Clinical, metabolic and psychological outcomes and treatment costs of a prospective-randomized trial based on different educational strategies to improve diabetes care (PRODIACOR)

Autores
Gagliardino, Juan Jose; Lapertosa, Silvia; Pfirter, Guillermina; Villagra, Mirta; Caporale, Joaquín E.; Gonzalez, Claudio; Elgart, Jorge Elgart; Gonzalez, Lorena; Cernadas, C.; Rucci, Enzo; Clark, C.
Año de publicación
2013
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Aim To evaluate the effect of system interventions (formalized data collection and 100% coverage of medications and supplies) combined with physician and/or patient education on therapeutic indicators and costs in Type 2 diabetes. Methods Randomized 2x2 design in public health, social security or private prepaid primary care clinics in Corrientes, Argentina. Thirty-six general practitioners and 468 adults with Type 2 diabetes participated. Patients of nine participating physicians were selected randomly and assigned to one of four structured group education programmes (117 patients each): control, physician education, patient education and both, with identical system interventions in all four groups. Outcome measures included glycated haemoglobin, body mass index, blood pressure, fasting glucose, lipid profile, drug consumption, resource use and patient well-being at baseline and every 6 months up to 42 months. Results Glycated haemoglobin decreased significantly from 0.34 to 0.84% by 42 months (P < 0.05); the largest and more consistent decrease was in the groups where patients and physicians were educated. Blood pressure and triglycerides decreased significantly in all groups; the largest changes were recorded in the combined education group. The WHO-5-Lowe score showed significant improvements, without differences among groups. The lowest treatment cost was seen in the combined education group. Conclusions In a primary care setting, educational interventions combined with comprehensive care coverage resulted in long-term improvement in clinical, metabolic and psychological outcomes at the best cost-effectiveness ratio. Trial registration NCT01456806 Keywords Type 2 diabetes management, patient and healthcare provider education, quality of care, patient satisfaction, psychological impact
Fil: Gagliardino, Juan Jose. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Cientifico Tecnológico La Plata. Centro de Endocrinologia Experimental y Aplicada (i); Argentina
Fil: Lapertosa, Silvia. Ministerio de Salud de la Provincia de Corrientes; Argentina
Fil: Pfirter, Guillermina . Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Cientifico Tecnológico La Plata. Centro de Endocrinologia Experimental y Aplicada (i); Argentina
Fil: Villagra, Mirta. Ministerio de Salud de la Provincia de Corrientes; Argentina
Fil: Caporale, Joaquín E.. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Cientifico Tecnológico La Plata. Centro de Endocrinologia Experimental y Aplicada (i); Argentina
Fil: Gonzalez, Claudio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Cientifico Tecnológico La Plata. Centro de Endocrinologia Experimental y Aplicada (i); Argentina
Fil: Elgart, Jorge Elgart. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Cientifico Tecnológico La Plata. Centro de Endocrinologia Experimental y Aplicada (i); Argentina
Fil: Gonzalez, Lorena. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Cientifico Tecnológico La Plata. Centro de Endocrinologia Experimental y Aplicada (i); Argentina
Fil: Cernadas, C.. Universidad de Buenos Aires. Facultad de Medicina; Argentina
Fil: Rucci, Enzo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Cientifico Tecnológico La Plata. Centro de Endocrinologia Experimental y Aplicada (i); Argentina
Fil: Clark, C.. Indiana University; Estados Unidos
Materia
Type 2 Diabetes
Educational Strategies
Treatment Costs
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-nd/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/3415
Acceder
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oai_identifier_str oai:ri.conicet.gov.ar:11336/3415
