PRODIACOR: A patient-centered treatment program for type 2 diabetes and associated cardiovascular risk factors in the city of Corrientes, Argentina

Gagliardino, Juan José; Lapertosa, Silvia; Villagra, Mirta; Caporale, Joaquín; Oliver, Patrick; Gonzalez, Claudio; Siri, Fernando; Clark, Charles M.

doi:10.1016/j.cct.2007.01.004

Cited by 7 publications

(8 citation statements)

References 36 publications

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“…The majority of the participants were middle aged women, had low educational level and relied exclusively on public health coverage. The sociodemographic profile of our cohort was similar to other studies conducted in healthcare centers located in low resource settings in Latin America [ 28 , 29 ]. Although persons with T2DM had a low educational attainment, the majority had access to a cell phone and agreed to receive SMS educational messages as part of the intervention.…”

Section: Discussionsupporting

confidence: 76%

Effectiveness of a diabetes program based on digital health on capacity building and quality of care in type 2 diabetes: a pragmatic quasi-experimental study

Morelli

Rubinstein

Santero

et al. 2023

BMC Health Serv Res

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Health systems in Latin America face many challenges in controlling the increasing burden of diabetes. Digital health interventions are a promise for the provision of care, especially in developing countries where mobile technology has a high penetration. This study evaluated the effectiveness of the implementation of a Diabetes Program (DP) that included digital health interventions to improve the quality of care of persons with type 2 Diabetes (T2DM) in a vulnerable population attending the public primary care network. Materials and methods A quasi-experimental pre-post uncontrolled study was conducted in 19 primary care centers and hospitals in the province of Corrientes, Argentina. We included persons with T2DM, age > = 18 years with access to a mobile phone. The multicomponent intervention included a mobile app with a diabetes registry, a clinical decision support tool for providers and a text messaging intervention for patients. Results and discussion One thousand sixty-five participants were included, 72.8% had less than 12 years of formal education and 53.5% lacked health coverage. Comorbidities were hypertension (60.8%) and overweight/obesity (88.2%). During follow-up there was a significant increase in the proportion of participants who underwent laboratory check-ups (HbA1c 20.3%-64.4%; p < 0.01) and foot exams (62.1%-87.2%; p < 0.01). No changes were observed at 12 and 24 months in the proportion of participants with poor metabolic control. The proportion of participants with uncontrolled blood pressure (≥ 140/90 mmHg) decreased from 47.2% at baseline to 30.8% at 24 months in those with a follow-up visit. Conclusion The DP was innovative by integrating digital health interventions in the public primary care level. The study showed improvements in quality indicators related with diabetes care processes and in blood pressure control.

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Section: Discussionsupporting

confidence: 76%

Effectiveness of a diabetes program based on digital health on capacity building and quality of care in type 2 diabetes: a pragmatic quasi-experimental study

Morelli

Rubinstein

Santero

et al. 2023

BMC Health Serv Res

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“…As previously reported , acute diabetic complications and hospitalizations were infrequent in our sample population during the 42‐month follow‐up period, which is the reason why these data were not included in the analysis.…”

Section: Resultsmentioning

confidence: 99%

“…The study protocol was evaluated and approved by an external ethical committee and participants gave informed consent according to the guidelines from the International Conference on Harmonization and the World Health Organization (WHO) good clinical practice standards. The study design has been previously described . Briefly, it was a randomized 2 × 2 design trial to address the effectiveness of system changes and the education of physicians and people with diabetes.…”

Section: Methodsmentioning

confidence: 99%

“…During the study period, all the laboratory tests were performed at the same place in order to use a homogeneous methodology, particularly HbA 1c assay (immunoturbidimetric procedure), and to avoid any possible inter‐laboratory variation. As, at the time of recruitment, many patients had no recorded HbA 1c measurement, and in some laboratories HbA 1c was being measured , we had to repeat all measurements at time 0 (baseline); consequently, the average values are different from those included in the original report.…”

Section: Methodsmentioning

confidence: 99%

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

et al. 2013

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“…A pesar de la fuerte evidencia de que el control apropiado de la glucemia y los factores de riesgo cardiovascular asociados previene efectivamente la incidencia y progresión de las complicaciones crónicas, en general las metas de tratamiento pocas veces se alcanzan y la calidad de atención brindada no es la adecuada para lograr dicha prevención (38)(39)(40).…”

Section: Calidad De Atención De Las Personas Con Dm Por Región Y En Argentinaunclassified

Análisis de costo efectividad de la educación de pacientes con diabetes tipo 2 por pares

González¹

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En general, las metas de tratamiento en personas con DMT2 pocas veces se alcanzan y la calidad de atención no es la adecuada para prevenir el desarrollo de complicaciones, generando un gran impacto socioeconómico y un creciente problema de salud pública. La educación a través de pares con DM, complementaria al control y tratamiento de la enfermedad, es una alternativa a la estrategia tradicional de educación de personas con DMT2, para mejorar la calidad de atención y disminuir el impacto socioeconómico de la enfermedad. Esta estrategia logra resultados de efectividad no inferiores a la educación tradicional. Sin embargo, para que los decisores del sistema de salud adopten esta estrategia, es necesario demostrar no sólo su eficacia sino también su costo-efectividad. Lamentablemente, la evidencia actual de costo-efectividad de la educación a través de pares respecto de la educación tradicional, es escasa. El objetivo del trabajo se centró en evaluar la costo-efectividad de la educación de pacientes con DMT2 educados, durante un año, por un equipo profesional en salud (educación tradicional) versus educación y apoyo impartida por un par con DM (educación de pares). Se realizó un análisis de costo efectividad en base a un estudio clínico retrospectivo desarrollado en la ciudad de La Plata, sobre 199 personas con DMT2, organizados en 2 grupos, uno que recibió educación tradicional (ET) y otro que recibió educación a través de personas con DM (pares). Se consideró el cambio en HbA1c como el indicador primario de efectividad; y otros indicadores secundarios: glucemia en ayunas, IMC, PAS y PAD. Se estimó el costo directo de cada estrategia en base a los recursos utilizados en el estudio clínico, y se evaluaron tres escenarios de costos para la estrategia de educación de pares. Se realizó un análisis de sensibilidad univariado para evaluar la robustez de los resultados. Como resultados, en la estrategia educativa tradicional, el costo por unidad de % de HbA1c descendido fue de $2.621; en la estrategia de educación a través de pares fue de $1. 508, $1.779 y $2.071, para cada uno de los tres escenarios considerados E1, E2 y E3 respectivamente. Por cada $100 invertidos se logra descender 0,04% de HbA1c con la estrategia de educativa tradicional, y 0,07% en E1, 0,06% en E2 y 0,05% en E3. El análisis de sensibilidad univariado demostró que los resultados obtenidos son robustos. En el presente trabajo la estrategia educativa a personas con DMT2, complementaria al control y tratamiento de la enfermedad, a través de pares es costo efectiva respecto a la estrategia de educación tradicional.

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PRODIACOR: A patient-centered treatment program for type 2 diabetes and associated cardiovascular risk factors in the city of Corrientes, Argentina

Cited by 7 publications

References 36 publications

Effectiveness of a diabetes program based on digital health on capacity building and quality of care in type 2 diabetes: a pragmatic quasi-experimental study

Effectiveness of a diabetes program based on digital health on capacity building and quality of care in type 2 diabetes: a pragmatic quasi-experimental study

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

Análisis de costo efectividad de la educación de pacientes con diabetes tipo 2 por pares

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