Team-based care approach to cholesterol management in diabetes mellitus: two-year cluster randomized controlled trial
| Autor: | Kerry Bonin, Yelena Rozenfeld, Joseph Siemienczuk, William Gillanders, Ginger Pape, Kristina L. Butler, Jacquelyn S. Hunt, Benjamin H. LeBlanc |
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| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty Health information technology Pharmacist Psychological intervention MEDLINE Disease cluster Pharmacists law.invention Oregon Patient satisfaction Randomized controlled trial law Diabetes mellitus Physicians Internal Medicine medicine Diabetes Mellitus Humans Cooperative Behavior Aged Glycated Hemoglobin business.industry Anticholesteremic Agents Cholesterol LDL Middle Aged medicine.disease Cholesterol Treatment Outcome Patient Satisfaction Health Care Surveys Physical therapy Patient Compliance Female business |
| Zdroj: | Archives of internal medicine. 171(16) |
| ISSN: | 1538-3679 |
| Popis: | Creative, cost-effective interventions to improve the quality of care of chronic illnesses are needed. This study was designed to evaluate the impact of remote physician-pharmacist team-based care on cholesterol levels in patients with diabetes mellitus (DM).This 2-year prospective, cluster randomized controlled trial was conducted within the Providence Primary Care Research Network in Oregon. Participants at least 18 years of age were identified by a diagnosis of DM. The intervention included remote physician-pharmacist team-based care focused on cholesterol management in DM. All clinicians in the study had access to the health information technology tool CareManager, which provided automated DM-related point-of-care prompts, a Web-based registry, and performance feedback with benchmarking. Study outcomes included the difference in low-density lipoprotein cholesterol (LDL-C) goal attainment, mean LDL-C, prescribed lipid-lowering therapy, and patient satisfaction between the intervention and control arms.A total of 6963 patients with DM cared for by 68 physicians in 9 clinics were evaluated. Patients in the intervention arm were more likely to achieve their target LDL-C levels compared with controls (78% vs 50%; P = .003). The mean LDL-C level was 12 mg/dL lower in the intervention arm compared with the control arm (P.001). The rate of LDL-C testing was significantly higher in the intervention arm compared with the control arm. Patients in the intervention arm were also 15% more likely to receive a prescription for a lipid-lowering medication (P = .008). There was no significant difference in patient satisfaction between study arms (P = .15).Remotely located physician-pharmacist team-based care resulted in significantly improved LDL-C levels and goal attainment among patients with DM. |
| Databáze: | OpenAIRE |
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