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Clinical, metabolic and psychological outcomes and treatment costs of a prospective-randomized trial based on different educational strategies to improve diabetes care (PRODIACOR)Gagliardino, Juan JoseLapertosa, SilviaPfirter, Guillermina Villagra, MirtaCaporale, Joaquín E.Gonzalez, ClaudioElgart, Jorge ElgartGonzalez, LorenaCernadas, C.Rucci, EnzoClark, C.Type 2 DiabetesEducational StrategiesTreatment Costshttps://purl.org/becyt/ford/3.3https://purl.org/becyt/ford/3Aim To evaluate the effect of system interventions (formalized data collection and 100% coverage of medications and supplies) combined with physician and/or patient education on therapeutic indicators and costs in Type 2 diabetes. Methods Randomized 2x2 design in public health, social security or private prepaid primary care clinics in Corrientes, Argentina. Thirty-six general practitioners and 468 adults with Type 2 diabetes participated. Patients of nine participating physicians were selected randomly and assigned to one of four structured group education programmes (117 patients each): control, physician education, patient education and both, with identical system interventions in all four groups. Outcome measures included glycated haemoglobin, body mass index, blood pressure, fasting glucose, lipid profile, drug consumption, resource use and patient well-being at baseline and every 6 months up to 42 months. Results Glycated haemoglobin decreased significantly from 0.34 to 0.84% by 42 months (P < 0.05); the largest and more consistent decrease was in the groups where patients and physicians were educated. Blood pressure and triglycerides decreased significantly in all groups; the largest changes were recorded in the combined education group. The WHO-5-Lowe score showed significant improvements, without differences among groups. The lowest treatment cost was seen in the combined education group. Conclusions In a primary care setting, educational interventions combined with comprehensive care coverage resulted in long-term improvement in clinical, metabolic and psychological outcomes at the best cost-effectiveness ratio. Trial registration NCT01456806 Keywords Type 2 diabetes management, patient and healthcare provider education, quality of care, patient satisfaction, psychological impactFil: Gagliardino, Juan Jose. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Cientifico Tecnológico La Plata. Centro de Endocrinologia Experimental y Aplicada (i); ArgentinaFil: Lapertosa, Silvia. Ministerio de Salud de la Provincia de Corrientes; ArgentinaFil: Pfirter, Guillermina . Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Cientifico Tecnológico La Plata. Centro de Endocrinologia Experimental y Aplicada (i); ArgentinaFil: Villagra, Mirta. Ministerio de Salud de la Provincia de Corrientes; ArgentinaFil: Caporale, Joaquín E.. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Cientifico Tecnológico La Plata. Centro de Endocrinologia Experimental y Aplicada (i); ArgentinaFil: Gonzalez, Claudio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Cientifico Tecnológico La Plata. Centro de Endocrinologia Experimental y Aplicada (i); ArgentinaFil: Elgart, Jorge Elgart. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Cientifico Tecnológico La Plata. Centro de Endocrinologia Experimental y Aplicada (i); ArgentinaFil: Gonzalez, Lorena. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Cientifico Tecnológico La Plata. Centro de Endocrinologia Experimental y Aplicada (i); ArgentinaFil: Cernadas, C.. Universidad de Buenos Aires. Facultad de Medicina; ArgentinaFil: Rucci, Enzo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Cientifico Tecnológico La Plata. Centro de Endocrinologia Experimental y Aplicada (i); ArgentinaFil: Clark, C.. Indiana University; Estados UnidosWiley Blackwell Publishing, Inc2013-05info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/3415Gagliardino, Juan Jose; Lapertosa, Silvia; Pfirter, Guillermina ; Villagra, Mirta; Caporale, Joaquín E.; et al.; Clinical, metabolic and psychological outcomes and treatment costs of a prospective-randomized trial based on different educational strategies to improve diabetes care (PRODIACOR); Wiley Blackwell Publishing, Inc; Diabetic Medicine; 13; 5-2013; 1102-11110742-3071enginfo:eu-repo/semantics/altIdentifier/doi/info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-nd/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-29T09:50:42Zoai:ri.conicet.gov.ar:11336/3415instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-29 09:50:42.527CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Clinical, metabolic and psychological outcomes and treatment costs of a prospective-randomized trial based on different educational strategies to improve diabetes care (PRODIACOR)
