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学科主题: 临床医学
题名:
The GIANT study, a cluster-randomised controlled trial of efficacy of education of doctors about type 2 diabetes mellitus management guidelines in primary care practice
作者: Reutens, Anne T.1; Hutchinson, Richard2; Ta Van Binh3; Cockram, Clive4; Deerochanawong, Chaicharn5; Ho, Low-Tone6; Ji, Linong7; Khalid, Bin Abdul Kadir8; Kong, Alice Pik Shan4; Lim-Abrahan, Mary Ann9; Tan, Chee-Eng10; Tjokroprawiro, Askandar11; Yoon, Kun-Ho12; Zimmet, Paul Z.1; Shaw, Jonathan E.1
关键词: Type 2 diabetes ; Glycaemic control ; Practice guidelines ; Primary care ; Asia-Pacific
刊名: DIABETES RESEARCH AND CLINICAL PRACTICE
发表日期: 2012-10-01
DOI: 10.1016/j.diabres.2012.06.002
卷: 98, 期:1, 页:38-45
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Endocrinology & Metabolism
研究领域[WOS]: Endocrinology & Metabolism
关键词[WOS]: CLINICAL INERTIA ; ADHERENCE
英文摘要:

Objectives: Primary aim: does general practitioner (GP) education on type 2 diabetes treatment improve HbA1c? Secondary aim: cardiovascular risk factors, hypoglycaemia, treatment intensification, health service utilisation, treatment barriers.

Methods: 99 Asia-Pacific GPs were cluster-randomised to be educated on regional diabetes management guidelines (intervention) or continue standard care (control). The intervention employed meetings, reminders, medical record summary sheets and patient result cards. Each GP recruited four type 2 diabetic patients, assessed at baseline, 6 and 12 months. The primary outcome was mean change in HbA1c from 0 to 6 months in patients with baseline HbA1c >= 6.5%.

Results: 361 patients (93%) completed 6 month follow-up. The primary HbA1c outcome was 0.11% (95% CI 0.27, 0.05) with intervention and 0.22% (95% CI 0.39, 0.05) in the control group (p = 0.340). The groups did not differ in control of other glycaemic indices, blood pressure or lipids after 6 or 12 months. In those with HbA1c >= 9.0%, approximately 50% received intensified treatment by 6 months, and 30% in the final 6 months. GPs identified treatment costs and patient reluctance to use insulin as management barriers.

Conclusions/interpretation: A structured GP education programme did not improve HbA1c in patients with type 2 diabetes. (C) 2012 Elsevier Ireland Ltd. All rights reserved.

语种: 英语
项目资助者: GlaxoSmithKline Pte Ltd.
WOS记录号: WOS:000311026100010
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/50830
Appears in Collections:北京大学第二临床医学院_期刊论文

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作者单位: 1.Covance Pty Ltd, N Ryde, NSW, Australia
2.Natl Inst Diabet & Metab Disorders, Hanoi, Vietnam
3.Ransit Univ, Coll Med, Rajavithi Hosp, Bangkok, Thailand
4.Taipei Vet Gen Hosp, Taipei, Taiwan
5.Baker IDI Heart & Diabet Inst, Alfred Ctr, Melbourne, Vic 3004, Australia
6.Peking Univ, Peoples Hosp, Beijing 100871, Peoples R China
7.Monash Univ, Johor Baharu, Malaysia
8.Gleneagles Med Ctr, Singapore, Singapore
9.Airlangga Univ, Soetomo Teaching Hosp, Surabaya, Indonesia
10.Chinese Univ Hong Kong, Shatin, Hong Kong, Peoples R China
11.Univ Philippines, Coll Med, Manila, Philippines
12.Catholic Univ Korea, Kangnam St Marys Hosp, Seoul, South Korea

Recommended Citation:
Reutens, Anne T.,Hutchinson, Richard,Ta Van Binh,et al. The GIANT study, a cluster-randomised controlled trial of efficacy of education of doctors about type 2 diabetes mellitus management guidelines in primary care practice[J]. DIABETES RESEARCH AND CLINICAL PRACTICE,2012,98(1):38-45.
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