Association Between Person And Disease Related Factors And The Planned Diabetes Care In People Who Receive Person-Centered Type 2 Diabetes Care: An Implementation Study

PLOS ONE(2019)

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摘要
AimsTo assess the planned diabetes care for the coming year and its associated factors in patients with Type 2 diabetes who have a person-centered annual consultation.MethodsImplementation study of a new consultation model in 47 general practices (primary care) and 6 outpatient clinics (secondary care); 1200 patients from primary and 166 from secondary care participated. Data collection took place between November 2015 and February 2017. Outcomes: preferred monitoring frequency; referral to other health care provider(s); medication change. One measurement at the end of the consultation. We performed logistic regression analyses. Differences between primary and secondary care were analyzed.ResultsMany patients arranged a monitoring frequency <4 times per year (general practices 19.5%, outpatient clinics 40%, p < .001). Type of provider (physician/nurse, OR 3.83, p < .001), baseline HbA1c (OR 1.02, p = .017), glucose lowering medication; and setting treatment goals (OR.65, p = .048) were associated with the chosen frequency. Independently associated with a referral were age (OR.99, p = .039), baseline glucose lowering medication and patients' goal setting (OR 1.52, p = .016). Medication change was associated with type of provider, baseline HbA1c, blood glucose lowering medication, quality of life (OR.80, p = .037) and setting treatment goals (OR 2.64, p = .001).ConclusionsNot only disease but also person related factors, especially setting treatment goals, are independently associated with planned care use in person-centered diabetes care.
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