Care management intervention to strengthen self-care of multimorbid patients with type 2 diabetes in a German primary care network

• Verfasst von: Ose, Dominik [VerfasserIn]
• Verfasst von: Kamradt, Martina [VerfasserIn]
• Verfasst von: Kiel, Marion [VerfasserIn]
• Verfasst von: Freund, Tobias [VerfasserIn]
• Verfasst von: Besier, Werner [VerfasserIn]
• Verfasst von: Mayer, Manfred [VerfasserIn]
• Verfasst von: Krisam, Johannes [VerfasserIn]
• Verfasst von: Wensing, Michel [VerfasserIn]
• Verfasst von: Salize, Hans Joachim [VerfasserIn]
• Verfasst von: Szecsenyi, Joachim [VerfasserIn]
• Titel: Care management intervention to strengthen self-care of multimorbid patients with type 2 diabetes in a German primary care network
• Titelzusatz: A randomized controlled trial
• Verf.angabe: Dominik Ose, Martina Kamradt, Marion Kiel, Tobias Freund, Werner Besier, Manfred Mayer, Johannes Krisam, Michel Wensing, Hans-Joachim Salize, Joachim Szecsenyi
• E-Jahr: 2019
• Jahr: June 12, 2019
• Umfang: 18 S.
• Fussnoten: Published June 12, 2019 ; Gesehen am 22.01.2020 ; Correction: 9 Aug 2019: Ose D, Kamradt M, Kiel M, Freund T, Besier W, et al. (2019) Correction: Care management intervention to strengthen self-care of multimorbid patients with type 2 diabetes in a German primary care network: A randomized controlled trial. PLOS ONE 14(8): e0221229. https://doi.org/10.1371/journal.pone.0221229
• Titel Quelle: Enthalten in: PLOS ONE
• Ort Quelle: San Francisco, California, US : PLOS, 2006
• Jahr Quelle: 2019
• Band/Heft Quelle: 14(2019,6), Artikel-Nummer e0214056, 18 Seiten
• ISSN Quelle: 1932-6203
• DOI: doi:10.1371/journal.pone.0214056
• Datenträger: Online-Ressource
• Sprache: eng
• Bibliogr. Hinweis: Errata: Ose, Dominik, 1975 - : Correction: Care management intervention to strengthen self-care of multimorbid patients with type 2 diabetes in a German primary care network
• Sach-SW: Blood sugar
• Sach-SW: Diabetes mellitus
• Sach-SW: German people
• Sach-SW: HbA1c
• Sach-SW: Patients
• Sach-SW: Physicians
• Sach-SW: Primary care
• Sach-SW: Type 2 diabetes
• K10plus-PPN: 1688024778

Abstract

Purpose: This study aimed to assess the effectiveness of a care management intervention in improving self-management behavior in multimorbid patients with type 2 diabetes; care was delivered by medical assistants in the context of a primary care network (PCN) in Germany. Methods This study is an 18-month, multi-center, two-armed, open-label, patient-randomized parallel-group superiority trial (ISRCTN 83908315). The intervention group received the care management intervention in addition to the usual care. The control group received usual care only. The primary outcome was the change in self-care behavior at month 9 compared to baseline. The self-care behavior was measured with the German version of the Summary of Diabetes Self-Care Activities Measure (SDSCA-G). A multilevel regression analysis was applied. Results: We assigned 495 patients to intervention (n = 252) and control (n = 243). At baseline, the mean age was 68 ±11 years, 47.8% of the patients were female and the mean HbA1c was 7.1±1.2%. The primary analysis showed no statistically significant effect, but a positive trend was observed (p = 0.206; 95%-CI = -0.084; 0.384). The descriptive analysis revealed a significantly increased sum score of the SDSCA-G in the intervention group over time (P = 0.012) but not in the control group (p = 0.1973). Conclusion: The sum score for self-care behavior markedly improved in the intervention group over time. However, the results of our primary analysis showed no statistically significant effect. Possible reasons are the high baseline performance in our sample and the low intervention fidelity. The implementation of this care management intervention in PCNs has the potential to improve self-care behavior of multimorbid patients with type 2 diabetes.