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 .
The North Dublin randomized controlled trial of structured diabetes shared care.
BACKGROUND A new diabetes shared care service was introduced in North Dublin . It was design ed as a r and omized controlled trial with a complex intervention comprising education of participating practitioners , the introduction of a community-based diabetes nurse specialist , local agreement on clinical protocol s and structured communication across the primary - secondary care interface . OBJECTIVES Our aim was to assess the feasibility and effectiveness of a structured diabetes shared care service in a mixed health care system and to analyse the impact on total patient care . METHODS A Cluster r and omized controlled trial lasting 18 months was carried out in 183 patients with type 2 diabetes from 30 general practice s in North Dublin . Biophysical outcomes ( HbA1c , blood pressure , body mass index ) , psychosocial measures ( smoking status and Diabetes Clinic Treatment Satisfaction and Diabetes Well-being scores ) and process outcomes were collected . RESULTS There were significant improvements in diabetes care delivery and in psychosocial outcomes , but no significant improvements in biomedical outcomes . Process data collection revealed a significant increase in diabetes care-related activity for participating patients with an increase in structured annual review s and fewer patients defaulting from care . There were also significant improvements in information exchange between primary and secondary care . CONCLUSION Structured diabetes shared care , in a mixed health care system , can produce significant improvements in diabetes care delivery and in psychosocial outcomes for patients , with improved information exchange across the primary - secondary care interface
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 .