Dataset Information

[Uncontrolled type 2 diabetes in primary care health center: Modifiable factors and target population].

ABSTRACT:

Aims

To detect modifiable factors and target populations associated with uncontrolled type 2 diabetes in primary care.

Design

Retrospective cross-sectional descriptive study.

Location

Health center of Barranco Grande, Tenerife.

Participants

Random selection of patients with DM2 attended by 12 family doctors and 12 nurses.

Main measurements

In addition to the control of DM2, sociodemographic, clinical data, lifestyle and follow-up of preventive and therapeutic measures were obtained. After bivariate analysis, a multilevel multivariate model was adjusted by taking the quota of patients assisted by each physician as a second-level mixed-effect variable and the rest as first-level variables.

Results

587 patients were recruited (46.5% female), treated with 1.9-1.1 antidiabetic drugs, with 4.1% therapeutic non-compliance, and suffering 13.8% therapeutic inertia. 23.7% showed poor DM2 control, being significantly worse (p<0.05) in male sex, age <65 years, evolution DM2 -5 years, work-active, upper-middle studies, inadequate diet, metabolic syndrome, ratio TG/HDL-3, complications of DM2, Charlson index<5, nursing visits <3/year, without ECG in the last year, and more drugs prescribed for DM2. The doctor-nurse quota was associated with poor control with an intraclass coefficient of 0.01.

Conclusions

Men under 65 years of age with DM2 evolution longer than 5 years are a target population to intensify interventions. Therapeutic non-compliance, inadequate diet, lack of adherence protocols and ratio TG/HDL>3 are the main modifiable factors on which to intervene. The association of the doctor-nurse quota with the control of DM2 is weak, probably due to adequate follow-up of preventive programs.

SUBMITTER: Cuevas Fernandez FJ

PROVIDER: S-EPMC8144534 | biostudies-literature | 2021 Nov

REPOSITORIES: biostudies-literature

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Publications

[Uncontrolled type 2 diabetes in primary care health center: Modifiable factors and target population].

Cuevas Fernández Francisco J FJ Pérez de Armas Adrián A Cerdeña Rodríguez Elena E Hernández Andreu Miguel M Iglesias Girón María José MJ García Marrero María Rosario MR Cabrera de León Antonio A García Bello Miguel Ángel MÁ

Atencion primaria 20210524 9

<h4>Aims</h4>To detect modifiable factors and target populations associated with uncontrolled type 2 diabetes in primary care.<h4>Design</h4>Retrospective cross-sectional descriptive study.<h4>Location</h4>Health center of Barranco Grande, Tenerife.<h4>Participants</h4>Random selection of patients with DM2 attended by 12 family doctors and 12 nurses.<h4>Main measurements</h4>In addition to the control of DM2, sociodemographic, clinical data, lifestyle and follow-up of preventive and therapeutic ...[more]

PMID: 34034078

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Project description:BackgroundInterprofessional collaborative care such as a split-shared care model involving family physicians and community pharmacists can reduce the economic burden of diabetes management. This study aimed to evaluate the economic outcome of a split-shared care model between family physicians and community pharmacists within a pharmacy chain in managing people with uncontrolled type 2 diabetes and polypharmacy.MethodThis was a multi-center, parallel arm, open label, randomized controlled trial comparing the direct and indirect economic outcomes of people who received collaborative care involving community pharmacists (intervention) versus those who received usual care without community pharmacist involvement (control). People with uncontrolled type 2 diabetes, defined as HbA1c > 7.0% and taking ≥ 5 chronic medications were included while people with missing baseline economic data (such as consultation costs, medication costs) were excluded. Direct medical costs were extracted from the institution's financial database while indirect costs were calculated from self-reported gross income and productivity loss, using Work Productivity Activity Impairment Global Health questionnaire. Separate generalized linear models with log link function and gamma distribution were used to analyze changes in direct and indirect medical costs.ResultsA total of 175 patients (intervention = 70, control = 105) completed the trial and were included for analysis. The mean age of the participants was 66.9 (9.2) years, with majority being male and Chinese. The direct medical costs were significantly lower in the intervention than the control group over 6 months (intervention: -US$70.51, control: -US$47.66, p < 0.001). Medication cost was the main driver in both groups. There were no significant changes in productivity loss and indirect costs in both groups.ConclusionImplementation of split-shared visits with frontline community partners may reduce economic burden for patient with uncontrolled type 2 diabetes and polypharmacy.Trial registrationClinicaltrials.gov Reference Number: NCT03531944 (Date of registration: June 6, 2018).

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Dataset Information

[Uncontrolled type 2 diabetes in primary care health center: Modifiable factors and target population].

Aims

Design

Location

Participants

Main measurements

Results

Conclusions

Publications

[Uncontrolled type 2 diabetes in primary care health center: Modifiable factors and target population].

Similar Datasets

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