Effects of Chronic Disease Management Based on Clinics for Blood Pressure or Glycemic Control in Patients with Hypertension or Type 2 Diabetes Mellitus

Cheong, W. K.; Yim, Jun; Oh, Dae-Kyu; Im, Jeong-Soo; Ko, Kwang Pil; Kim, Yunmi

doi:10.5393/jamch.2013.38.2.108

Cited by 8 publications

(3 citation statements)

References 12 publications

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“…This is consistent with the results of another study in Korea that reported higher rates of controlled diabetes and hypertension in women. 11) However, in another research study performed in the USA, women, Mexican-Americans, and those aged ≥60 years had significantly lower rates of blood pressure control than men, younger individuals, and non-Hispanic whites. 12) In addition, patients with comorbidities showed better blood pressure control achievement rates in our study.…”

Section: Discussionmentioning

confidence: 95%

The Effect of Lifestyle Changes on Blood Pressure Control among Hypertensive Patients

et al. 2017

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BackgroundHypertension is highly prevalent among patients who visit primary care clinics. Various factors and lifestyle behaviors are associated with effective blood pressure control. We aimed to identify factors and lifestyle modifications associated with blood pressure control among patients prescribed antihypertensive agents.MethodsThis survey was conducted at 15 hospital-based family practices in Korea from July 2008 to June 2010. We prospectively recruited and retrospectively assessed 1,453 patients prescribed candesartan. An initial evaluation of patients' lifestyles was performed using individual questions. Follow-up questionnaires were administered at 4, 8, and 12 weeks. We defined successful blood pressure control as blood pressure <140 mm Hg systolic and <90 mm Hg diastolic.ResultsOf the 1,453 patients, 1,139 patients with available data for initial and final blood pressures were included. In the univariate analysis of the change in performance index, weight gain (odds ratio [OR], 2.18; 95% confidence interval [CI], 1.52 to 3.11; P<0.001), physical inactivity (OR, 1.195; 95% CI, 1.175 to 3.387; P=0.011), and increased salt intake (OR, 1.461; 95% CI, 1.029 to 2.075; P=0.034) were related to inadequate blood pressure control. Salt intake also showed a significant association. Multivariate ORs were calculated for age, sex, body mass index, education, income, alcohol consumption, smoking status, salt intake, comorbidity, and family history of hypertension. In the multivariate analysis, sex (OR, 3.55; 95% CI, 2.02 to 6.26; P<0.001), salt intake (OR, 0.64; 95% CI 0.43 to 0.97; P=0.034), and comorbidity (OR, 1.82; 95% CI, 1.23 to 2.69; P=0.003) were associated with successful blood pressure control.ConclusionWeight gain, physical inactivity, and high salt intake were associated with inadequate blood pressure control.

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Section: Discussionmentioning

confidence: 95%

The Effect of Lifestyle Changes on Blood Pressure Control among Hypertensive Patients

et al. 2017

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“…Third, individuals' HbA1c levels are divided into two categories, 6.5% and < 6.5%, where information may be lost about individuals with HbA1c levels of nearly 6.5%. Additionally, diagnosing diabetes is not solely based on HbA1c levels; rather, other tests, including screening tests and glycemia tests, may be used; moreover, there are no perfect guidelines for diabetes diagnosis [23][24][25]. Finally, in statistical analysis, few regional covariates are linear combinations of other variables, which leads to unreliable and unstable estimates of regression coe cients [26].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of primary care-based chronic disease management program on glycated hemoglobin levels

Kim,

Yun,

Park

et al. 2024

Preprint

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Background: Diabetes is one of the most common causes of cardiovascular disease and has led to death over time. For better management of glycated hemoglobin levels, which is a well-known index in diagnosing diabetes, many countries have been launching chronic disease management programs. Therefore, this study aimed to evaluate the effectiveness of the primary care-based chronic disease management integrated pilot program (PCDMP) in controlling glycated hemoglobin (HbA1c) levels in Korea. Nation-wide data from the 2019–2021 Korea National Health and Nutrition Examination Survey were used. Methods: We analyzed nationwide health examination data combined with various regional data sources. Using appropriate inclusion criteria for this study, a total of 13,901 individuals were suitable for the analysis. A generalized linear mixed model was applied to consider the clustered structure of the regional level data, where individual-level data, containing demographic characteristics and health-related information, were nested. Results: Individuals living in areas with a low PCDMP participation (< 30.37%) had odds (95% CI, 1.08–1.82) of exhibiting glycated hemoglobin levels ≥ 6.5% greater than did those residing in areas with a high PCDMP participation (≥ 30.37%). According to the stratified analysis of HbA1c levels, people residing in areas with low PCDMP participation had significantly greater odds of having an HbA1c > 6.5%, which may indicate diabetes mellitus. Conclusion: The lower the number of internal medicine clinics in an area participating in PCDMP was, the greater the possibility of an HbA1c > 6.5%. Our findings advocate the need for the government to pay attention to chronic disease management programs, which may lead individuals to have normal HbA1c levels (< 6.5%).

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“…To improve the above described problems in the management of chronic diseases, numerous public projects have been implemented in some regions. Although these projects have resulted in some achievements related to developing awareness on diseases and medication adherence [3,4], this approach comprising sporadically implemented individual projects has not shown population-level effects in the South Korean environment, where there are no incentives for healthcare providers to engage in chronic disease management [5].…”

Section: Introductionmentioning

confidence: 99%

Implementation of a care coordination system for chronic diseases

Lee¹,

Bae²

2019

Yeungnam Univ J Med

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The number of people with chronic diseases has been increasing steadily but the indicators for the management of chronic diseases have not improved significantly. To improve the existing chronic disease management system, a new policy will be introduced, which includes the establishment of care plans for hypertension and diabetes patients by primary care physicians and the provision of care coordination services based on these plans. Care coordination refers to a series of activities to assist patients and their families and it has been known to be effective in reducing medical costs and avoiding the unnecessary use of the hospital system by individuals. To offer well-coordinated and high-quality care services, it is necessary to develop a service quality assurance plan, track and manage patients, provide patient support, agree on patient referral and transition, and develop an effective information system. Local governance should be established for chronic disease management, and long-term plans and continuous quality improvement are necessary.

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Effects of Chronic Disease Management Based on Clinics for Blood Pressure or Glycemic Control in Patients with Hypertension or Type 2 Diabetes Mellitus

Cited by 8 publications

References 12 publications

The Effect of Lifestyle Changes on Blood Pressure Control among Hypertensive Patients

The Effect of Lifestyle Changes on Blood Pressure Control among Hypertensive Patients

Effectiveness of primary care-based chronic disease management program on glycated hemoglobin levels

Implementation of a care coordination system for chronic diseases

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