goal levels post intervention were in the group that had baseline A1C of 7.5 to 9%. However, patients with > 9% A1C levels at baseline had a significant reduction (mean 2.1, p < 0.001) post intervention. Conclusion: The community pharmacist-based diabetes disease management program improved A1C levels of patients with poorly controlled diabetes.

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Effectiveness of disease-management programs for improving diabetes care: a meta-analysis

Cited by 223 publications

References 66 publications

Nursing appointment and cardiometabolic control of diabetics: a randomized clinical trial

Nursing appointment and cardiometabolic control of diabetics: a randomized clinical trial

Complicações e o tempo de diagnóstico do diabetes mellitus na atenção primária

Community Pharmacist-Based Collaborative Disease Management Program for Patients with Poorly Controlled Diabetes

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