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Conference Paper: Effectiveness of Self-care Enablement Programmes Delivered in Small Groups or by Telephone to Prevent Complications of Diabetes Mellitus
Title | Effectiveness of Self-care Enablement Programmes Delivered in Small Groups or by Telephone to Prevent Complications of Diabetes Mellitus |
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Authors | |
Issue Date | 2017 |
Publisher | North American Primary Care Research Group. |
Citation | 45th North American Primary Care Research Group (NAPCRG) Annual Meeting 2017, Montreal, Quebec, Canada, 17-21 November 2017 How to Cite? |
Abstract | Context: Self-care is an essential part of the management of diabetes mellitus (DM). Studies have demonstrated the benefit of structured DM self-care enablement programs in trial settings but their effectiveness in real-world practice is not clear. Objectives: To evaluate and compare the effectiveness of two DM self-care enablement programmes delivered in small groups (PEP) or by telephone (Call Centre) in real-world primary care. Design: Retrospective cohort study. Setting: Public primary care in Hong Kong. Patients: 63,846 Chinese primary care patients with type 2 DM and without any known complication managed in public primary care clinics in 2012-2013. Usual care only group: 47,802; usual care and PEP: 10,030; usual care and Call Centre: 6,014. Primary and Secondary Outcome Measures: Incidence of CVD was primary; incidence of end stage renal disease (ESRD) and all-cause mortality were secondary. Results: After a median 3-year follow-up, the unadjusted absolute risk reduction (ARR) in CVD, ESRD and all-cause mortality by PEP was -1.34%, -0.26% and -1.66%, respectively. The ARR in CVD, ESRD and all-cause mortality by Call Centre was -0.56%, -0.02% and -0.48%, respectively. Multivariable Cox proportional regressions showed that PEP and Call Centre were associated with significant relative risk reduction (RRR) of CVD compared with usual care group by 14% (Hazard ratio (HR): 0.86; P < 0.001) and 16% (HR: 0.84; P < 0.001), respectively, after adjustment of baseline characteristics. PEP was associated with a significant RRR of 33% (HR: 0.67; P < 0.001) of all-cause mortality compared with Call Centre, but no significant difference was found in the risk of CVD and ESRD between PEP and Call Centre groups. Conclusions: DM self-care enablement programmes delivered in small groups or by telephone in real-world primary care were effective in reducing the risk of CVD, ESRD and all-cause mortality for DM patients. |
Description | Oral Presentation on Completed Research: Free Paper Session no. DB14 |
Persistent Identifier | http://hdl.handle.net/10722/261650 |
DC Field | Value | Language |
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dc.contributor.author | Lam, CLK | - |
dc.contributor.author | Wong, WCW | - |
dc.contributor.author | Wan, EYF | - |
dc.contributor.author | Wong, CKH | - |
dc.contributor.author | Chan, AKC | - |
dc.date.accessioned | 2018-09-28T04:45:21Z | - |
dc.date.available | 2018-09-28T04:45:21Z | - |
dc.date.issued | 2017 | - |
dc.identifier.citation | 45th North American Primary Care Research Group (NAPCRG) Annual Meeting 2017, Montreal, Quebec, Canada, 17-21 November 2017 | - |
dc.identifier.uri | http://hdl.handle.net/10722/261650 | - |
dc.description | Oral Presentation on Completed Research: Free Paper Session no. DB14 | - |
dc.description.abstract | Context: Self-care is an essential part of the management of diabetes mellitus (DM). Studies have demonstrated the benefit of structured DM self-care enablement programs in trial settings but their effectiveness in real-world practice is not clear. Objectives: To evaluate and compare the effectiveness of two DM self-care enablement programmes delivered in small groups (PEP) or by telephone (Call Centre) in real-world primary care. Design: Retrospective cohort study. Setting: Public primary care in Hong Kong. Patients: 63,846 Chinese primary care patients with type 2 DM and without any known complication managed in public primary care clinics in 2012-2013. Usual care only group: 47,802; usual care and PEP: 10,030; usual care and Call Centre: 6,014. Primary and Secondary Outcome Measures: Incidence of CVD was primary; incidence of end stage renal disease (ESRD) and all-cause mortality were secondary. Results: After a median 3-year follow-up, the unadjusted absolute risk reduction (ARR) in CVD, ESRD and all-cause mortality by PEP was -1.34%, -0.26% and -1.66%, respectively. The ARR in CVD, ESRD and all-cause mortality by Call Centre was -0.56%, -0.02% and -0.48%, respectively. Multivariable Cox proportional regressions showed that PEP and Call Centre were associated with significant relative risk reduction (RRR) of CVD compared with usual care group by 14% (Hazard ratio (HR): 0.86; P < 0.001) and 16% (HR: 0.84; P < 0.001), respectively, after adjustment of baseline characteristics. PEP was associated with a significant RRR of 33% (HR: 0.67; P < 0.001) of all-cause mortality compared with Call Centre, but no significant difference was found in the risk of CVD and ESRD between PEP and Call Centre groups. Conclusions: DM self-care enablement programmes delivered in small groups or by telephone in real-world primary care were effective in reducing the risk of CVD, ESRD and all-cause mortality for DM patients. | - |
dc.language | eng | - |
dc.publisher | North American Primary Care Research Group. | - |
dc.relation.ispartof | NAPCRG 2017 (North American Primary Care Research Group) Annual Meeting | - |
dc.title | Effectiveness of Self-care Enablement Programmes Delivered in Small Groups or by Telephone to Prevent Complications of Diabetes Mellitus | - |
dc.type | Conference_Paper | - |
dc.identifier.email | Lam, CLK: clklam@hku.hk | - |
dc.identifier.email | Wong, WCW: wongwcw@hku.hk | - |
dc.identifier.email | Wan, EYF: yfwan@hku.hk | - |
dc.identifier.email | Wong, CKH: carlosho@hku.hk | - |
dc.identifier.email | Chan, AKC: kcchanae@hku.hk | - |
dc.identifier.authority | Lam, CLK=rp00350 | - |
dc.identifier.authority | Wong, WCW=rp01457 | - |
dc.identifier.authority | Wong, CKH=rp01931 | - |
dc.identifier.hkuros | 292824 | - |
dc.publisher.place | Montreal, Canada | - |