It is likely that investments at the social context level will also help to decrease the development of barriers at the organisational context level , especially by increasing staff involvement and satisfaction .
Background Integrated care interventions for chronic conditions can lead to improved outcomes , but it is not clear when and why this is the case .
This study aims to answer the following two research questions : First , what are the context , mechanisms and outcomes of integrated care for people with type 2 diabetes ?
Second , what are the relationships between context , mechanisms and outcomes of integrated care for people with type 2 diabetes ?
Interdisciplinary diabetes care teams operating on the interface between primary and specialty care are associated with improved outcomes of care: findings from the Leuven Diabetes Project
Background Type 2 diabetes mellitus is a complex , progressive disease which requires a variety of quality improvement strategies . Limited information is available on the feasibility and effectiveness of interdisciplinary diabetes care teams ( IDCT ) operating on the interface between primary and specialty care . A first study hypothesis was that the implementation of an IDCT is feasible in a health care setting with limited tradition in shared care . A second hypothesis was that patients who make use of an IDCT  would have significantly better outcomes compared to non-users of the IDCT after an 18-month intervention period . A third hypothesis was that patients who used the IDCT in an Advanced quality Improvement Program ( AQIP ) would have significantly better outcomes compared to users of a Usual Quality Improvement Program ( UQIP ) . Methods This investigation comprised a two-arm cluster r and omized trial conducted in a primary care setting in Belgium . Primary care physicians ( PCPs , n = 120 ) and their patients with type 2 diabetes mellitus ( n = 2495 ) were included and subjects were r and omly assigned to the intervention arms . The IDCT acted as a cornerstone to both the intervention arms , but the number , type and intensity of IDCT related interventions varied depending upon the intervention arm . Results Final registration included 67 PCPs and 1577 patients in the AQIP and 53 PCPs and 918 patients in the UQIP . 84 % of the PCPs made use of the IDCT .  The expected participation rate in patients ( 30 % ) was not attained , with 12,5 % of the patients using the IDCT .  When comparing users and non-users of the IDCT ( irrespective of the intervention arm ) and after 18 months of intervention the use of the IDCT was significantly associated with improvements in HbA1c , LDL-cholesterol , an increase in statins and anti-platelet therapy as well as the number of targets that were reached . When comparing users of the IDCT in the two intervention arms no significant differences were noted , except for anti-platelet therapy . Conclusion IDCT 's operating on the interface between primary and specialty care are associated with improved outcomes of care . More research is required on what team and program characteristics contribute to improvements in diabetes care . Trial registration NTR 1369
It is likely that investments at the social context level will also help to decrease the development of barriers at the organisational context level , especially by increasing staff involvement and satisfaction .
Background Integrated care interventions for chronic conditions can lead to improved outcomes , but it is not clear when and why this is the case .
This study aims to answer the following two research questions : First , what are the context , mechanisms and outcomes of integrated care for people with type 2 diabetes ?
Second , what are the relationships between context , mechanisms and outcomes of integrated care for people with type 2 diabetes ?