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- Title
Translating the chronic care model into the community: results from a randomized controlled trial of a multifaceted diabetes care intervention.
- Authors
Piatt GA; Orchard TJ; Emerson S; Simmons D; Songer TJ; Brooks MM; Korytkowski M; Siminerio LM; Ahmad U; Zgibor JC; Piatt, Gretchen A; Orchard, Trevor J; Emerson, Sharlene; Simmons, David; Songer, Thomas J; Brooks, Maria M; Korytkowski, Mary; Siminerio, Linda M; Ahmad, Usman; Zgibor, Janice C
- Abstract
<bold>Objective: </bold>To determine whether using the chronic care model (CCM) in an underserved community leads to improved clinical and behavioral outcomes for people with diabetes.<bold>Research Design and Methods: </bold>This multilevel, cluster-design, randomized controlled trial examined the effectiveness of a CCM-based intervention in an underserved urban community. Eleven primary care practices, along with their patients, were randomized to three groups: CCM intervention (n = 30 patients), provider education only (PROV group) (n = 38), and usual care (UC group) (n = 51).<bold>Results: </bold>A marked decline in HbA(1c) was observed in the CCM group (-0.6%, P = 0.008) but not in the other groups. The magnitude of the association remained strong after adjustment for clustering (P = 0.01). The same pattern was observed for a decline in non-HDL cholesterol and for the proportion of participants who self-monitor blood glucose in the CCM group (non-HDL cholesterol: -10.4 mg/dl, P = 0.24; self-monitor blood glucose: +22.2%, P < 0.0001), with statistically significant between-group differences in improvement (non-HDL cholesterol: P = 0.05; self-monitor blood glucose: P = 0.03) after adjustment. The CCM group also showed improvement in HDL cholesterol (+5.5 mg/dl, P = 0.0004), diabetes knowledge test scores (+6.7%, P = 0.07), and empowerment scores (+2, P = 0.02).<bold>Conclusions: </bold>These results suggest that implementing the CCM in the community is effective in improving clinical and behavioral outcomes in patients with diabetes.
- Publication
Diabetes Care, 2006, Vol 29, Issue 4, p811
- ISSN
0149-5992
- Publication type
journal article
- DOI
10.2337/diacare.29.04.06.dc05-1785