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 .
Development and Validation of a Computer Application to Aid the Physician's Decision-Making Process at the Start of and during Treatment with Insulin in Type 2 Diabetes: A Randomized and Controlled Trial
Background : Achieving optimum blood glucose control in patients with type 2 diabetes mellitus ( T2DM ) is difficult . Some primary care physicians ( PCPs ) delay the start of insulin use because of the uncertainty in intensifying insulin therapy . The objective was to develop and vali date a computer application ( CA ) that helps PCPs to make decisions about insulin therapy in order to achieve a significant improvement in glycated hemoglobin ( HbA1c ) . Methods : This was a cluster-r and omized clinical trial . Fourteen primary care centers ( PCCs ) in Madrid with 66 PCPs and 697 T2DM patients on insulin therapy were r and omly divided into two groups of seven PCCs each . In the intervention group , seven PCCs included 39 PCPs and 365 T2DM patients on insulin therapy . These PCPs were free to use the CA . A further seven PCCs were assigned to the control group with 27 PCPs and 332 T2DM patients on insulin therapy . The control group did not use the CA . The duration of the trial was 18 months to vali date the CA . The outcome was a change in HbA1c from baseline . Results : In the intervention group , the final HbA1c was 7.19 % ( st and ard deviation [ SD ] ± 0.93 ) , with a difference from the start of −0.69 % ( p = .001 ) . In the control group , it was 7.71 % ( SD ± 1.37 ) , with a difference from the start of −0.09 % ( p not significant ) . Conclusions : This CA helps to improve HbA1c figures of T2DM patients with insulin when it is used by PCPs to make decisions when starting , continuing , or changing insulin and its dosage
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 .