Relationship between number of contacts between previous dropouts with type 2 diabetes and health care professionals on glycaemic control: A cohort study in public primary health care

Kauppila, Timo; Eriksson, Johan G.; Honkasalo, Mikko; Raina, Marko; Laine, Merja K.

doi:10.1016/j.pcd.2019.03.003

Cited by 7 publications

(11 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…To support this, a Danish study showed that systematic approach in planned follow-up contacts increased the level of well-controlled asthma by 20% and reduced uncontrolled asthma by 14% 29 . Advantages of more frequent contacts were also reported recently with type 2 diabetes patients who had stopped to attend to follow-up in diabetes clinics as prescribed: with more frequent contacts, they succeeded to improve their glycaemic control in primary diabetes health care 30 . Previous results support the assumption that with regular followup it is possible to improve control of a persistent disease.…”

Section: Discussionmentioning

confidence: 75%

Planned primary health care asthma contacts during 12-year follow-up after Finnish National Asthma Programme: focus on spirometry

Takala

Ilmarinen

Tuomisto

et al. 2020

npj Prim. Care Respir. Med.

View full text Add to dashboard Cite

Primary health care (PHC) providers are at the front line of asthma management. To evaluate how planned asthma follow-up occurred in PHC and whether lung function tests were used, 203 patients were followed for 12 years as part of a real-life asthma cohort Seinäjoki Adult Asthma Study (SAAS). A total of 152 patients had visits in PHC attending on average to four planned contacts during 12-year follow-up corresponding to one visit every third year. National guideline recommends annual visits. Patients with ≥4 contacts seemed to have more difficult asthma and better adherence to inhaled corticosteroid medication. Lung function tests were performed on average in 87.5% of annual planned follow-up contacts. Spirometry was performed in 70%, 71% and 97% of all contacts depending on whether it was a contact to GP, nurse or both. Overall, the frequency of follow-up contacts was insufficient but PHC adherence to lung function testing was excellent. npj Primary Care Respiratory Medicine (2020) 30:8 ; https://doi.Published in partnership with Primary Care Respiratory Society UK 1234567890():,; Female, n (%) 96 (63.2) Age 59 (13) BMI 28.5 (5.9) Smokers (ex or current), n (%) 76 (50.0) Atopic, n (%) a 51 (37.2) Rhinitis, n (%) 107 (71.8) Uncontrolled asthma, n (%) b 46 (30.3) Daily LABA in use, n (%) 78 (51.3) Daily add-on drug in use, n (%) 85 (83.3) Daily ICS in use, n (%) 125 (81.2)

show abstract

Section: Discussionmentioning

confidence: 75%

Planned primary health care asthma contacts during 12-year follow-up after Finnish National Asthma Programme: focus on spirometry

Takala

Ilmarinen

Tuomisto

et al. 2020

npj Prim. Care Respir. Med.

View full text Add to dashboard Cite

show abstract

“…Metformin has been shown to improve the prognosis of T2D patients [ 16 ]. The increasing communication, and thereby increasing exchange of information, between the T2D treatment system and the recruited “LTFs” with improved glycaemic control which we observed [ 6 ] did not solely explain the improved glycaemic status. Recommendation based [ 13 – 15 ] increases in medication also seemed to be required for favourable results in T2D treatment of the “LTFs”.…”

Section: Discussionmentioning

confidence: 70%

“…One group was defined as "LTFs" with an improvement in glycaemic control, e.g. those who had a HbA 1 c level ≥53 mmol/mol (7%) at the baseline visit and a reduction in HbA 1 c ≥ 6 mmol/mol (0.5%) at the follow-up visit 12-30 months later [6]. The second group was defined as "LTFs" without improvement, e.g.…”

Section: Study Proceduresmentioning

confidence: 99%

“…The second group was defined as "LTFs" without improvement, e.g. those who had a HbA 1 c level ≥53 mmol/mol (7%) at the baseline visit and the decrease of HbA 1 c level was <6 mmol/l (0.5%) or "LTFs" who had a HbA 1 c level <53 mmol/mol (7%) at the baseline visit but more than that at the follow-up visit 12-30 months later [6]. The third group was defined as "LTFs" with good glycaemic control, e.g.…”

Section: Study Proceduresmentioning

confidence: 99%

“…Although "LTFs" with T2D are generally difficult to bring back into the system, those with poor glycaemic control and who are successfully re-attached to the diabetes treatment system seem to benefit from being recalled [5]. Further, this subgroup of "LTFs" with T2D seems to benefit, at least glycaemic control improves, from intensive communication and counselling with the health-care professionals [6]. However, it is unknown whether there are any differences in the changes in diabetes medication between "LTFs" who improved their glycaemic control and those who did not.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A longitudinal follow-up study of a type 2 diabetes “lost to follow-up” cohort – positive effect on glycaemic control after changes in medication

