 |
 |
|
Home |
Current Issue |
Past Issues |
In the Clinic |
ACP Journal Club |
CME |
Collections |
Audio/Video |
Mobile |
Subscribe |
Tools |
Help |
ACP Online
|
15 October 1998 | Volume 129 Issue 8 | Pages 605-612
Background: Control of hyperglycemia delays or prevents complications of diabetes, but many persons with diabetes do not achieve optimal control.
Objective: To compare diabetes control in patients receiving nurse case management and patients receiving usual care.
Design: Randomized, controlled trial.
Setting: Primary care clinics in a group-model health maintenance organization (HMO).
Patients: 17 patients with type 1 diabetes mellitus and 121 patients with type 2 diabetes mellitus.
Intervention: The nurse case manager followed written management algorithms under the direction of a family physician and an endocrinologist. Changes in therapy were communicated to primary care physicians. All patients received ongoing care through their primary care physicians.
Measurements: The primary outcome, hemoglobin A1c (HbA1c) value, was measured at baseline and at 12 months. Fasting blood glucose levels, medication type and dose, body weight, blood pressure, lipid levels, patient-perceived health status, episodes of severe hypoglycemia, and emergency department and hospital admissions were also assessed.
Results: 72% of patients completed follow-up. Patients in the nurse case management group had mean decreases of 1.7 percentage points in HbA1c values and 43 mg/dL (2.38 mmol/L) in fasting glucose levels; patients in the usual care group had decreases of 0.6 percentage points in HbA1c values and 15 mg/dL (0.83 mmol/L) in fasting glucose levels (P < 0.01). Self-reported health status improved in the nurse case management group (P = 0.02). The nurse case management intervention was not associated with statistically significant changes in medication type or dose, body weight, blood pressure, or lipids or with adverse events.
Conclusions: A nurse case manager with considerable management responsibility can, in association with primary care physicians and an endocrinologist, help improve glycemic control in diabetic patients in a group-model HMO.
Author and Article Information
From Prudential Center for Health Care Research, Atlanta, Georgia; University of Michigan School of Medicine, Ann Arbor, Michigan; Jacksonville Health Care Group and Northeast Florida Endocrine and Diabetes, P.A., Jacksonville, Florida; and Duke University Medical Center, Durham, North Carolina.
ARTICLE
Nurse Case Management To Improve Glycemic Control in Diabetic Patients in a Health Maintenance Organization
A Randomized, Controlled Trial
Acknowledgments: The authors thank the study coordinator, Stephanie Powers, for coordination of all aspects of the primary data collection; Mary Cogswell for assistance with study development; Maryjo Greco-Krumviede and Pat Barta for their participation in algorithm development; Mary-Grace Flaherty and Xiomara Rivera for review and assistance with manuscript preparation; the physicians and staff of the Jacksonville Health Care Group; the Prudential HealthCare plan members for their participation and support; and Roche Diagnostics/Boehringer Mannheim Corporation for the in-kind contribution of Accu-Chek Advantage blood glucose meters and monitoring strips.
Requests for Reprints: Ronald E. Aubert, PhD, MSPH, Prudential Center for Health Care Research, 2859 Paces Ferry Road, Suite 820, Atlanta, GA 30339.
Current Author Addresses: Drs. Aubert and Koplan and Ms. Bailey: Prudential Center for Health Care Research, 2859 Paces Ferry Road, Suite 820, Atlanta, GA 30339.
