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Randomized Controlled Trial
. 2008 Dec;31(12):2273-5.
doi: 10.2337/dc08-0312. Epub 2008 Sep 16.

Combined task delegation, computerized decision support, and feedback improve cardiovascular risk for type 2 diabetic patients: a cluster randomized trial in primary care

Frits G W Cleveringa  1 , Kees J Gorter, Maureen van den Donk, Guy E H M Rutten
Affiliations
Randomized Controlled Trial

Combined task delegation, computerized decision support, and feedback improve cardiovascular risk for type 2 diabetic patients: a cluster randomized trial in primary care

Frits G W Cleveringa et al. Diabetes Care. 2008 Dec.

Abstract

Objective: The Diabetes Care Protocol combines task delegation (a practice nurse), computerized decision support, and feedback every 3 months. We studied the effect of the Diabetes Care Protocol on A1C and cardiovascular risk factors in type 2 diabetic patients in primary care.

Research design and methods: In a cluster randomized trial, mean changes in cardiovascular risk factors between the intervention and control groups after 1 year were calculated by generalized linear models.

Results: Throughout the Netherlands, 26 intervention practices included 1,699 patients and 29 control practices 1,692 patients. The difference in A1C change was not significant, whereas total cholesterol, LDL cholesterol, and blood pressure improved significantly more in the intervention group. The 10-year coronary heart disease risk estimate of the UK Prospective Diabetes Study improved 1.4% more in the intervention group.

Conclusions: Delegation of routine diabetes care to a practice nurse combined with computerized decision support and feedback did not improve A1C but reduced cardiovascular risk in type 2 diabetes patients.

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References

    1. Renders CM, Valk GD, Griffin SJ, Wagner EH, van Eijk JT, Assendelft WJ: Interventions to improve the management of diabetes in primary care, outpatient, and community settings: a systematic review. Diabetes Care 24:1821–1833, 2001 - PubMed
    1. Shojania KG, Ranji SR, McDonald KM, Grimshaw JM, Sundaram V, Rushakoff RJ, Owens DK: Effects of quality improvement strategies for type 2 diabetes on glycemic control: a meta-regression analysis. JAMA 296:427–440, 2006 - PubMed
    1. Garg AX, Adhikari NK, McDonald H, Rosas-Arellano MP, Devereaux PJ, Beyene J, Sam J, Haynes RB: Effects of computerized clinical decision support systems on practitioner performance and patient outcomes: a systematic review. JAMA 293:1223–1238, 2005 - PubMed
    1. Ziemer DC, Doyle JP, Barnes CS, Branch WT Jr, Cook CB, El-Kebbi IM, Gallina DL, Kolm P, Rhee MK, Phillips LS: An intervention to overcome clinical inertia and improve diabetes mellitus control in a primary care setting: Improving Primary Care of African Americans with Diabetes (IPCAAD) 8. Arch Intern Med 166:507–513, 2006 - PubMed
    1. Cleveringa FG, Gorter KJ, van den Donk M, Pijman PL, Rutten GE: Task delegation and computerized decision support reduce coronary heart disease risk factors in type 2 diabetes patients in primary care. Diabetes Technol Ther 9:473–481, 2007 - PubMed

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