Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:


Research finds that diabetes disease-management programs improve quality of care

But patients' health outcomes are not affected

With diabetes disease-management programs becoming more commonly used among physician groups, the question arises: Just how effective are they at improving patient care? The answer, according to UCLA researchers, is that they lead to better examination and testing--but not to better control of key factors associated with diabetes complications, such as blood pressure, cholesterol or blood sugar levels.

A new study, to be published in the July 18 issue of Annals of Internal Medicine, finds that health care providers' use of management programs resulted in higher rates among their patients of recommended examinations, such as eye and foot exams, testing for kidney function or damage due to the disease, cholesterol checks, and getting influenza vaccinations.

These management strategies, however, had no impact on good medication management and were not linked to improved sugar, blood pressure or cholesterol levels.

The three disease-management strategies include physician reminders (reminders that health plans or physician groups can send to their clinicians, including preprinted guidelines, flow sheets, and flags or customized alerts for medical records); regular feedback from physician groups to their doctors on the care they provide; and structured care management, which is when patients also see case managers, attend diabetes education classes and/or receive reminders about the care they need, such as eye examinations or flu shots, between doctor visits.

"The good news is that physician groups that are investing in care-management strategies are doing a better job of delivering eye care, screening for kidney problems and high cholesterol, and providing regular foot exams to more of their patients with diabetes," said Dr. Carol Mangione, professor of medicine in the department of medicine at the David Geffen School of Medicine at UCLA and in the department of health services at the UCLA School of Public Health. "These results also suggest that it is much more challenging to achieve better control of the factors that are most strongly associated with the long-term complications of diabetes that patients care about, such as heart attacks and strokes. To prevent these serious complications, disease management programs may need to directly monitor the levels of blood pressure, cholesterol and glucose, and the treatments used to control them."

The researchers studied 8,661 patients from 63 physician groups in several health plans, seven of them sponsored by Translating Research Into Action for Diabetes (TRIAD), a multi-center study of diabetes care within managed care systems, and four plans with individual physician contracts. The patients were recruited between July 2000 and October 2001.

The study shows that use of any of the three disease-management strategies resulted in higher rates of retinal screening, kidney checks, foot examinations and hemoglobin measurements. These are important because diabetes can lead to blindness, kidney failure and loss of limbs when not properly controlled.

Additionally, the researchers found that greater use of structured care management and performance feedback were linked with serum lipid level testing and influenza vaccine administration. They also found a correlation between the use of performance feedback and increased rates of foot examinations, and between physician reminders and increased rates for microalbuminuria checks, which test for small but abnormal amounts of the protein albumin in the urine.

Over the past 10 years, disease-management programs have focused on improving processes of care rather than outcomes. The study's findings suggest that to achieve better control of blood pressure, cholesterol and sugar--and ultimately reduce the risk of complications such as heart attacks and strokes--these programs will need to actively engage the participation of doctors and patients and will need to measure and report on the levels of these outcomes on a regular basis.

Enrique Rivero | EurekAlert!
Further information:

More articles from Health and Medicine:

nachricht Advanced analysis of brain structure shape may track progression to Alzheimer's disease
26.10.2016 | Massachusetts General Hospital

nachricht Indian roadside refuse fires produce toxic rainbow
26.10.2016 | Duke University

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Etching Microstructures with Lasers

Ultrafast lasers have introduced new possibilities in engraving ultrafine structures, and scientists are now also investigating how to use them to etch microstructures into thin glass. There are possible applications in analytics (lab on a chip) and especially in electronics and the consumer sector, where great interest has been shown.

This new method was born of a surprising phenomenon: irradiating glass in a particular way with an ultrafast laser has the effect of making the glass up to a...

Im Focus: Light-driven atomic rotations excite magnetic waves

Terahertz excitation of selected crystal vibrations leads to an effective magnetic field that drives coherent spin motion

Controlling functional properties by light is one of the grand goals in modern condensed matter physics and materials science. A new study now demonstrates how...

Im Focus: New 3-D wiring technique brings scalable quantum computers closer to reality

Researchers from the Institute for Quantum Computing (IQC) at the University of Waterloo led the development of a new extensible wiring technique capable of controlling superconducting quantum bits, representing a significant step towards to the realization of a scalable quantum computer.

"The quantum socket is a wiring method that uses three-dimensional wires based on spring-loaded pins to address individual qubits," said Jeremy Béjanin, a PhD...

Im Focus: Scientists develop a semiconductor nanocomposite material that moves in response to light

In a paper in Scientific Reports, a research team at Worcester Polytechnic Institute describes a novel light-activated phenomenon that could become the basis for applications as diverse as microscopic robotic grippers and more efficient solar cells.

A research team at Worcester Polytechnic Institute (WPI) has developed a revolutionary, light-activated semiconductor nanocomposite material that can be used...

Im Focus: Diamonds aren't forever: Sandia, Harvard team create first quantum computer bridge

By forcefully embedding two silicon atoms in a diamond matrix, Sandia researchers have demonstrated for the first time on a single chip all the components needed to create a quantum bridge to link quantum computers together.

"People have already built small quantum computers," says Sandia researcher Ryan Camacho. "Maybe the first useful one won't be a single giant quantum computer...

All Focus news of the innovation-report >>>



Event News

#IC2S2: When Social Science meets Computer Science - GESIS will host the IC2S2 conference 2017

14.10.2016 | Event News

Agricultural Trade Developments and Potentials in Central Asia and the South Caucasus

14.10.2016 | Event News

World Health Summit – Day Three: A Call to Action

12.10.2016 | Event News

Latest News

Greater Range and Longer Lifetime

26.10.2016 | Power and Electrical Engineering

VDI presents International Bionic Award of the Schauenburg Foundation

26.10.2016 | Awards Funding

3-D-printed magnets

26.10.2016 | Power and Electrical Engineering

More VideoLinks >>>