Complex professional interventions improved the process of care , but the effect on patient outcomes remained less clear because such outcomes were rarely assessed .
Organizational interventions that facilitated the structured and regular review of patients also showed a favorable effect on process measures .
Complex interventions in which patient education was added and /or the role of a nurse was enhanced led to improvements in patient outcomes as well as the process of care .
CONCLUSIONS Multifaceted professional interventions and organizational interventions that facilitate structured and regular review of patients were effective in improving the process of care .
The addition of patient education to these interventions and the enhancement of the role of nurses in diabetes care led to improvements in patient outcomes and the process of care
Feasibility and effects of a diabetes type II protocol with blood glucose self-monitoring in general practice.
A diabetes protocol characterized by self-monitoring of blood glucose was introduced in four general practice s with the aim of making the frequency of consultations dependent on the metabolic regulation and emphasizing body weight reduction . The feasibility of the programme was investigated and the results after 1 year were compared with those of conventional care in four control practice s. In the experimental practice s , 13 patients switched from a medical specialist 's to a general practitioner 's supervision  , 20 remained under supervision of their GP  and 33 started self-monitoring .  The self-monitoring rate , the consultation frequency according to protocol , the low number of dropouts and inadequate referrals and adherence to the therapeutic scheme showed that the protocol was feasible for both the GPs and the patients . At the initial assessment , the regulation of the diabetes was worse in patients of the experimental group , compared with those of the control group ( mean HbA1 9.7 % vs 8.9 % ; p less than 0.05 ) . On average , patients in the experimental group ( n = 56 ) lost 0.4 kg of body weight , whereas those in the control group ( n = 73 ) gained 0.1 kg ( n.s . ) . The mean change in HbA1 , adjusted for the initial value , was -0.4 % in the experimental and + 0.5 % in the control group ( p less than 0.05 ) . The results of the protocol can be attributed to a combination of greater participation of the patient , the individualized consultation frequency and the prescription of oral hypoglycaemic agents according to body weight development
Complex professional interventions improved the process of care , but the effect on patient outcomes remained less clear because such outcomes were rarely assessed .
Organizational interventions that facilitated the structured and regular review of patients also showed a favorable effect on process measures .
Complex interventions in which patient education was added and /or the role of a nurse was enhanced led to improvements in patient outcomes as well as the process of care .
CONCLUSIONS Multifaceted professional interventions and organizational interventions that facilitate structured and regular review of patients were effective in improving the process of care .
The addition of patient education to these interventions and the enhancement of the role of nurses in diabetes care led to improvements in patient outcomes and the process of care