{"title":"Effectiveness of an Interprofessional Program (Siscare) for Supporting Patients With Type 2 Diabetes.","authors":"Noura Bawab, Marie-Paule Schneider, Pierluigi Ballabeni, Isabella Locatelli, Olivier Bugnon, Clémence Perraudin","doi":"10.2337/ds21-0084","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To assess the effectiveness of an interprofessional support program (Siscare) that includes motivational interviews (patient-pharmacist), electronic monitoring (EM) of medications, patient-reported and clinical outcomes monitoring, and interactions with physicians for patients with type 2 diabetes in French-speaking Switzerland.</p><p><strong>Methods: </strong>This was a prospective, multicenter, observational cohort study using a hybrid implementation-effectiveness design. Individual daily adherence to at least one oral antidiabetic medication was measured by EM. A global adherence score was estimated by the product of a model-estimated implementation and a nonparametric estimate of persistence over time. Clinical outcomes (A1C, blood glucose, BMI, blood pressure, heart rate, and cholesterol levels) and quality of life (QoL) were analyzed over time using linear mixed-effect models.</p><p><strong>Results: </strong>A total of 212 patients were included from 27 pharmacies; 120 patients (57%) were followed up for at least 15 months. In total, 140 patients (66%) were male, the mean age was 64 ± 11 years, and the mean number of chronic medications per patient at baseline was 5 ± 3. Of 178 patients who used EM, 95% (95% CI 92-99%) remained persistent at the end of the follow-up period. The percentage of persistent patients taking their medications appropriately (implementation) was stable during follow-up and was estimated to be 90% (95% CI 87-92%) at baseline and 88% (95% CI 84-91%) at month 15. At baseline, the mean A1C and BMI were 7.5% and 31 kg/m<sup>2</sup>, respectively, which decreased by 0.5% (<i>P</i> = 0.012) and 0.6 kg/m<sup>2</sup> (<i>P</i> = 0.017), respectively, after 15 months. QoL remained stable during follow-up.</p><p><strong>Conclusion: </strong>The program supports medication adherence and improves clinical outcomes, illustrating the overall preventive effect of coordinated care.</p>","PeriodicalId":39737,"journal":{"name":"Diabetes Spectrum","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9935292/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetes Spectrum","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2337/ds21-0084","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: To assess the effectiveness of an interprofessional support program (Siscare) that includes motivational interviews (patient-pharmacist), electronic monitoring (EM) of medications, patient-reported and clinical outcomes monitoring, and interactions with physicians for patients with type 2 diabetes in French-speaking Switzerland.
Methods: This was a prospective, multicenter, observational cohort study using a hybrid implementation-effectiveness design. Individual daily adherence to at least one oral antidiabetic medication was measured by EM. A global adherence score was estimated by the product of a model-estimated implementation and a nonparametric estimate of persistence over time. Clinical outcomes (A1C, blood glucose, BMI, blood pressure, heart rate, and cholesterol levels) and quality of life (QoL) were analyzed over time using linear mixed-effect models.
Results: A total of 212 patients were included from 27 pharmacies; 120 patients (57%) were followed up for at least 15 months. In total, 140 patients (66%) were male, the mean age was 64 ± 11 years, and the mean number of chronic medications per patient at baseline was 5 ± 3. Of 178 patients who used EM, 95% (95% CI 92-99%) remained persistent at the end of the follow-up period. The percentage of persistent patients taking their medications appropriately (implementation) was stable during follow-up and was estimated to be 90% (95% CI 87-92%) at baseline and 88% (95% CI 84-91%) at month 15. At baseline, the mean A1C and BMI were 7.5% and 31 kg/m2, respectively, which decreased by 0.5% (P = 0.012) and 0.6 kg/m2 (P = 0.017), respectively, after 15 months. QoL remained stable during follow-up.
Conclusion: The program supports medication adherence and improves clinical outcomes, illustrating the overall preventive effect of coordinated care.
期刊介绍：
The mission of Diabetes Spectrum: From Research to Practice is to assist health care professionals in the development of strategies to individualize treatment and diabetes self-management education for improved quality of life and diabetes control. These goals are achieved by presenting review as well as original, peer-reviewed articles on topics in clinical diabetes management, professional and patient education, nutrition, behavioral science and counseling, educational program development, and advocacy. In each issue, the FROM RESEARCH TO PRACTICE section explores, in depth, a diabetes care topic and provides practical application of current research findings.
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