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Research: Many programs to help diabetics manage their health do work
Date:6/22/2012

get the health care system are quite effective, especially team changes and case management. High levels of HbA1c indicate patients are in poorer health than those with low levels. Team changes programs are those that add another health care worker to a patient's team, such as an endocrinologist or nutritionist. Case management programs require someone other than the primary physician, such as a nurse, to coordinate care in a clinic. The review found these strategies had a positive impact on cardiovascular risk factors such as LDL cholesterol and blood pressure after 12 months
  • Strategies that target patients are effective regardless of their HbA1c levels
  • Strategies aimed at physicians are not as effective, especially not for people who are already controlling their diabetes well

    Dr. Tricco said the findings of the study could help physicians decide which patients would benefit from which programs. Those who are not controlling their diabetes well, for example, might benefit from some of the more costly programs, such as team changes and case management. Yet that might not be a good use of resources for patients who are managing their illness well.

    Overall, the use of quality improvement strategiesclinical reminders, clinical education. patient behavior, patient education-- resulted in a 0.37 per cent reduction of HbA1c after an average follow-up of one year. The meta-analysis did not find a statistically significant improvement in the use of statins (drugs that reduce cholesterol), hypertension reduction or smoking cessation. The interventions did play an important role in increasing the use of aspirin and antihypertensive medication over a median follow-up of 13 months. They also were associated with an increase in retinopathy (inflammation of the eye), screening, screening for renal disease and foot screening over a median follow-up of 12 months.

    Dr. Tricco said wide implementation of such strategies could have important be
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  • Contact: Leslie Shepherd
    shepherdl@smh.ca
    416-864-6094
    St. Michael's Hospital
    Source:Eurekalert

    Page: 1 2 3

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