多成分医疗保健干预对血压和血脂控制不佳的 2 型糖尿病患者的效果:INTEGRA 研究结果。

IF 2.6 4区 医学 Q3 ENDOCRINOLOGY & METABOLISM
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引用次数: 0

摘要

目的:我们的目标是评估加泰罗尼亚初级医疗机构中以改善血糖控制为主要目的的多成分医疗保健干预措施对血压和血脂控制不佳的 2 型糖尿病患者的影响 方法:我们在 11 个初级医疗中心开展了一项群集、非随机、对照的实用性试验。干预组(N=225)采用以患者为中心的综合方法,包括专门的专科咨询,以解决治疗惰性问题。对照组(人数=181)与干预组相同,但不提供专科咨询。次要终点包括基线和 12 个月随访后的血脂和血压控制评估。我们发现,在最后一次访问时,各组之间在血脂实验室参数的降低方面没有差异。但是,在其他血脂指标或达到血脂目标值的参与者比例方面,各组之间没有发现明显差异。同样,在最终检查时,各组之间在血压、血压目标控制和治疗方面也未发现差异。参与者的各种临床因素,如年龄、性别、糖尿病病程、HbA1c水平、体重指数和大血管并发症等,与最终就诊时血脂和血压是否达标有关:INTEGRA研究中提出的务实的多成分干预措施表明,在血糖管理中加入旨在减少临床惰性的成分,并不能对改善控制不佳的T2DM患者的血脂和血压产生益处。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effectiveness of a multicomponent healthcare intervention on blood pressure and lipids among subjects with poorly controlled type 2 diabetes: Findings from the INTEGRA study

Aim

We aimed to evaluate the impact of a multicomponent healthcare intervention, primarily designed to improve glycemic control, on blood pressure and lipids in individuals with poorly controlled type 2 diabetes mellitus (T2DM) in the Catalonian primary care setting

Methods

A cluster, non-randomized, controlled pragmatic trial was conducted across 11 primary care centers. The intervention group (N=225) received a comprehensive, patient-centered approach, including a dedicated monographic consultation to address therapeutic inertia. The control group (N=181) mirrored the intervention group but lacked the monographic consultation. Secondary endpoints included lipid and blood pressure control assessed at baseline and after a 12-month follow-up.

Results

245 participants completed the study over 12 months. We found no differences in the reduction of lipid laboratory parameters between the groups at the final visit. However, no significant differences were found between the groups for other lipids or the proportion of participants achieving lipid target values. Likewise, no differences were noted between the groups for blood pressure, its target control, and treatment at the final visit. Various clinical factors such as age, sex, diabetes duration, HbA1c levels, BMI, and macrovascular complications among the participants were associated with achieving lipid and blood pressure targets at the final visit.

Conclusion

The pragmatic multicomponent intervention proposed in the INTEGRA study, showed that including a component designed to reduce clinical inertia in the management of glycemia did not demonstrate benefits in improving lipids and blood pressure in patients with poorly controlled T2DM.

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来源期刊
Primary Care Diabetes
Primary Care Diabetes ENDOCRINOLOGY & METABOLISM-PRIMARY HEALTH CARE
CiteScore
5.00
自引率
3.40%
发文量
134
审稿时长
47 days
期刊介绍: The journal publishes original research articles and high quality reviews in the fields of clinical care, diabetes education, nutrition, health services, psychosocial research and epidemiology and other areas as far as is relevant for diabetology in a primary-care setting. The purpose of the journal is to encourage interdisciplinary research and discussion between all those who are involved in primary diabetes care on an international level. The Journal also publishes news and articles concerning the policies and activities of Primary Care Diabetes Europe and reflects the society''s aim of improving the care for people with diabetes mellitus within the primary-care setting.
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