Implementation of a personalized care plan for patients with type 2 diabetes is associated with improvements in clinical outcomes : an observational real-world study
Vuohijoki, Anni; Mikkola, Ilona; Jokelainen, Jari; Keinänen-Kiukaanniemi, Sirkka; Winell, Klas; Frittitta, Lucia; Timonen, Markku; Hagnäs, Maria (2020-05-26)
Vuohijoki, A., Mikkola, I., Jokelainen, J., Keinänen-Kiukaanniemi, S., Winell, K., Frittitta, L., … Hagnäs, M. (2020). Implementation of a Personalized Care Plan for Patients With Type 2 Diabetes Is Associated With Improvements in Clinical Outcomes: An Observational Real-World Study. Journal of Primary Care & Community Health. https://doi.org/10.1177/2150132720921700
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https://creativecommons.org/licenses/by-nc/4.0/
https://urn.fi/URN:NBN:fi-fe2020070847153
Tiivistelmä
Abstract
Objective: To analyze the clinical outcomes of patients with type 2 diabetes (T2D) before and after implementation of a personalized care plan in the primary health care setting.
Design: Observational, retrospective, real-world study. Setting: All T2D patients with a care plan in Rovaniemi Health Center, Rovaniemi, Finland, for whom data were available from a baseline visit (in 2013–2015 during which the care plan was written) and from a follow-up visit, including an updated care plan by the year 2017.
Subjects: In total, 447 patients were included. Mean age was 66.9 (SD 10.1) years, 58.8% were male, 15.4% were smokers, 33.1% had vascular disease, and 17.0% were receiving insulin treatment. The mean follow-up time was 14.4 months.
Main Outcome Measures: Glycosylated hemoglobin A1 (HbA1c), low-density lipoprotein (LDL), blood pressure (BP), and body mass index (BMI). Clinical values were taken at both baseline and follow-up.
Results: LDL decreased by 0.2 mmol/L, systolic blood pressure by 2.2 mm Hg, diastolic blood pressure by 1.5 mm Hg, and BMI by 0.5 kg/m² (P < 0.05 for each). The decrease in HbA1c was 0.8 mmol/mol (P = 0.07).
Conclusion: We observed statistically significant decreases in LDL, BP, and BMI. Our results indicate that, over 14 months of follow-up, implementation of a written care plan was associated with small improvements in the clinical outcomes of T2D patients in a primary health care study population in a real-world setting.
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