Related articles in Annals:
This article has been cited by other articles:
|
|
 |
|
  M. M. Funnell, T. L. Brown, B. P. Childs, L. B. Haas, G. M. Hosey, B. Jensen, M. Maryniuk, M. Peyrot, J. D. Piette, D. Reader, et al. National Standards for Diabetes Self-Management Education Diabetes Care, January 1, 2008; 31(Supplement_1): S97 - S104. [Full Text] [PDF]
|
|
|
|
 |
|
 N. M. Albert Switching to Once-Daily Evidence-Based -Blockers in Patients With Systolic Heart Failure or Left Ventricular Dysfunction After Myocardial Infarction Crit. Care Nurse, December 1, 2007; 27(6): 62 - 72. [Full Text] [PDF]
|
|
|
|
 |
|
 M. Heisler Overview of Peer Support Models to Improve Diabetes Self-Management and Clinical Outcomes Diabetes Spectr, October 1, 2007; 20(4): 214 - 221. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. E. Peek, A. Cargill, and E. S. Huang Diabetes Health Disparities: A Systematic Review of Health Care Interventions Med Care Res Rev, October 1, 2007; 64(5_suppl): 101S - 156S. [Abstract] [PDF]
|
|
|
|
 |
|
 M. M. Funnell, T. L. Brown, B. P. Childs, L. B. Haas, G. M. Hosey, B. Jensen, M. Maryniuk, M. Peyrot, J. D. Piette, D. Reader, et al. National Standards for Diabetes Self-Management Education The Diabetes Educator, July 1, 2007; 33(4): 599 - 614. [Full Text] [PDF]
|
|
|
|
|
|
M. M. Funnell, T. L. Brown, B. P. Childs, L. B. Haas, G. M. Hosey, B. Jensen, M. Maryniuk, M. Peyrot, J. D. Piette, D. Reader, et al. National Standards for Diabetes Self-Management Education Diabetes Care, June 1, 2007; 30(6): 1630 - 1637. [Full Text] [PDF]
|
|
|
|
|
|
R. G. Hiss, B. A. Armbruster, M. L. Gillard, and L. A. McClure Nurse Care Manager Collaboration With Community-Based Physicians Providing Diabetes Care: A Randomized Controlled Trial The Diabetes Educator, May 1, 2007; 33(3): 493 - 502. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. B. Davidson, A. Ansari, and V. J. Karlan Effect of a Nurse-Directed Diabetes Disease Management Program on Urgent Care/Emergency Room Visits and Hospitalizations in a Minority Population Diabetes Care, February 1, 2007; 30(2): 224 - 227. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Lin, S. Hale, and E. Kirby Improving diabetes management: Structured clinic program for Canadian primary care Can Fam Physician, January 1, 2007; 53(1): 73 - 77. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. S. Holmboe and C. K. Cassel The Role of Physicians and Certification Boards to Improve Quality American Journal of Medical Quality, January 1, 2007; 22(1): 18 - 25. [Abstract] [PDF]
|
|
|
|
 |
|
 S. L Upchurch Review: case management and team changes are particularly effective strategies for reducing HbA1c concentrations in type 2 diabetes Evid. Based Nurs., January 1, 2007; 10(1): 25 - 25. [Full Text] [PDF]
|
|
|
|
|
|
L. M. Siminerio, M. M. Funnell, M. Peyrot, and R. R. Rubin US Nurses' Perceptions of Their Role in Diabetes Care: Results of the Cross-national Diabetes Attitudes Wishes and Needs (DAWN) Study The Diabetes Educator, January 1, 2007; 33(1): 152 - 162. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. A. Nutting, W. P. Dickinson, L. M. Dickinson, C. C. Nelson, D. K. King, B. F. Crabtree, and R. E. Glasgow Use of Chronic Care Model Elements Is Associated With Higher-Quality Care for Diabetes Ann. Fam. Med, January 1, 2007; 5(1): 14 - 20. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Mensing, J. Boucher, M. Cypress, K. Weinger, K. Mulcahy, P. Barta, G. Hosey, W. Kopher, A. Lasichak, B. Lamb, et al. National Standards for Diabetes Self-Management Education Diabetes Care, January 1, 2007; 30(suppl_1): S96 - S103. [Full Text] [PDF]
|
|
|
|
|
|
C. N. Sciamanna, K. Alvarez, J. Miller, T. Gary, and M. Bowen Attitudes toward nurse practitioner-led chronic disease management to improve outpatient quality of care. American Journal of Medical Quality, November 1, 2006; 21(6): 375 - 381. [Abstract] [PDF]
