Evaluating Effectiveness of Outpatient Monitoring in Type 2 Diabetes: The One-Year Experience in an Italian Group of Primary Care

Nowadays, chronic disease management is the primary challenge of the healthcare system. From 2015, in the Veneto region (Italy), patients with a diagnosis of type 2 diabetes mellitus (T2DM) have been included in the diagnostic-therapeutic pathway (PDTA) program, and their clinical condition has been...

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Autores principales:	Francesca Lazzarini, Luca Barbacane, Giuseppe Scoleri, Rosanna I. Comoretto, Gianni Cogno, Benedetta Disarò, Luigi Gomirato, Francesca Stocco, Alessandro Suppa, Gianluca Toninato, Clara Minto, Danila Azzolina, Sabino Iliceto, Dario Gregori
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	type 2 diabetes mellitus primary care care plan effectiveness chronic disease management longitudinal analysis Medicine R
Acceso en línea:	https://doaj.org/article/191f7cfb72d74913bfcb500c74064b63
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spelling	oai:doaj.org-article:191f7cfb72d74913bfcb500c74064b632021-11-11T16:39:23ZEvaluating Effectiveness of Outpatient Monitoring in Type 2 Diabetes: The One-Year Experience in an Italian Group of Primary Care10.3390/ijerph1821115401660-46011661-7827https://doaj.org/article/191f7cfb72d74913bfcb500c74064b632021-11-01T00:00:00Zhttps://www.mdpi.com/1660-4601/18/21/11540https://doaj.org/toc/1661-7827https://doaj.org/toc/1660-4601Nowadays, chronic disease management is the primary challenge of the healthcare system. From 2015, in the Veneto region (Italy), patients with a diagnosis of type 2 diabetes mellitus (T2DM) have been included in the diagnostic-therapeutic pathway (PDTA) program, and their clinical condition has been continuously monitored. The aim of this retrospective study is to determine the effectiveness of PDTA intervention, alone or in combination with a specialized one, in subjects with diagnosis of T2DM. Clinical and behavioral characteristics were collected at baseline and after 1 year of follow-up. Two subgroups were considered: subjects enrolled in PDTA only and subjects enrolled in both the PDTA program and in the care plan proposed by the specialized medical center (CAD group). Longitudinal analysis showed a relevant positive effect of time on diastolic blood pressure, while CAD enrollment appears to be related to higher levels of glycated hemoglobin. When included together in the same model, interaction between time and CAD covariates results in completely nonsignificant effects. As long-term management of chronic disorders, such as T2DM, is often difficult due to disease characteristics and problems in healthcare organization, monitoring programs, such as PDTA, and specialized care programs, such as CAD, do not show a clinically relevant effect in the first year of follow-up. Therefore, they should be analyzed over a longer period. However, they should also carefully consider the need for adequate tools for data collection and sharing, in addition to the context of application, patient expectations and the need for a long-term educational program.Francesca LazzariniLuca BarbacaneGiuseppe ScoleriRosanna I. ComorettoGianni CognoBenedetta DisaròLuigi GomiratoFrancesca StoccoAlessandro SuppaGianluca ToninatoClara MintoDanila AzzolinaSabino IlicetoDario GregoriMDPI AGarticletype 2 diabetes mellitusprimary carecare planeffectivenesschronic disease managementlongitudinal analysisMedicineRENInternational Journal of Environmental Research and Public Health, Vol 18, Iss 11540, p 11540 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	type 2 diabetes mellitus primary care care plan effectiveness chronic disease management longitudinal analysis Medicine R
spellingShingle	type 2 diabetes mellitus primary care care plan effectiveness chronic disease management longitudinal analysis Medicine R Francesca Lazzarini Luca Barbacane Giuseppe Scoleri Rosanna I. Comoretto Gianni Cogno Benedetta Disarò Luigi Gomirato Francesca Stocco Alessandro Suppa Gianluca Toninato Clara Minto Danila Azzolina Sabino Iliceto Dario Gregori Evaluating Effectiveness of Outpatient Monitoring in Type 2 Diabetes: The One-Year Experience in an Italian Group of Primary Care
description	Nowadays, chronic disease management is the primary challenge of the healthcare system. From 2015, in the Veneto region (Italy), patients with a diagnosis of type 2 diabetes mellitus (T2DM) have been included in the diagnostic-therapeutic pathway (PDTA) program, and their clinical condition has been continuously monitored. The aim of this retrospective study is to determine the effectiveness of PDTA intervention, alone or in combination with a specialized one, in subjects with diagnosis of T2DM. Clinical and behavioral characteristics were collected at baseline and after 1 year of follow-up. Two subgroups were considered: subjects enrolled in PDTA only and subjects enrolled in both the PDTA program and in the care plan proposed by the specialized medical center (CAD group). Longitudinal analysis showed a relevant positive effect of time on diastolic blood pressure, while CAD enrollment appears to be related to higher levels of glycated hemoglobin. When included together in the same model, interaction between time and CAD covariates results in completely nonsignificant effects. As long-term management of chronic disorders, such as T2DM, is often difficult due to disease characteristics and problems in healthcare organization, monitoring programs, such as PDTA, and specialized care programs, such as CAD, do not show a clinically relevant effect in the first year of follow-up. Therefore, they should be analyzed over a longer period. However, they should also carefully consider the need for adequate tools for data collection and sharing, in addition to the context of application, patient expectations and the need for a long-term educational program.
format	article
author	Francesca Lazzarini Luca Barbacane Giuseppe Scoleri Rosanna I. Comoretto Gianni Cogno Benedetta Disarò Luigi Gomirato Francesca Stocco Alessandro Suppa Gianluca Toninato Clara Minto Danila Azzolina Sabino Iliceto Dario Gregori
author_facet	Francesca Lazzarini Luca Barbacane Giuseppe Scoleri Rosanna I. Comoretto Gianni Cogno Benedetta Disarò Luigi Gomirato Francesca Stocco Alessandro Suppa Gianluca Toninato Clara Minto Danila Azzolina Sabino Iliceto Dario Gregori
author_sort	Francesca Lazzarini
title	Evaluating Effectiveness of Outpatient Monitoring in Type 2 Diabetes: The One-Year Experience in an Italian Group of Primary Care
title_short	Evaluating Effectiveness of Outpatient Monitoring in Type 2 Diabetes: The One-Year Experience in an Italian Group of Primary Care
title_full	Evaluating Effectiveness of Outpatient Monitoring in Type 2 Diabetes: The One-Year Experience in an Italian Group of Primary Care
title_fullStr	Evaluating Effectiveness of Outpatient Monitoring in Type 2 Diabetes: The One-Year Experience in an Italian Group of Primary Care
title_full_unstemmed	Evaluating Effectiveness of Outpatient Monitoring in Type 2 Diabetes: The One-Year Experience in an Italian Group of Primary Care
title_sort	evaluating effectiveness of outpatient monitoring in type 2 diabetes: the one-year experience in an italian group of primary care
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/191f7cfb72d74913bfcb500c74064b63
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Evaluating Effectiveness of Outpatient Monitoring in Type 2 Diabetes: The One-Year Experience in an Italian Group of Primary Care

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