Translating the chronic care model into the community: results from a randomized controlled trial of a multifaceted diabetes care intervention

摘要: OBJECTIVE —To determine whether using the chronic care model (CCM) in an underserved community leads to improved clinical and behavioral outcomes for people with diabetes. RESEARCH DESIGN AND METHODS —This multilevel, cluster-design, randomized controlled trial examined effectiveness of a CCM-based intervention urban community. Eleven primary practices, along their patients, were three groups: CCM ( n = 30 patients), provider education only (PROV group) 38), usual (UC 51). RESULTS —A marked decline HbA 1c was observed group (−0.6%, P 0.008) but not other groups. The magnitude association remained strong after adjustment clustering 0.01). same pattern non-HDL cholesterol proportion participants who self-monitor blood glucose (non-HDL cholesterol: −10.4 mg/dl, 0.24; glucose: +22.2%, 0.05; 0.03) adjustment. also showed improvement HDL (+5.5 0.0004), diabetes knowledge test scores (+6.7%, 0.07), empowerment (+2, 0.02). CONCLUSIONS —These results suggest that implementing is effective improving patients