title Clinical, metabolic and psychological outcomes and treatment costs of a prospective-randomized trial based on different educational strategies to improve diabetes care (PRODIACOR)
spellingShingle Clinical, metabolic and psychological outcomes and treatment costs of a prospective-randomized trial based on different educational strategies to improve diabetes care (PRODIACOR)
Gagliardino, Juan Jose
Type 2 Diabetes
Educational Strategies
Treatment Costs
title_short Clinical, metabolic and psychological outcomes and treatment costs of a prospective-randomized trial based on different educational strategies to improve diabetes care (PRODIACOR)
title_full Clinical, metabolic and psychological outcomes and treatment costs of a prospective-randomized trial based on different educational strategies to improve diabetes care (PRODIACOR)
title_fullStr Clinical, metabolic and psychological outcomes and treatment costs of a prospective-randomized trial based on different educational strategies to improve diabetes care (PRODIACOR)
title_full_unstemmed Clinical, metabolic and psychological outcomes and treatment costs of a prospective-randomized trial based on different educational strategies to improve diabetes care (PRODIACOR)
title_sort Clinical, metabolic and psychological outcomes and treatment costs of a prospective-randomized trial based on different educational strategies to improve diabetes care (PRODIACOR)
dc.creator.none.fl_str_mv Gagliardino, Juan Jose
Lapertosa, Silvia
Pfirter, Guillermina
Villagra, Mirta
Caporale, Joaquín E.
Gonzalez, Claudio
Elgart, Jorge Elgart
Gonzalez, Lorena
Cernadas, C.
Rucci, Enzo
Clark, C.
author Gagliardino, Juan Jose
author_facet Gagliardino, Juan Jose
Lapertosa, Silvia
Pfirter, Guillermina
Villagra, Mirta
Caporale, Joaquín E.
Gonzalez, Claudio
Elgart, Jorge Elgart
Gonzalez, Lorena
Cernadas, C.
Rucci, Enzo
Clark, C.
author_role author
author2 Lapertosa, Silvia
Pfirter, Guillermina
Villagra, Mirta
Caporale, Joaquín E.
Gonzalez, Claudio
Elgart, Jorge Elgart
Gonzalez, Lorena
Cernadas, C.
Rucci, Enzo
Clark, C.
author2_role author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Type 2 Diabetes
Educational Strategies
Treatment Costs
topic Type 2 Diabetes
Educational Strategies
Treatment Costs
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.3
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Aim To evaluate the effect of system interventions (formalized data collection and 100% coverage of medications and supplies) combined with physician and/or patient education on therapeutic indicators and costs in Type 2 diabetes. Methods Randomized 2x2 design in public health, social security or private prepaid primary care clinics in Corrientes, Argentina. Thirty-six general practitioners and 468 adults with Type 2 diabetes participated. Patients of nine participating physicians were selected randomly and assigned to one of four structured group education programmes (117 patients each): control, physician education, patient education and both, with identical system interventions in all four groups. Outcome measures included glycated haemoglobin, body mass index, blood pressure, fasting glucose, lipid profile, drug consumption, resource use and patient well-being at baseline and every 6 months up to 42 months. Results Glycated haemoglobin decreased significantly from 0.34 to 0.84% by 42 months (P < 0.05); the largest and more consistent decrease was in the groups where patients and physicians were educated. Blood pressure and triglycerides decreased significantly in all groups; the largest changes were recorded in the combined education group. The WHO-5-Lowe score showed significant improvements, without differences among groups. The lowest treatment cost was seen in the combined education group. Conclusions In a primary care setting, educational interventions combined with comprehensive care coverage resulted in long-term improvement in clinical, metabolic and psychological outcomes at the best cost-effectiveness ratio. Trial registration NCT01456806 Keywords Type 2 diabetes management, patient and healthcare provider education, quality of care, patient satisfaction, psychological impact
Fil: Gagliardino, Juan Jose. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Cientifico Tecnológico La Plata. Centro de Endocrinologia Experimental y Aplicada (i); Argentina
Fil: Lapertosa, Silvia. Ministerio de Salud de la Provincia de Corrientes; Argentina