|
|
|
|
 |
|
 C. H.M. Latour, R. de Vos, F. J. Huyse, P. de Jonge, L. A.M. van Gemert, and W. A.B. Stalman Effectiveness of Post-Discharge Case Management in General-Medical Outpatients: A Randomized, Controlled Trial Psychosomatics, October 1, 2006; 47(5): 421 - 429. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. M. Krumholz, P. M. Currie, B. Riegel, C. O. Phillips, E. D. Peterson, R. Smith, C. W. Yancy, and D. P. Faxon A Taxonomy for Disease Management: A Scientific Statement From the American Heart Association Disease Management Taxonomy Writing Group Circulation, September 26, 2006; 114(13): 1432 - 1445. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. A. Morse, P. S. Ciechanowski, W. J. Katon, and I. B. Hirsch Isn't This Just Bedtime Snacking?: The potential adverse effects of night-eating symptoms on treatment adherence and outcomes in patients with diabetes Diabetes Care, August 1, 2006; 29(8): 1800 - 1804. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. G. Shojania, S. R. Ranji, K. M. McDonald, J. M. Grimshaw, V. Sundaram, R. J. Rushakoff, and D. K. Owens Effects of quality improvement strategies for type 2 diabetes on glycemic control: a meta-regression analysis. JAMA, July 26, 2006; 296(4): 427 - 440. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. M. Mangione, R. B. Gerzoff, D. F. Williamson, W. N. Steers, E. A. Kerr, A. F. Brown, B. E. Waitzfelder, D. G. Marrero, R. A. Dudley, C. Kim, et al. The Association between Quality of Care and the Intensity of Diabetes Disease Management Programs Ann Intern Med, July 18, 2006; 145(2): 107 - 116. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Leeman Interventions to Improve Diabetes Self-management: Utility and Relevance for Practice. The Diabetes Educator, July 1, 2006; 32(4): 571 - 583. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. M. Delamater Improving Patient Adherence Clin. Diabetes, April 1, 2006; 24(2): 71 - 77. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S Royal, L Smeaton, A J Avery, B Hurwitz, and A Sheikh Interventions in primary care to reduce medication related adverse events and hospital admissions: systematic review and meta-analysis Qual. Saf. Health Care, February 1, 2006; 15(1): 23 - 31. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Gambling and A. F. Long Exploring Patient Perceptions of Movement through the Stages of Change Model within a Diabetes Tele-care Intervention J Health Psychol, January 1, 2006; 11(1): 117 - 128. [Abstract] [PDF]
|
|
|
|
|
|
C. Mensing, J. Boucher, M. Cypress, K. Weinger, K. Mulcahy, P. Barta, G. Hosey, W. Kopher, A. Lasichak, B. Lamb, et al. National Standards for Diabetes Self-Management Education Diabetes Care, January 1, 2006; 29(suppl_1): S78 - S85. [Full Text] [PDF]
|
|
|
|
 |
|
 B. L. Rollman, B. H. Belnap, S. Mazumdar, P. R. Houck, F. Zhu, W. Gardner, C. F. Reynolds III, H. C. Schulberg, and M. K. Shear A Randomized Trial to Improve the Quality of Treatment for Panic and Generalized Anxiety Disorders in Primary Care Arch Gen Psychiatry, December 1, 2005; 62(12): 1332 - 1341. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Hollander, D. Nicewander, C. Couch, D. Winter, J. Herrin, Z. Haydar, and D. J. Ballard Quality of Care of Medicare Patients With Diabetes in a Metropolitan Fee-for-Service Primary Care Integrated Delivery System American Journal of Medical Quality, November 1, 2005; 20(6): 344 - 352. [Abstract] [PDF]
|
|
|
|
|
|
