Practice network-based care management for patients with type 2 diabetes and multiple comorbidities (GEDIMAplus):...

Area of Science:

• Health Services Research
• Chronic Disease Management
• Diabetes Care

Background:

• Care management interventions show promise in Germany but require further research for multi-morbid patients.
• Patients with type 2 diabetes mellitus (T2DM) and multiple chronic conditions present complex healthcare needs.
• Primary care practice networks can serve as a platform for integrated care management.

Purpose of the Study:

• To evaluate the efficacy of a primary care practice network-based care management intervention.
• To improve self-care behaviors among patients with T2DM and multiple co-occurring chronic conditions.
• To assess the impact on health-related quality of life, glycemic control, and cost-effectiveness.

Main Methods:

• Prospective, 18-month, randomized controlled trial involving 582 patients with T2DM and at least two severe chronic conditions.
• Intervention group received usual care plus structured home visits, telephone monitoring, and self-monitoring of blood glucose.
• Primary outcome: change in diabetes-related self-care behaviors (SDSCA-G) from baseline to 9 months.

Main Results:

• The study aims to determine differences in self-care behavior changes between intervention and control groups.
• Secondary outcomes include changes in glycosylated hemoglobin A1c, quality of life, and cost-effectiveness.
• Analysis will follow the intention-to-treat (ITT) principle.

Conclusions:

• This trial is expected to provide valuable insights into the effectiveness of care management for complex patient populations.
• Findings will inform the optimization of care management strategies within German primary care settings.
• The study contributes to understanding the role of practice networks in managing multi-morbid patients.