Evaluation of a nurse-care management system to improve outcomes in patients with complicated diabetes
| Autor: | Darby Cunning, George Greenwald, Kelly R. Reilly, Liana Abascal, Nancy Houston Miller, Allison Deeter, C. Barr Taylor |
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| Rok vydání: | 2003 |
| Předmět: |
Research design
Male medicine.medical_specialty Time Factors Databases Factual Endocrinology Diabetes and Metabolism Blood Pressure California law.invention Fasting glucose Diabetes Complications Randomized controlled trial law Intervention (counseling) Diabetes mellitus Internal Medicine Diabetes Mellitus Ethnicity Medicine Humans In patient Life Style Advanced and Specialized Nursing business.industry Middle Aged medicine.disease Lipids Surgery Telephone Blood pressure Treatment Outcome Diabetes Mellitus Type 2 Emergency medicine Hypertension Educational Status Female business Psychosocial Algorithms Diabetic Angiopathies Follow-Up Studies |
| Zdroj: | Diabetes care. 26(4) |
| ISSN: | 0149-5992 |
| Popis: | OBJECTIVE—This study evaluated the efficacy of a nurse-care management system designed to improve outcomes in patients with complicated diabetes. RESEARCH DESIGN AND METHODS—In this randomized controlled trial that took place at Kaiser Permanente Medical Center in Santa Clara, CA, 169 patients with longstanding diabetes, one or more major medical comorbid conditions, and HbAlc >10% received a special intervention (n = 84) or usual medical care (n = 85) for 1 year. Patients met with a nurse-care manager to establish individual outcome goals, attended group sessions once a week for up to 4 weeks, and received telephone calls to manage medications and self-care activities. HbAlc, LDL, HDL, and total cholesterol, triglycerides, fasting glucose, systolic and diastolic blood pressure, BMI, and psychosocial factors were measured at baseline and 1 year later. Annualized physician visits were determined for the year before and during the study. RESULTS—At 1 year, the mean reductions in HbAlc, total cholesterol, and LDL cholesterol were significantly greater for the intervention group compared with the usual care group. Significantly more patients in the intervention group met the goals for HbA1c ( CONCLUSIONS—A nurse-care management program can significantly improve some medical outcomes in patients with complicated diabetes without increasing physician visits. |
| Databáze: | OpenAIRE |
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