Educational interventions did not seem to have a positive impact on HbA1c , systolic blood pressure or lipid profiles .
The use of telemedicine , clinician reminders and feedback showed mixed results but there was a level of consistency in improvement in HbA1c when multifaceted interventions on multidisciplinary teams were implemented .
Targeting general or family physicians was largely ineffective in improving the cardiovascular risk factors considered , except when using a computer application on insulin h and ling of type 2 diabetes or customised simulated cases with feedbacks .
Similarly , interventions targeting nurses did not improve outcomes compared to st and ard care .
Multifaceted professional interventions were more effective than single interventions targeting single primary or community care professionals in improving glycaemic control
OBJECTIVE To review the interventions targeting primary care or community based professionals on glycaemic and cardiovascular risk factor control in people with diabetes .
Effectiveness of a Training Course for General Practice Nurses in Motivation Support in Type 2 Diabetes Care: A Cluster-Randomised Trial
Background Type 2 diabetes is a common metabolic disease with the potential for prevention of complications . The prevention requires a high level of lasting actions from the patients , which may be burdensome . The aim of this trial was to evaluate the effectiveness of a training course for general practice nurses  in motivation support at 18 months follow-up in the affiliated type 2 diabetes population . Methods Forty general practice s with nurse-led diabetes consultations from the area of Aarhus , Denmark were r and omised 1∶1 to either intervention or usual practice . Intervention practice s were offered a 16-hour Self-determination theory - based course including communication training for general practice nurses delivered over 10 months . The affiliated diabetes population s ( aged 40–74 years ) were identified from registers ( intervention n = 2,005 ; usual n = 2,029 ) . Primary outcomes were register-based glycated haemoglobin ( HbA1c ) - , total cholesterol levels , and well-being measured by the Problem Areas In Diabetes scale ( PAID ) and the mental component summary score , SF12 ( SF12 , mcs ) . Intention-to-treat analyses were performed . Predefined subgroups analyses were performed . Results The differences between the intervention- and the control practice s ’ mean HbA1c and total cholesterol at follow-up adjusted for baseline values and clustering were respectively : −0.02%-points ( 95 % CI : −0.11 to 0.07 ; p : 0.67 ) ; 0.08 mmol/l ( 95 % CI : 0.01 to 0.15 ; p : 0.02 ) . Differences in median scores adjusted for clustering were for PAID : 1.25 ; p = 0.31 and SF12 , mcs : 0.99 ; p = 0.15 . Women in intervention practice s differed from women in usual practice s on mean HbA1c : −0.12%-points ( −0.23 to −0.02 ; p = 0.02 ) and SF12 , mcs : 2.6 ; p = 0.01 . Conclusions Offering a training course for general practice nurses in applying the Self-determination theory in current type 2 diabetes care had no effect compared with usual practice measured by HbA1c and total cholesterol levels and the well-being at 18 months of follow-up in a comprehensive register-based diabetes population . Subgroup analyses suggested a possible effect in women , which deserves further attention . Trial Registration Clinical Trials.gov ( Identifier NCT01187069 )
Educational interventions did not seem to have a positive impact on HbA1c , systolic blood pressure or lipid profiles .
The use of telemedicine , clinician reminders and feedback showed mixed results but there was a level of consistency in improvement in HbA1c when multifaceted interventions on multidisciplinary teams were implemented .
Targeting general or family physicians was largely ineffective in improving the cardiovascular risk factors considered , except when using a computer application on insulin h and ling of type 2 diabetes or customised simulated cases with feedbacks .
Similarly , interventions targeting nurses did not improve outcomes compared to st and ard care .
Multifaceted professional interventions were more effective than single interventions targeting single primary or community care professionals in improving glycaemic control
OBJECTIVE To review the interventions targeting primary care or community based professionals on glycaemic and cardiovascular risk factor control in people with diabetes .