OBJECTIVE: To demonstrate improvements in diabetes care stimulated by comprehensive evaluation of community-based diabetic patients with feedback to the patients and their physicians. RESEARCH DESIGN AND METHODS: A comprehensive evaluation of community-based diabetic patients with annotated reporting of results to both patients and their physicians (universal intervention) was followed by random assignment of 50% of patients to individual counseling (randomized intervention). In four communities, two large and two small, 55 type 1 and 376 type 2 diabetic patients were recruited, evaluated, and reassessed at 1 year. Outcome measures were HbA1c, serum cholesterol, and systolic and diastolic blood pressure. RESULTS: There were significant improvements in all outcome measures for type 2 diabetic patients randomized to individual counseling (P = 0.03; follow-up rate 84%) and significant improvements in all outcome measures for all high-risk type 2 patients (highest P value = 0.004; follow-up rate 85%). CONCLUSIONS: Comprehensive evaluation of diabetic patients at the community level with annotated reporting of results to the patients and their physicians was associated with improvement of mean HbA1c, cholesterol, and systolic and diastolic blood pressure, particularly in patients in high-risk status for these outcome variables. Individual counseling of 50% of patients, randomly selected, enhanced these results.
RCT Entities:
OBJECTIVE: To demonstrate improvements in diabetes care stimulated by comprehensive evaluation of community-based diabeticpatients with feedback to the patients and their physicians. RESEARCH DESIGN AND METHODS: A comprehensive evaluation of community-based diabeticpatients with annotated reporting of results to both patients and their physicians (universal intervention) was followed by random assignment of 50% of patients to individual counseling (randomized intervention). In four communities, two large and two small, 55 type 1 and 376 type 2 diabeticpatients were recruited, evaluated, and reassessed at 1 year. Outcome measures were HbA1c, serum cholesterol, and systolic and diastolic blood pressure. RESULTS: There were significant improvements in all outcome measures for type 2 diabeticpatients randomized to individual counseling (P = 0.03; follow-up rate 84%) and significant improvements in all outcome measures for all high-risk type 2 patients (highest P value = 0.004; follow-up rate 85%). CONCLUSIONS: Comprehensive evaluation of diabeticpatients at the community level with annotated reporting of results to the patients and their physicians was associated with improvement of mean HbA1c, cholesterol, and systolic and diastolic blood pressure, particularly in patients in high-risk status for these outcome variables. Individual counseling of 50% of patients, randomly selected, enhanced these results.
Authors: Robert M Anderson; Martha M Funnell; James E Aikens; Sarah L Krein; James T Fitzgerald; Robin Nwankwo; Cheryl L Tannas; Tricia S Tang Journal: Ther Patient Educ Date: 2009-06-01
Authors: Martha M Funnell; Tammy L Brown; Belinda P Childs; Linda B Haas; Gwen M Hosey; Brian Jensen; Melinda Maryniuk; Mark Peyrot; John D Piette; Diane Reader; Linda M Siminerio; Katie Weinger; Michael A Weiss Journal: Diabetes Care Date: 2012-01 Impact factor: 19.112
Authors: Miguel A Salinero-Fort; Enrique Carrillo-de Santa Pau; Francisco J Arrieta-Blanco; Juan C Abanades-Herranz; Carmen Martín-Madrazo; Berta Rodés-Soldevila; Carmen de Burgos-Lunar Journal: BMC Public Health Date: 2011-04-28 Impact factor: 3.295
Authors: Patrick J O'Connor; JoAnn Sperl-Hillen; Paul E Johnson; William A Rush; A Lauren Crain Journal: Diabetes Care Date: 2009-04-14 Impact factor: 17.152
Authors: Martha M Funnell; Tammy L Brown; Belinda P Childs; Linda B Haas; Gwen M Hosey; Brian Jensen; Melinda Maryniuk; Mark Peyrot; John D Piette; Diane Reader; Linda M Siminerio; Katie Weinger; Michael A Weiss Journal: Diabetes Care Date: 2010-01 Impact factor: 19.112