Complex professional interventions improved the process of care , but the effect on patient outcomes remained less clear because such outcomes were rarely assessed .
Organizational interventions that facilitated the structured and regular review of patients also showed a favorable effect on process measures .
Complex interventions in which patient education was added and /or the role of a nurse was enhanced led to improvements in patient outcomes as well as the process of care .
CONCLUSIONS Multifaceted professional interventions and organizational interventions that facilitate structured and regular review of patients were effective in improving the process of care .
The addition of patient education to these interventions and the enhancement of the role of nurses in diabetes care led to improvements in patient outcomes and the process of care
A randomized controlled trial of an intervention designed to improve the care given in general practice to Type II diabetic patients: patient outcomes and professional ability to change behaviour.
AIM Our objective was to evaluate the effect of training in a patient-centred intervention for GPs and practice nurses on outcomes for patients with Type II diabetes .  METHODS We carried out a r and omized controlled trial within general practice s as the basis for r and omization and a before- and -after design for measures of patient outcome . A parallel process study examined the use of the method by professionals . The study was carried out in 29 general practice s in South Glamorgan who had participated for at least 2 years in a local scheme of audit and CME in relation to Type II diabetes care . The subjects were 252 Type II diabetic patients recruited by 15 experimental and 14 control practice s. The main outcome measures were changes in glycosylated haemoglobin , patient satisfaction with care and treatment , functional health status and professional ability to apply the intervention . RESULTS Professionals adopted the innovative method with enthusiasm , but after 2 years only 19 % continued to apply the method systematic ally . The trial was , therefore , unable to demonstrate significant biochemical or functional improvements . This highlights the need to underst and the factors associated with professional uptake and subsequent ability to sustain changes in behaviour . CONCLUSIONS The efficacy of this behavioural intervention remains unproved , despite its acceptability to professional staff . Detailed and prolonged development and testing of behavioural interventions is an essential first step before embarking on r and omized controlled trials which involve complex behavioural changes in professionals or patients
Complex professional interventions improved the process of care , but the effect on patient outcomes remained less clear because such outcomes were rarely assessed .
Organizational interventions that facilitated the structured and regular review of patients also showed a favorable effect on process measures .
Complex interventions in which patient education was added and /or the role of a nurse was enhanced led to improvements in patient outcomes as well as the process of care .
CONCLUSIONS Multifaceted professional interventions and organizational interventions that facilitate structured and regular review of patients were effective in improving the process of care .
The addition of patient education to these interventions and the enhancement of the role of nurses in diabetes care led to improvements in patient outcomes and the process of care