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 .
Simulated Physician Learning Program Improves Glucose Control in Adults With Diabetes
OBJECTIVE Inexpensive and st and ardized methods to deliver medical education to primary care physicians ( PCPs ) are desirable . Our objective was to assess the impact of an individualized simulated learning intervention on diabetes care provided by PCPs . RESEARCH DESIGN AND METHODS Eleven clinics with 41 consenting PCPs in a Minnesota medical group were r and omized to receive or not receive the learning intervention . Each intervention PCP was assigned 12 simulated type 2 diabetes cases that took about 15 min each to complete . Cases were design ed to remedy specific physician deficits found in their electronic medical record observed practice patterns . General linear mixed models that accommo date d the cluster r and omized study design were used to assess patient-level change from preintervention to 12-month postintervention of A1C , blood pressure , and LDL cholesterol . The relationship between the study arm and the total of intervention and patient health care costs was also analyzed . RESULTS Intervention clinic patients with baseline A1C ≥7 % significantly improved glycemic control at the last postintervention A1C measurement , intervention effect of −0.19 % mean A1C ( P = 0.034 ) and + 6.7 % in A1C < 7 % goal achievement ( P = 0.0099 ) . Costs trended lower , with the cost per patient −$71 ( SE = 142 , P = 0.63 ) relative to nonintervention clinic patients . The intervention did not significantly improve blood pressure or LDL control . Models adjusting for age , sex , and comorbidity showed similar results . PCPs reported high satisfaction . CONCLUSIONS A brief individualized case-based simulated learning intervention for PCPs led to modest but significant glucose control improvement in adults with type 2 diabetes without increasing costs
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 .