Less frequently reported were quality of life , patient satisfaction , self-care , and healthcare utilization .
Most care management modalities were carved out from primary care .
Conclusions Most care management programs for patients with type 2 diabetes are ' carved-out ' , accomplish limited effects on metabolic outcomes , and have unknown effects on patient important outcomes .
Background This systematic review and meta- analysis aims at assessing the composition and performance of care management models evaluated in the last decade and their impact on patient important outcomes .
Translating a Community-Based Motivational Support Program to Increase Physical Activity Among Older Adults With Diabetes at Community Clinics: A Pilot Study of Physical Activity for a Lifetime of Success (PALS)
Background Regular physical activity is an important goal for elders with chronic health conditions . Context This report describes Physical Activity for a Lifetime of Success ( PALS ) , an attempt to translate a motivational support program for physical activity , Active Choices , for use by a group of diverse , low-income , community-dwelling elders with diabetes . Methods PALS linked physical activity assessment and brief counseling by primary care providers with a structured referral to a community-based motivational telephone support program delivered by older adult volunteers . People with diabetes aged 65 years or older who were receiving care at two community clinics were r and omized to receive either immediate or delayed intervention . The main intended outcome measure was physical activity level ; the secondary outcome measure was mean hemoglobin A1c . Consequences One-third of those offered referral to the PALS program in the clinic setting declined . Another 44 % subsequently declined enrollment or were unreachable by the support center . Only 14 ( 21 % ) of those offered referral enrolled in the program . Among these 14 , the percentage who were sufficiently active was higher at follow-up than at enrollment , though not significantly so . Using an intent-to-treat analysis , which included all r and omized clinic patients , we found no significant change in mean hemoglobin A1c for the intervention group compared with controls . Interpretation A community-based referral and support program to increase physical activity  among elderly , ethnically diverse , low-income people with diabetes , many of whom are not English-speaking , may be thwarted by unforeseen barriers . Those who enroll and participate in the PALS program appear to increase their level of physical activity
Less frequently reported were quality of life , patient satisfaction , self-care , and healthcare utilization .
Most care management modalities were carved out from primary care .
Conclusions Most care management programs for patients with type 2 diabetes are ' carved-out ' , accomplish limited effects on metabolic outcomes , and have unknown effects on patient important outcomes .
Background This systematic review and meta- analysis aims at assessing the composition and performance of care management models evaluated in the last decade and their impact on patient important outcomes .