Willadsen Tora Grauers, Siersma Volkert, Nielsen Anni Brit Sternhagen, Køster-Rasmussen Rasmus, Guassora Ann Dorrit, Jarbøl Dorte Ejg, Eusebi Paolo, Malterud Kirsti, Reventlow Susanne, de Fine Olivarius Niels
The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Prim Care Diabetes. 2018 Aug;12(4):354-363. doi: 10.1016/j.pcd.2018.03.007. Epub 2018 Apr 26.
To explore the effect of structured personal care on diabetes symptoms and self-rated health over 14 years after diabetes diagnosis while patients are gradually diagnosed with other chronic conditions (multimorbidity).
Post hoc analysis of the Danish randomized controlled trial Diabetes Care in General Practice including 1381 patients newly diagnosed with type 2 diabetes. The effect of structured personal care compared with routine care on diabetes symptoms and self-rated health was analysed 6 and 14 years after diagnosis with a generalized multilevel Rasch model.
Structured personal care reduced the overall likelihood of reporting diabetes symptoms at the end of the intervention (OR 0.79; 95% CI: 0.64-0.97), but this effect was not explained by glycaemic control or multimorbidity. There was no effect of the intervention on diabetes symptoms after 14 years or on self-rated health after 6 years or 14 years.
Structured personal care had a beneficial effect on diabetes symptoms 6 years after diagnosis, but not on self-rated health at either follow up point. To optimally manage patients over time it is important to supplement clinical information by information provided by the patients.
探讨结构化个人护理对糖尿病诊断后14年期间糖尿病症状及自我评估健康状况的影响，此期间患者会逐渐被诊断出患有其他慢性疾病（共病）。
对丹麦全科医疗中糖尿病护理的随机对照试验进行事后分析，该试验纳入了1381例新诊断的2型糖尿病患者。采用广义多水平Rasch模型，分析诊断后6年和14年时结构化个人护理与常规护理相比对糖尿病症状及自我评估健康状况的影响。
在干预结束时，结构化个人护理降低了报告糖尿病症状的总体可能性（比值比0.79；95%置信区间：0.64 - 0.97），但这种效果无法通过血糖控制或共病来解释。干预对14年后的糖尿病症状或6年及14年后的自我评估健康状况均无影响。
结构化个人护理在诊断后6年对糖尿病症状有有益影响，但在两个随访点对自我评估健康状况均无影响。为了随时间最佳地管理患者，通过患者提供的信息补充临床信息很重要。
