There were no significant mean reductions for body mass index or serum cholesterol .
Nurse-led interventions produced greater improvements than ' usual care ' for HbA1c , serum triglyceride and smoking cessation and support an increased independent role for nurses in diabetes management
Nurse-run, telephone-based outreach to improve lipids in people with diabetes.
BACKGROUND There is a need for r and omized , prospect i ve trials of case management interventions with re source utilization analyses . OBJECTIVES To determine whether algorithm-driven telephone care by nurses improves lipid control in patients with diabetes . DESIGN Prospect i ve , r and omized , controlled trial . PARTICIPANTS Adults with diabetes at a federally funded community health center were r and omly assigned to intervention ( n = 381 ) or usual-care ( n = 381 ) groups . INTERVENTIONS Nurses independently initiated and titrated lipid therapy and promoted behavioral change through motivational interviewing and self-management techniques . Other parameters of diabetes care were addressed based on time constraints . MAIN MEASURES The primary outcome was the proportion of patients with a low-density lipoprotein ( LDL ) less than 100 mg/dL. Secondary outcomes included the number of hospital admissions , total hospital charges per patient , and the proportion of patients meeting other lipid , glycemic , and blood pressure guidelines . KEY RESULTS The percent of patients with an LDL < 100 mg/dL increased from 52.0 % to 58.5 % in the intervention group and decreased from 55.6 % to 46.7 % in the control group ( P < .01 ) . Average cost per patient to the healthcare system was less for the intervention group ( $ 6600 vs $ 9033 , P = .03 ) . Intervention patients trended toward fewer hospital admissions ( P = .06 ) . The intervention did not affect glycemic and blood pressure outcomes . CONCLUSIONS Nurses can improve lipid control in patients with diabetes in a primarily indigent population through telephone care using moderately complex algorithms , but a more targeted approach is warranted . Telephone-based outreach may decrease re source utilization , but more study is needed
There were no significant mean reductions for body mass index or serum cholesterol .
Nurse-led interventions produced greater improvements than ' usual care ' for HbA1c , serum triglyceride and smoking cessation and support an increased independent role for nurses in diabetes management