Fil: Pfirter, Guillermina . Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Cientifico Tecnológico La Plata. Centro de Endocrinologia Experimental y Aplicada (i); Argentina
Fil: Villagra, Mirta. Ministerio de Salud de la Provincia de Corrientes; Argentina
Fil: Caporale, Joaquín E.. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Cientifico Tecnológico La Plata. Centro de Endocrinologia Experimental y Aplicada (i); Argentina
Fil: Gonzalez, Claudio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Cientifico Tecnológico La Plata. Centro de Endocrinologia Experimental y Aplicada (i); Argentina
Fil: Elgart, Jorge Elgart. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Cientifico Tecnológico La Plata. Centro de Endocrinologia Experimental y Aplicada (i); Argentina
Fil: Gonzalez, Lorena. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Cientifico Tecnológico La Plata. Centro de Endocrinologia Experimental y Aplicada (i); Argentina
Fil: Cernadas, C.. Universidad de Buenos Aires. Facultad de Medicina; Argentina
Fil: Rucci, Enzo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Cientifico Tecnológico La Plata. Centro de Endocrinologia Experimental y Aplicada (i); Argentina
Fil: Clark, C.. Indiana University; Estados Unidos
description Aim To evaluate the effect of system interventions (formalized data collection and 100% coverage of medications and supplies) combined with physician and/or patient education on therapeutic indicators and costs in Type 2 diabetes. Methods Randomized 2x2 design in public health, social security or private prepaid primary care clinics in Corrientes, Argentina. Thirty-six general practitioners and 468 adults with Type 2 diabetes participated. Patients of nine participating physicians were selected randomly and assigned to one of four structured group education programmes (117 patients each): control, physician education, patient education and both, with identical system interventions in all four groups. Outcome measures included glycated haemoglobin, body mass index, blood pressure, fasting glucose, lipid profile, drug consumption, resource use and patient well-being at baseline and every 6 months up to 42 months. Results Glycated haemoglobin decreased significantly from 0.34 to 0.84% by 42 months (P < 0.05); the largest and more consistent decrease was in the groups where patients and physicians were educated. Blood pressure and triglycerides decreased significantly in all groups; the largest changes were recorded in the combined education group. The WHO-5-Lowe score showed significant improvements, without differences among groups. The lowest treatment cost was seen in the combined education group. Conclusions In a primary care setting, educational interventions combined with comprehensive care coverage resulted in long-term improvement in clinical, metabolic and psychological outcomes at the best cost-effectiveness ratio. Trial registration NCT01456806 Keywords Type 2 diabetes management, patient and healthcare provider education, quality of care, patient satisfaction, psychological impact
publishDate 2013
dc.date.none.fl_str_mv 2013-05
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/3415
Gagliardino, Juan Jose; Lapertosa, Silvia; Pfirter, Guillermina ; Villagra, Mirta; Caporale, Joaquín E.; et al.; Clinical, metabolic and psychological outcomes and treatment costs of a prospective-randomized trial based on different educational strategies to improve diabetes care (PRODIACOR); Wiley Blackwell Publishing, Inc; Diabetic Medicine; 13; 5-2013; 1102-1111
0742-3071
url http://hdl.handle.net/11336/3415
identifier_str_mv Gagliardino, Juan Jose; Lapertosa, Silvia; Pfirter, Guillermina ; Villagra, Mirta; Caporale, Joaquín E.; et al.; Clinical, metabolic and psychological outcomes and treatment costs of a prospective-randomized trial based on different educational strategies to improve diabetes care (PRODIACOR); Wiley Blackwell Publishing, Inc; Diabetic Medicine; 13; 5-2013; 1102-1111
0742-3071
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/doi/
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-nd/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-nd/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
application/pdf
dc.publisher.none.fl_str_mv Wiley Blackwell Publishing, Inc
publisher.none.fl_str_mv Wiley Blackwell Publishing, Inc
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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score 13.070432

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