TY - JOUR
T1 - EVALUATING THE EFFECTIVENESS OF A SUPPORT PROGRAMME FOR PEOPLE WITH TYPE 2 DIABETES MELLITUS IN PRIMARY CARE: AN OBSERVATIONAL PROSPECTIVE STUDY IN ECUADOR
T2 - An Observational Prospective Study in Ecuador
AU - Barrera-Guarderas, Francisco
AU - de la Torre-Cisneros, Katherine
AU - Barrionuevo-Tapia, Maria
AU - Cabezas-Escobar, Carmen
N1 - Publisher Copyright:
© 2020, The Authors.
PY - 2020
Y1 - 2020
N2 - Background: The success of primary health care relies on the integration of empowered practitioners with cooperative patients regardless of socioeconomic status. Using resources efficiently would help to improve healthcare promotion and reduce complications of chronic non-communicable diseases (NCDs). The importance of network support programmes relies on the fact that they allow to accurately deliver medical care by shaping a sense of community and purpose among the patients. Aim: To evaluate the effectiveness of a network support programme for patients with type 2 diabetes mellitus (T2DM). Design & setting: A centre-based observational prospective study took place in a primary care setting in Ecuador. Method: The impact of the diabetes care programme was assessed by comparing initial and final metabolic characteristics and outcomes of 593 patients with T2DM, followed-up from April 2007 to December 2017, using paired sample t-test. Electrocardiograms (ECGs), ankle-brachial indexes (ABIs), ocular fundus, and monofilament neuropathy tests were assessed with the McNemar test to evaluate complications at the beginning and end of the study. Results: Glycated haemoglobin (HbA1c), lipid profile, and systolic blood pressure (SBP) showed statistically significant decreases between the initial measurement (IMs) and final measurements (FMs). In the FM, significantly lower HbA1c, diastolic blood pressure (DBP), and atherogenic index were found. Despite the length of time since diagnosis, during the follow-up time, long-term micro-and macro-vascular complications, such as ocular fundus, serum creatinine, and ABI, remained unchanged throughout the period of active participation in this healthcare programme. Conclusion: This study demonstrates the feasibility of reducing plasma glucose, plasma lipids, and long-term complications in patients with T2DM by implementing a network support programme, which involves the medical team and patients themselves in an environment with limited resources.
AB - Background: The success of primary health care relies on the integration of empowered practitioners with cooperative patients regardless of socioeconomic status. Using resources efficiently would help to improve healthcare promotion and reduce complications of chronic non-communicable diseases (NCDs). The importance of network support programmes relies on the fact that they allow to accurately deliver medical care by shaping a sense of community and purpose among the patients. Aim: To evaluate the effectiveness of a network support programme for patients with type 2 diabetes mellitus (T2DM). Design & setting: A centre-based observational prospective study took place in a primary care setting in Ecuador. Method: The impact of the diabetes care programme was assessed by comparing initial and final metabolic characteristics and outcomes of 593 patients with T2DM, followed-up from April 2007 to December 2017, using paired sample t-test. Electrocardiograms (ECGs), ankle-brachial indexes (ABIs), ocular fundus, and monofilament neuropathy tests were assessed with the McNemar test to evaluate complications at the beginning and end of the study. Results: Glycated haemoglobin (HbA1c), lipid profile, and systolic blood pressure (SBP) showed statistically significant decreases between the initial measurement (IMs) and final measurements (FMs). In the FM, significantly lower HbA1c, diastolic blood pressure (DBP), and atherogenic index were found. Despite the length of time since diagnosis, during the follow-up time, long-term micro-and macro-vascular complications, such as ocular fundus, serum creatinine, and ABI, remained unchanged throughout the period of active participation in this healthcare programme. Conclusion: This study demonstrates the feasibility of reducing plasma glucose, plasma lipids, and long-term complications in patients with T2DM by implementing a network support programme, which involves the medical team and patients themselves in an environment with limited resources.
KW - Diabetes mellitus
KW - Health systems
KW - Non-communicable diseases
KW - Primary health care
UR - http://www.scopus.com/inward/record.url?scp=85090000252&partnerID=8YFLogxK
U2 - 10.3399/BJGPOPEN20X101025
DO - 10.3399/BJGPOPEN20X101025
M3 - Article
AN - SCOPUS:85090000252
SN - 2398-3795
VL - 4
JO - BJGP Open
JF - BJGP Open
IS - 2
M1 - 1025
ER -