Kauppila

Laine

Honkasalo

et al. 2020

International Journal of Circumpolar Health

Self Cite

View full text Add to dashboard Cite

The aim of this study was to evaluate whether patients with type 2 diabetes (T2D) who had stopped attending their diabetes treatment system (referred to as "lost to follow-up", LTF) but who succeeded in improving their glycaemic control after returning to the diabetes treatment system had changes in their diabetes medication when compared with similar patients who did not show improvement. "LTFs" who had baseline haemoglobin A 1 c (HbA 1 c) ≥53 mmol/mol and succeeded in reducing HbA 1 c ≥ 6 mmol/mol during a 12-30 month follow-up period after adhering again to their diabetes treatment system were compared with "LTFs" who had an unsatisfactory change in HbA 1 c or with "LTFs" who maintained good glycaemic control throughout the 12-30 month follow-up period. Unsatisfactory change in HbA 1 c was determined as HbA 1 c ≥ 53 mmol/mol and change <6 mmol/mol after the 12-30 month follow-up period in their diabetes treatment system or HbA 1 c < 53 mmol/mol when returning to the diabetes treatment system but ≥53 mmol/mol at the end of the 12-30 month follow-up period. "LTFs" with improvement in glycaemic control used a higher number of different anti-hyperglycaemic agents (P < 0.001) and their dosages of metformin increased (P < 0.05) when compared with "LTFs" without improvement or "LTFs" with satisfactory glycaemic control. Cholesterol-, LDL-cholesteroland triglyceride-concentrations decreased during the 12-30 month follow-up period (P < 0.05) in "LTFs" with improved glycaemic control, but not in the other groups. "LTFs" with T2D who had poor glycaemic control seemed to require an increase in their anti-diabetic medication when attempting to improve their glycaemic control.

show abstract

Use of primary health care services and mortality in older patients with type 2 diabetes with or without comorbidities

Mellanen,

Kauppila,

Kautiainen

et al. 2023

Scandinavian Journal of Primary Health Care

Self Cite

View full text Add to dashboard Cite

Objective This study aimed to examine primary health care (PHC) service utilization and mortality in older patients with type 2 diabetes (T2D) with or without comorbidities. Design and setting A cohort study in PHC in the city of Vantaa, Finland. Follow-up period was set between the years 2011 and 2018. Subjects PHC patients aged 60 years or more with a T2D were included. Main outcome measures Service utilization was defined as the number of face-to-face appointments and telephone contacts between a patient and general practitioner (GP) or nurse. The presence of comorbidities was defined using the Charlson Comorbidity Index (CCI). Mortality was assessed using hazard ratio (HR) and standardized mortality ratio (SMR). Results In total, 11,020 patients were included and followed for 71,596 person years. Mean age of the women and men in the beginning of follow-up were 71 and 69 years, respectively. The patients in the study cohort had a mean of eight appointments per person year to the GPs or nurses. Patients with T2D with comorbidities had more appointments than patients with T2D without comorbidities (incidence rate ratio (IRR) 1.44 [95% CI 1.39–1.49]). Increase in the number of all appointments reduced mortality in patients with T2D with and without comorbidities. Between patients with T2D with comorbidities and patients with T2D without comorbidities, the age and sex adjusted HR for death was 1.50 (95% CI 1.39–1.62). The SMR was higher in patients with T2D with comorbidities (1.83 [95% CI 1.74–1.92]) than in patients with T2D without comorbidities (0.91 [95% CI 0.86–0.96]). Conclusions In older patients with T2D, the presence of comorbidities was associated with increased use of PHC services and increased mortality. Increase in the number of appointments was associated with reduced mortality in patients with T2D with or without comorbidities. Key Points In older patients with T2D, it has not been studied whether and to what extend multimorbidity affects use of PHC services and mortality. The presence of comorbidities according to the Charlson Comorbidity Index (CCI) was associated with increased use of PHC services. The number of appointments to GPs or nurses was associated with reduced mortality in patients with T2D with or without comorbidities according to the CCI.

show abstract

Relationship between number of contacts between previous dropouts with type 2 diabetes and health care professionals on glycaemic control: A cohort study in public primary health care

Abstract: Please cite this article in press as: T. Kauppila, et al., Relationship between number of contacts between previous dropouts with type 2 diabetes and health care professionals on glycaemic control: A cohort study in public primary health care, Prim. Care Diab.

Cited by 7 publications

References 20 publications

Planned primary health care asthma contacts during 12-year follow-up after Finnish National Asthma Programme: focus on spirometry

Planned primary health care asthma contacts during 12-year follow-up after Finnish National Asthma Programme: focus on spirometry

A longitudinal follow-up study of a type 2 diabetes “lost to follow-up” cohort – positive effect on glycaemic control after changes in medication

Use of primary health care services and mortality in older patients with type 2 diabetes with or without comorbidities

Contact Info

Product

Resources

About