Community-based programmes achieved good results for most risk factors except BMI and ( glycated haemoglobin ) HbA1c .
INTRODUCTION Although cardiovascular disease ( CVD ) and type 2 diabetes mellitus ( T2DM ) prevention programmes have been effective in urban residents , their effectiveness in non-urban setting s , where cardio-metabolic risk is typically elevated , is unknown .
We systematic ally review ed the effectiveness of primary prevention programmes aim ed at reducing risk factors for CVD/T2DM , including blood pressure , body mass index ( BMI ) , blood lipid and glucose , diet , lifestyle , and knowledge in adults residing in non-urban areas .
Controlled trial of a multifaceted intervention for improving quality of care for rural patients with type 2 diabetes.
OBJECTIVE Despite good evidence and clinical practice guidelines , studies document that treatment of type 2 diabetes is less than optimal . Lack of re sources or limited access may put patients in rural communities at particular risk for suboptimal care . RESEARCH DESIGN AND METHODS We conducted a prospect i ve , before/after study with concurrent controls to assess the effectiveness of a multidisciplinary diabetes outreach service ( intervention ) for improving the quality of care for rural patients with type 2 diabetes . Our intervention consisted of six monthly visits by a traveling team of specialist physicians , nurses , dieticians , and a pharmacist . The core of this service was specialist-to-rural primary care physician academic group detailing . Two comparable regions in Northern Alberta were r and omly allocated to control or intervention . Data were collected before and 6 months after intervention in a representative volunteer sample . The primary outcome was a 10 % improvement in any one of the following : blood pressure , total cholesterol , or HbA(1c ) . RESULTS Our analysis included 200 intervention and 179 control subjects ; 14 subjects were at all three primary outcome targets at baseline . The intervention was associated with a trend toward improvement in primary outcome at 6 months ( 44 % intervention vs. 37 % control ; odds ratio 1.32 , 95 % CI 0.87 - 1.99 ) . The intervention was associated with a significant improvement in blood pressure ( 42 % intervention vs. 25 % control , P = 0.004 ) ; however , there were only small , nonsignificant changes in cholesterol or HbA(1c ) . The intervention was associated with a significant increase in satisfaction with diabetes care . Multivariate adjustment for baseline differences between intervention and control subjects did not affect any of the main results . CONCLUSIONS A diabetes outreach service has the potential to improve the quality of diabetes care for rural patients . Future studies need to involve longer timelines and larger sample sizes
Community-based programmes achieved good results for most risk factors except BMI and ( glycated haemoglobin ) HbA1c .
INTRODUCTION Although cardiovascular disease ( CVD ) and type 2 diabetes mellitus ( T2DM ) prevention programmes have been effective in urban residents , their effectiveness in non-urban setting s , where cardio-metabolic risk is typically elevated , is unknown .
We systematic ally review ed the effectiveness of primary prevention programmes aim ed at reducing risk factors for CVD/T2DM , including blood pressure , body mass index ( BMI ) , blood lipid and glucose , diet , lifestyle , and knowledge in adults residing in non-urban areas .