Dunkelberg S, Zingel D, Noack A, van den Bussche H, Kaduszkiewicz H
Institut für Allgemeinmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg.
Gesundheitswesen. 2006 May;68(5):289-93. doi: 10.1055/s-2006-926768.
The disease management programme for diabetes mellitus type 2 (DMP) is joined by many General Practitioners. Aim of the study is to compare patients included in this programme with patients not included and to explore reasons for the selection.
10 GPs in Hamburg participated. From each patient list 10 participants in the DMP and the same number of non-participants were randomly selected. HbA1c before start of the programme, presence of insulin therapy, comorbidity and language skills were documented. GPs reported their estimation of the compliance and their reasoning in the selection process. The hypothesis for the primary endpoint was: Diabetics not included have a worse HbA1c value than those included in the DMP.
The hypothesis was not confirmed. In both groups similarly good HbA1c values were observed (7.0 in DMP participants, 7.3 in non-participants). The included participants differed from those not included with respect to age (statistically significantly younger) and a better compliance. In the subgroup of patients younger than 70 years the patients included have a better HbA1c and get insulin more frequently (both n. s.).
One part of the patients seems to be not included into the DMP for good reasons. Two questions should be further evaluated: To what extent are patients included although they already have a good metabolic situation? And to what extent are patients with a poor compliance not included, although they might benefit from participation?
