3-Year Follow-up of Clinical and Behavioral Improvements Following a Multifaceted Diabetes Care Intervention Results of a Randomized Controlled Trial
3-Year Follow-up of Clinical and Behavioral Improvements Following a Multifaceted Diabetes Care Intervention Results of a Randomized Controlled Trial
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DOI：
10.1177/0145721710361388
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发表时间：
2010-03-01
影响因子：
3.9
通讯作者：
Zgibor, Janice C.
中科院分区：
文献类型：
--
作者：
Piatt, Gretchen A.;Anderson, Robert M.;Zgibor, Janice C.
PurposeThe的目的是，本研究的目的是要确定，如果观察到的改善，在12个月后，多方面的糖尿病护理干预措施的临床，行为和心理社会的结果，持续在3年follow-up.MethodsThis研究是一个多层次的，非盲，集群设计，随机对照试验，发生在一个服务不足的郊区匹兹堡，宾夕法尼亚州，1999年至2005年之间。将11个初级保健实践及其患者随机分配到3组：慢性护理模式（CCM）干预（n = 30），仅提供者教育（PROV）（n = 38）和常规护理（UC）（n = 51）。受试者进行了3 years. ResultsImprovement观察到在12个月的后续血糖（-0.5%）和血压控制（-4.8毫米汞柱），和参与者的比例谁自我监测他们的血糖（86.7%-100%），持续在3年的后续CCM组。所有研究组的非HDLc水平和CCM干预组的幸福感评分质量均有所改善。所有协会仍然控制药物治疗intensify.ConclusionsWe已经证明，随着时间的推移，多方面的糖尿病护理干预后，可以持续改善的结果。这一领域的未来研究是必要的，以了解糖尿病自我管理教育（DSME）后结局的改善是否可以持续，以及什么类型的患者从多方面的糖尿病护理干预中获得最佳效果。
PurposeThe purpose of this study was to determine if improvements observed in clinical, behavioral, and psychosocial outcomes measured at 12 months following a multifaceted diabetes care intervention were sustained at 3-year follow-up.MethodsThis study was a multilevel, nonblinded, cluster design, randomized controlled trial that took place in an underserved suburb of Pittsburgh, Pennsylvania, between 1999 and 2005. Eleven primary care practices, and their patients, were randomly assigned to 3 groups: chronic care model (CCM) intervention (n = 30), provider education only (PROV) (n = 38), and usual care (UC) (n = 51). Subjects were followed for 3 years.ResultsImprovements observed at 12-month follow-up in glycemic (-0.5%) and blood pressure control (-4.8 mm Hg), and the proportion of participants who self-monitor their blood glucose (86.7%-100%), were sustained at 3-year follow-up in the CCM group. Additional improvements occurred in non-HDLc levels in all study groups and quality of well-being scores in the CCM intervention group. All associations remained after controlling for medication treatment intensification.ConclusionsWe have demonstrated that improvements in outcomes can be sustained over time following a multifaceted diabetes care intervention. Future research in this area is necessary to understand if improvements in outcomes can be sustained following diabetes self-management education (DSME) and what type of patient fares the best from multifaceted diabetes care interventions.