M. Heisler and J. D. Piette "I Help You, and You Help Me": Facilitated Telephone Peer Support Among Patients With Diabetes The Diabetes Educator, November 1, 2005; 31(6): 869 - 879. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. S. Phillips, D. C. Ziemer, J. P. Doyle, C. S. Barnes, P. Kolm, W. T. Branch, J. M. Caudle, C. B. Cook, V. G. Dunbar, I. M. El-Kebbi, et al. An Endocrinologist-Supported Intervention Aimed at Providers Improves Diabetes Management in a Primary Care Site: Improving Primary Care of African Americans with Diabetes (IPCAAD) 7 Diabetes Care, October 1, 2005; 28(10): 2352 - 2360. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. L. Wolff and C. Boult Moving beyond Round Pegs and Square Holes: Restructuring Medicare To Improve Chronic Care Ann Intern Med, September 20, 2005; 143(6): 439 - 445. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Bray, M. Roupe, S. Young, J. Harrell, D. M. Cummings, and L. M. Whetstone Feasibility and Effectiveness of System Redesign for Diabetes Care Management in Rural Areas: The Eastern North Carolina Experience The Diabetes Educator, September 1, 2005; 31(5): 712 - 718. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. B. Fisher, C. A. Brownson, M. L. O'Toole, G. Shetty, V. V. Anwuri, and R. E. Glasgow Ecological Approaches to Self-Management: The Case of Diabetes Am J Public Health, September 1, 2005; 95(9): 1523 - 1535. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. C. Ziemer, C. D. Miller, M. K. Rhee, J. P. Doyle, C. Watkins Jr, C. B. Cook, D. L. Gallina, I. M. El-Kebbi, C. S. Barnes, V. G. Dunbar, et al. Clinical Inertia Contributes to Poor Diabetes Control in a Primary Care Setting The Diabetes Educator, July 1, 2005; 31(4): 564 - 571. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. T. McMahon, H. E. Gomes, S. Hickson Hohne, T. M.-J. Hu, B. A. Levine, and P. R. Conlin Web-Based Care Management in Patients With Poorly Controlled Diabetes Diabetes Care, July 1, 2005; 28(7): 1624 - 1629. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. M. Anderson Is It Ethical to Assign Medically Underserved African Americans to a Usual-Care Control Group in Community-Based Intervention Research? Diabetes Care, July 1, 2005; 28(7): 1817 - 1820. [Full Text] [PDF]
|
|
|
|
 |
|
 M. Lynch, C. L. Estes, and M. Hernandez Chronic Care Initiatives for the Elderly: Can They Bridge the Gerontology-Medicine Gap? Journal of Applied Gerontology, April 1, 2005; 24(2): 108 - 124. [Abstract] [PDF]
|
|
|
|
 |
|
 T. Bodenheimer, K. MacGregor, and N. Stothart Nurses as leaders in chronic care BMJ, March 19, 2005; 330(7492): 612 - 613. [Full Text] [PDF]
|
|
|
|
|
|
A. F. Long, T. Gambling, R. J. Young, J. Taylor, J. M. Mason, and on behalf of the PACCTS Team Acceptability and Satisfaction With a Telecarer Approach to the Management of Type 2 Diabetes Diabetes Care, February 1, 2005; 28(2): 283 - 289. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Mensing, J. Boucher, M. Cypress, K. Weinger, K. Mulcahy, P. Barta, G. Hosey, W. Kopher, A. Lasichak, B. Lamb, et al. National Standards for Diabetes Self-Management Education Diabetes Care, January 1, 2005; 28(suppl_1): S72 - S79. [Full Text] [PDF]
|
|
|
|
 |
|
 R. Newcomer, V. Maravilla, P. Faculjak, and M. T. Graves Outcomes of Preventive Case Management Among High-Risk Elderly in Three Medical Groups: A Randomized Clinical Trial Eval Health Prof, December 1, 2004; 27(4): 323 - 348. [Abstract] [PDF]
|
|
|
|
 |
|
 A. Kempe Telephone Care in Chronic Disease Management AAP Grand Rounds, October 1, 2004; 12(4): 49 - 50. [Full Text] [PDF]
|
|
|
|
|
|
R. W. Grant, E. Cagliero, C. M. Sullivan, A. K. Dubey, G. A. Estey, E. M. Weil, J. Gesmundo, D. M. Nathan, D. E. Singer, H. C. Chueh, et al. A Controlled Trial of Population Management: Diabetes Mellitus: Putting Evidence into Practice (DM-PEP) Diabetes Care, October 1, 2004; 27(10): 2299 - 2305. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Li, J. Simon, T. Bodenheimer, R. R. Gillies, L. Casalino, J. Schmittdiel, and S. M. Shortell Organizational Factors Affecting the Adoption of Diabetes Care Management Processes in Physician Organizations Diabetes Care, October 1, 2004; 27(10): 2312 - 2316. