Ilona Mikkola1, Maria Hagnäs2, Jelena Hartsenko3, Minna Kaila4, Klas Winell3. 1. Rovaniemi Health Centre, Rovaniemi, Finland; Conmedic, Espoo, Finland. Electronic address: ilona.mikkola@rovaniemi.fi. 2. Rovaniemi Health Centre, Rovaniemi, Finland; Center for Life Course Health Research, University of Oulu, Oulu, Finland. 3. Conmedic, Espoo, Finland. 4. Public Health Medicine, University of Helsinki and Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
Abstract
OBJECTIVES: Our aim in this study was to determine whether the use of a personalized care plan is associated with better clinical outcomes of type 2 diabetes treatment in the real world. METHODS: Quality of treatment was assessed using data from a yearly sample of patients with type 2 diabetes visiting primary care health centres in 2012-2016. Patients were divided into 3 groups as follows: 1) the patient has a copy of their personalized care plan, 2) the care plan exists in the patient record only or 3) the patient has no care plan. Data on smoking, laboratory tests, systolic blood pressure (sBP) and statin use were collected. We compared the outcomes between the 3 groups in terms of proportions of patients achieving the clinical targets recommended by international guidelines. RESULTS: Evaluable data were available for 10,403 patients. Of these, 1,711 (16%) had a copy of their personalized care plan, and 3,623 (35%) had no care plan. Those patients who had a copy of their care plan were significantly more likely than those without to achieve the sBP target (odds ratio [OR], 1.39; 95% confidence interval [CI], 1.29 to 1.51; p<0.001; adjusted for age and gender) and low-density lipoprotein target (OR, 1.46; 95% CI, 1.34 to 1.58; p<0.001), and to use statins (OR, 1.70; 95% CI, 1.57 to 1.85; p<0.001). CONCLUSIONS: Patients who had a copy of their care plan had a better control of sBP and low-density lipoprotein, and were more likely to use statins than patients without a care plan.
OBJECTIVES: Our aim in this study was to determine whether the use of a personalized care plan is associated with better clinical outcomes of type 2 diabetes treatment in the real world. METHODS: Quality of treatment was assessed using data from a yearly sample of patients with type 2 diabetes visiting primary care health centres in 2012-2016. Patients were divided into 3 groups as follows: 1) the patient has a copy of their personalized care plan, 2) the care plan exists in the patient record only or 3) the patient has no care plan. Data on smoking, laboratory tests, systolic blood pressure (sBP) and statin use were collected. We compared the outcomes between the 3 groups in terms of proportions of patients achieving the clinical targets recommended by international guidelines. RESULTS: Evaluable data were available for 10,403 patients. Of these, 1,711 (16%) had a copy of their personalized care plan, and 3,623 (35%) had no care plan. Those patients who had a copy of their care plan were significantly more likely than those without to achieve the sBP target (odds ratio [OR], 1.39; 95% confidence interval [CI], 1.29 to 1.51; p<0.001; adjusted for age and gender) and low-density lipoprotein target (OR, 1.46; 95% CI, 1.34 to 1.58; p<0.001), and to use statins (OR, 1.70; 95% CI, 1.57 to 1.85; p<0.001). CONCLUSIONS:Patients who had a copy of their care plan had a better control of sBP and low-density lipoprotein, and were more likely to use statins than patients without a care plan.
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