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 .
Simulated Physician Learning Intervention to Improve Safety and Quality of Diabetes Care: A Randomized Trial
OBJECTIVE To assess two physician learning interventions design ed to improve safety and quality of diabetes care delivered by primary care physicians ( PCPs ) . RESEARCH DESIGN AND METHODS This group r and omized clinical trial included 57 consenting PCPs and their 2,020 eligible adult patients with diabetes . Physicians were r and omized to no intervention ( group A ) , a simulated case-based physician learning intervention ( group B ) , or the same simulated case-based learning intervention with physician opinion leader feedback ( group C ) . Dependent variables included A1C values , LDL cholesterol values , pharmacotherapy intensification rates in patients not at clinical goals , and risky prescribing events . RESULTS Groups B and C had substantial reductions in risky prescribing of metformin in patients with renal impairment ( P = 0.03 ) . Compared with groups A and C , physicians in group B achieved slightly better glycemic control ( P = 0.04 ) , but physician intensification of oral glucose-lowering medications was not affected by interventions ( P = 0.41 ) . Lipid management improved over time ( P < 0.001 ) but did not differ across study groups ( P = 0.67 ) . CONCLUSIONS A simulated , case-based learning intervention for physicians significantly reduced risky prescribing events and marginally improved glycemic control in actual patients . The addition of opinion leader feedback did not improve the learning intervention . Refinement and further development of this approach is warranted
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 .