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. J. Katon, M. Von Korff, E. H. B. Lin, G. Simon, E. Ludman, J. Russo, P. Ciechanowski, E. Walker, and T. Bush The Pathways Study: A Randomized Trial of Collaborative Care in Patients With Diabetes and Depression Arch Gen Psychiatry, October 1, 2004; 61(10): 1042 - 1049. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. F. Brown, S. L. Ettner, J. Piette, M. Weinberger, E. Gregg, M. F. Shapiro, A. J. Karter, M. Safford, B. Waitzfelder, P. A. Prata, et al. Socioeconomic Position and Health among Persons with Diabetes Mellitus: A Conceptual Framework and Review of the Literature Epidemiol. Rev., July 1, 2004; 26(1): 63 - 77. [Full Text] [PDF]
|
|
|
|
|
|
E. L. Fanning, B. J. Selwyn, A. C. Larme, and R. A. DeFronzo Improving Efficacy of Diabetes Management Using Treatment Algorithms in a Mainly Hispanic Population Diabetes Care, July 1, 2004; 27(7): 1638 - 1646. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. G. Villagra and T. Ahmed Effectiveness Of A Disease Management Program For Patients With Diabetes Health Aff., July 1, 2004; 23(4): 255 - 266. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Friedman and J. Basu The Rate and Cost of Hospital Readmissions for Preventable Conditions Med Care Res Rev, June 1, 2004; 61(2): 225 - 240. [Abstract] [PDF]
|
|
|
|
|
|
K. M. Venkat Narayan, E. Benjamin, E. W. Gregg, S. L. Norris, and M. M. Engelgau Diabetes Translation Research: Where Are We and Where Do We Want To Be? Ann Intern Med, June 1, 2004; 140(11): 958 - 963. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. D Ralston, D. Revere, L. S Robins, and H. I Goldberg Patients' experience with a diabetes support programme based on an interactive electronic medical record: qualitative study BMJ, May 15, 2004; 328(7449): 1159. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. G H Laurant, R. P M G Hermens, J. C C Braspenning, B. Sibbald, and R. P T M Grol Impact of nurse practitioners on workload of general practitioners: randomised controlled trial BMJ, April 17, 2004; 328(7445): 927. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Siminerio, J. Zgibor, and F. X. Solano Jr. Implementing the Chronic Care Model for Improvements in Diabetes Practice and Outcomes in Primary Care: The University of Pittsburgh Medical Center Experience Clin. Diabetes, April 1, 2004; 22(2): 54 - 58. [Full Text] [PDF]
|
|
|
|
|
|
K. Grumbach and T. Bodenheimer Can Health Care Teams Improve Primary Care Practice? JAMA, March 10, 2004; 291(10): 1246 - 1251. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Gask Powerlessness, Control, and Complexity: The Experience of Family Physicians in a Group Model HMO Ann. Fam. Med, March 1, 2004; 2(2): 150 - 155. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Wheeler, R. Crawford, D. McAdams, S. Benel, V. G. Dunbar, J. M. Caudle, C. George, I. El-Kebbi, D. L. Gallina, D. C. Ziemer, et al. Inpatient to Outpatient Transfer of Care in Urban Patients With Diabetes: Patterns and Determinants of Immediate Postdischarge Follow-up Arch Intern Med, February 23, 2004; 164(4): 447 - 453. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
The California Medi-Cal Type 2 Diabetes Study Grou Closing the Gap: Effect of Diabetes Case Management on Glycemic Control Among Low-Income Ethnic Minority Populations: The California Medi-Cal Type 2 Diabetes Study Diabetes Care, January 1, 2004; 27(1): 95 - 103. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Philis-Tsimikas, C. Walker, L. Rivard, G. Talavera, J. O.F. Reimann, M. Salmon, and R. Araujo Improvement in Diabetes Care of Underinsured Patients Enrolled in Project Dulce: A community-based, culturally appropriate, nurse case management and peer education diabetes care model Diabetes Care, January 1, 2004; 27(1): 110 - 115. [Abstract] [Full Text] [PDF]
|
|
|
|
|
Article
