Impact of a diabetes disease management program on diabetes control and patient quality of life

Popul Health Manag. 2012 Feb;15(1):12-9. doi: 10.1089/pop.2011.0002. Epub 2012 Jan 9.

Abstract

The worldwide burden of diabetes is projected to be 5.4% of the adult population by the year 2025. Diabetes is associated with multiple medical complications that both decrease health-related quality of life (HR-QOL) and contribute to earlier mortality. There is growing evidence for the effectiveness of multidisciplinary disease management programs that incorporate self-management principles in improving patients' long-term outcomes. The aim of this project was to evaluate the effectiveness of this approach in improving: (1) glycemic control measured by HbA1c, and (2) HR-QOL measured by the Assessment of Quality of Life (AQOL), at enrollment and at 12-months follow-up. Between 2004 and 2008, a total of 967 patients were enrolled in the program; 545 (56%) of these patients had HbA1c data available at baseline and at 12 months. Mean HbA1c at enrollment was 8.6% (SD 1.9) versus 7.3% (SD 1.2) at 12 months (P<0.001). Overall, 68% of patients experienced improvements in HbA1c. At enrollment, patients reported "fair" HR-QOL, which was significantly lower than age-adjusted population norms who reported "good" HR-QOL. At 12 months, 251 (64%) patients had improved HR-QOL, 27 (7%) had no change, and 114 (29%) deteriorated. Mean utility scores improved by 0.11 (P<0.001), which is almost twice the minimum clinically important difference for the AQOL. This study confirms that a multidisciplinary disease management program for patients with poorly controlled type 2 diabetes can improve both glycemic control and HR-QOL.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomarkers / analysis
  • Blood Glucose / analysis
  • Diabetes Mellitus, Type 2 / therapy*
  • Disease Management*
  • Female
  • Follow-Up Studies
  • Glycated Hemoglobin / analysis
  • Health Services Research
  • Humans
  • Male
  • Middle Aged
  • Patient Care Team
  • Patient Education as Topic
  • Quality of Life*
  • Self Care
  • Surveys and Questionnaires
  • Treatment Outcome

Substances

  • Biomarkers
  • Blood Glucose
  • Glycated Hemoglobin A