The effect on patient outcomes remained less clear as these were rarely assessed .
Arrangements for follow-up ( organisational intervention ) also showed a favourable effect on process outcomes .
Multiple interventions in which patient education was added or in which the role of the nurse was enhanced also reported favourable effects on patients ' health outcomes .
REVIEW ER 'S CONCLUSIONS Multifaceted professional interventions can enhance the performance of health professionals in managing patients with diabetes .
Organisational interventions that improve regular prompted recall and review of patients ( central computerised tracking systems or nurses who regularly contact the patient ) can also improve diabetes management .
The addition of patient-oriented interventions can lead to improved patient health outcomes .
BACKGROUND Diabetes is a common chronic disease that is increasingly managed in primary care .
Different systems have been proposed to manage diabetes care .
Benefits provided by an integrated education and clinical diabetes centre: a follow-up study.
The effects of a new integrated system of diabetes care with an enhanced role of the diabetes specialist nurse based in a purpose d design diabetes centre , on diabetes control , attendance and cancellation rates , and admission for diabetic emergencies have been review ed . Glycaemic control was examined in : ( a ) a cohort of 163 insulin-treated and 47 non-insulin treated diabetic subjects ( age < 65 years ) studied prospect ively before and 3 years following the introduction of a new system of care ; ( b ) a second cohort of more elderly patients aged greater than 65 years studied for the 3 years after the change over ; ( c ) a cross-sectional study of the clinic population ( n = 700 ) the year before and 3 years after the changeover ; ( d ) a group of patients attending st and ard unaltered clinics in the same district ( n = 157 ) . Significant and sustained falls in HbA1 were observed in all groups of subjects attending the centre , with the means for those aged less than 65 falling from 11.9 + /- 2.3 % to 9.9 + /- 1.9 % and for those aged over 65 from a mean of 11.7 + /- 2.0 % to 10.3 + /- 2.3 % , 3 years later . The cross-sectional study provided similar results with a mean HbA1 of 12.2 + /- 3.0 % prior to changeover and 10.4 + /- 4.4 % , 3 years later . Smaller but significant changes were observed in patients continuing to attend the routine clinic ( from 12.2 + /- 2.3 % to 11.3 + /- 2.6 % ) over a similar period . Yearly admission rates for ketoacidosis and hypoglycaemia fell from 44 and 23 , to 33 and 5 per annum , respectively . ( ABSTRACT TRUNCATED AT 250 WORDS
The effect on patient outcomes remained less clear as these were rarely assessed .
Arrangements for follow-up ( organisational intervention ) also showed a favourable effect on process outcomes .
Multiple interventions in which patient education was added or in which the role of the nurse was enhanced also reported favourable effects on patients ' health outcomes .
REVIEW ER 'S CONCLUSIONS Multifaceted professional interventions can enhance the performance of health professionals in managing patients with diabetes .
Organisational interventions that improve regular prompted recall and review of patients ( central computerised tracking systems or nurses who regularly contact the patient ) can also improve diabetes management .
The addition of patient-oriented interventions can lead to improved patient health outcomes .
BACKGROUND Diabetes is a common chronic disease that is increasingly managed in primary care .
Different systems have been proposed to manage diabetes care .