Group visits improve metabolic control in type 2 diabetes - A 2-year follow-up
Group visits improve metabolic control in type 2 diabetes - A 2-year follow-up
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DOI：
10.2337/diacare.24.6.995
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发表时间：
2001-06-01
期刊：
影响因子：
16.2
通讯作者：
Porta, M
中科院分区：
文献类型：
--
作者：
Trento, M;Passera, P;Porta, M
目的：评估作为常规糖尿病护理并根据系统教育方法构建的团体访视在改善非胰岛素治疗的代谢控制方面是否比个体咨询更有效。研究设计和方法-在112名患者的随机对照临床试验中，56名患者被分配到9或10名个体的组中，这些个体参与小组咨询，并且56名患者（被认为是对照受试者）经历单独访问加支持教育。结果：2年后，观察组患者的HbA（1c）水平低于对照组（P < 0.002）。HDL胆固醇水平在组中观察到患者增加，但在对照组中没有增加（P = 0.045）。BMI（P = 0.06）和空腹甘油三酯水平（P = 0.053）较低。参加团体访视的患者对糖尿病的认知水平和生活质量均有所提高（P <0.001），健康行为也有所改善（P < 0.001）。医生花了更少的时间看到9-10名患者作为一个群体，而不是单独的，但患者有更长的互动与卫生保健providers.CONCLUSIONS -小组咨询可能会提高代谢控制在中期诱导更适当的健康行为。在日常临床实践中是可行的，而不增加工作时间。
OBJECTIVE - To evaluate whether group visits, delivered as routine diabetes care and structured according to a systemic education approach, are more effective than individual consultations in improving metabolic control in non-insulin treated. type 2 diabetes.RESEARCH DESIGN AND METHODS - In a randomized controlled clinical trial of 112 patients, 56 patients were allocated to groups of 9 or 10 individuals who participated in group consultations, and 56 patients (considered control subjects) underwent individual visits plus support education. All visits were scheduled every 3 months.RESULTS - After 2 years, HbA(1c) levels were lower in patients seen in groups than in control subjects (P < 0.002). Levels of HDL cholesterol had increased in patients seen in groups but had not increased in control subjects (P = 0.045). BMI (P = 0.06) and fasting triglyceride level (P = 0.053) were lower. Patients participating in group visits had improved knowledge of diabetes (P < 0.001) and quality of life (P < 0.001) and experienced more appropriate health behaviors (P < 0.001). Physicians spent less time seeing 9-10 patients as a group rather than individually, but patients had longer interaction with health care providers.CONCLUSIONS - Group consultations may improve metabolic control in the medium term by inducing more appropriate health behaviors. They are feasible in everyday clinical practice without increasing working hours.