Effectiveness of the EMPOWER-PAR Intervention on Primary Care Providers’ Adherence to Clinical Practice Guideline on the Management of Type 2 Diabetes Mellitus: A Pragmatic Cluster Randomised Controlled Trial
| Autor: | Sharmila Lakshmanan, Jamaiyah Haniff, Nur Khairul Bariyyah Mohd Hatta, Tg Mohd Ikhwan Tg Abu Bakar Sidik, Sarimah Mahmood, Maryam Hannah Daud, Suraya Abdul-Razak, Anis Safura Ramli |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
lcsh:Medicine 030209 endocrinology & metabolism Disease cluster law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Intervention (counseling) Type 2 diabetes mellitus medicine Primary care providers 030212 general & internal medicine Cluster randomised controlled trial Clinical practice guideline Chronic care business.industry Medical record lcsh:R Type 2 Diabetes Mellitus General Medicine Guideline Adherence Physical therapy business |
| Zdroj: | Open Access Macedonian Journal of Medical Sciences; Vol. 8 No. B (2020): B-Clinical Sciences; 470-479 Open Access Macedonian Journal of Medical Sciences, Vol 8, Iss B (2020) |
| ISSN: | 1857-9655 |
| DOI: | 10.3889/oamjms.2020.3764 |
| Popis: | AIM: The objective of this study was to evaluate the effectiveness of the EMPOWER- participatory action research (PAR) intervention, a multifaceted strategy based on the chronic care model (CCM) on primary care providers (PCP)’ adherence to type 2 diabetes mellitus (T2DM) clinical practice guideline (CPG) in the Malaysian primary care setting. METHODS: This was a pragmatic cluster randomized controlled trial –PAR conducted in ten public primary care clinics in Malaysia. Five clinics were randomly selected to provide the EMPOWER-PAR intervention for 1 year and another five clinics continued with usual care. The outcome measure was the absolute change in the proportion of PCP’s adherence to T2DM CPG captured using the “Indicators of Care Pro forma,” based on the recommendation by the Malaysian CPG on the Management of T2DM. Data were collected from the patients’ medical records, at baseline and at 1-year follow-up; and were analyzed using mixed method model. RESULTS: A total of 888 patients were recruited at baseline; 471 were in the intervention and 417 were in the control group. There was no significant demographic difference between the two groups at baseline except for ethnicity. At 1-year, 455 (96.6%) and 406 (97.3%) patients in the intervention and control groups completed the study, respectively. There were significant improvements in the absolute change in the proportion of PCPs’ adherence to T2DM CPG in the intervention group compared to the control group at 1-year follow-up in several indicators of care. These included the recording of BMI (0.6% vs. −1.8%, p |
| Databáze: | OpenAIRE |
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