A prospective randomized controlled study of a virtual clinic integrating primary and specialist care for patients with Type 2 diabetes mellitus.
Aims To investigate the effectiveness of a diabetes virtual clinic to enhance diabetes in primary care by developing clinical management plans for patients with suboptimal metabolic control and/or case complexity. Methods A prospective study with randomized allocation to virtual clinic or usual care...
| Publicado en: | Diabetic Medicine Vol. 33; no. 6; pp. 768 - 777 |
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| Autores principales: | , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Jun2016
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=115423374&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 115423374 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 07423071 F07 jtl: Diabetic Medicine issn: 07423071 maglogo: Y pubinfo: dt: Jun2016 vid: 33 iid: 6 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 115423374 115423374 115423374 10.1111/dme.12985 115423374 ppf: 768 ppct: 9 formats: tig: atl: A prospective randomized controlled study of a virtual clinic integrating primary and specialist care for patients with Type 2 diabetes mellitus. aug: au: Basudev, N. Crosby‐Nwaobi, R. Thomas, S. Chamley, M. Murrells, T. Forbes, A. affil: Lambeth Diabetes Intermediate Care Team, King's College London, London UK sug: subj: Health Care Delivery Evaluation Primary Health Care Specialization Diabetes Mellitus, Type 2 Diagnosis Diabetes Mellitus, Type 2 Physiopathology Human Prospective Studies Randomized Controlled Trials Diabetic Patients Evaluation Disease Management Glycated Hemoglobin Blood Medical Practice Disease Duration Adult Protocols Early Intervention Data Analysis Analysis of Covariance T-Tests Data Analysis Software Diabetes Mellitus, Type 2 Metabolism Demography Middle Age Male Female Ethnic Groups Blood Pressure Determination Systolic Pressure Evaluation Diastolic Pressure Evaluation Glomerular Filtration Rate Glycemic Control Evaluation Diet Metformin Administration and Dosage Insulin Administration and Dosage Treatment Outcomes Calcium Channel Blockers Hypertension Therapy Funding Source Adult: 19-44 years Middle Aged: 45-64 years Male Female ab: Aims To investigate the effectiveness of a diabetes virtual clinic to enhance diabetes in primary care by developing clinical management plans for patients with suboptimal metabolic control and/or case complexity. Methods A prospective study with randomized allocation to virtual clinic or usual care. Patients with Type 2 diabetes ( n = 208) were recruited from six general practices in South London. The primary outcome for the study was glycaemic control, secondary outcomes included: lipids, blood pressure, weight (kg and BMI) and renal function ( eGFR). Data were collected from participants' records at baseline and 12 months. We also considered process measures including therapy optimization. Results The 12-month data show equivalence between the virtual clinic and control groups for glycaemic control with both achieving clinically significant reductions in HbA1c of 8 mmol/mol (0.6 ± 1.7%) and 10 mmol/mol (0.8 ± 1.9%), respectively ( P = 0.4). The virtual clinic group showed superiority over the intervention group for blood pressure control with a mean reduction in systolic blood pressure of 6 ± 16 mmHg compared with an increased of 2 ± 18 mmHg in the control group ( P = 0.008). There were no significant differences between the groups in terms of cholesterol, weight and renal function. Process measures showed an increased level of therapy adjustment in the virtual clinic group. Conclusion The virtual clinic model explored in this study showed a clinically important improvement in glycaemic control. Although this improvement was not superior to that observed in the control participants, this might be attributable to the systemic impact of the virtual clinic on the practice as a whole. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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