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 .
A randomized trial of three diabetes registry implementation strategies in a community internal medicine practice.
BACKGROUND Disease registries are powerful tools with the potential to transform the way chronic diseases are managed . To date , however , little work has been done to determine how to optimize the implementation of a chronic disease registry in practice . METHODS Twenty-nine physicians and their nurse teams in a large community internal medicine practice participated in this 6-month prospect i ve r and omized trial in 2000 . Teams were assigned to one of three implementation strategies using information from a diabetes registry .  Process and outcome measures for diabetes management were analyzed . Process measures included the percentage of patients completing glycosylated hemoglobin ( Hgb ) testing within 6 months and low-density lipoprotein ( LDL ) testing within 12 months . Outcome measures included the percentage of patients with a glycosylated Hgb > 9.3 % ( equivalent to a HgbA1c > 8.0 % ) , the percentage of patients with an LDL cholesterol > 130 mg/dl , and the percentage of patients with controlled blood pressure , defined as < 130/85 millimeters of mercury . Mean change in LDL and glycosylated Hgb values was also measured . RESULTS Teams r and omized to an intervention strategy that included direct letters to patients showed significant improvement across a number of measures . The improvement was most apparent among patients without recent testing or with poorly controlled disease . The two interventions that did not include direct patient letters result ed in limited improvement . DISCUSSION Disease registries can be used to improve outcomes in the management of diabetes and other chronic diseases . Better outcomes were seen in patients who received letters based on registry-generated data . This strategy should be included as part of a comprehensive chronic disease management plan . Further refinements in the use of registries should result in further incremental improvement
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 .