Effects of a Technology-Assisted Integrated Diabetes Care Program on Cardiometabolic Risk Factors Among Patients With
Lee-Ling Lim1,2,3, Eric S H Lau1,2, Amy W C Fu2
1Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong Special Administrative Region, China.
JAMA Network Open
|April 30, 2021
Summary
A quality improvement intervention using technology and nurses improved cardiometabolic risk factors for type 2 diabetes patients in the Asia-Pacific. The intervention showed greater benefits for patients in low- and middle-income countries.
Area of Science:
- Cardiology
- Endocrinology
- Public Health
Background:
- Healthcare systems globally face challenges managing type 2 diabetes, particularly in low- and middle-income countries.
- There is a need for efficient interventions to improve care and outcomes for patients with type 2 diabetes.
Purpose of the Study:
- To assess the impact of a quality improvement intervention using information and communications technology (ICT) and nonphysician personnel on type 2 diabetes care and cardiometabolic risk factors.
- To evaluate the intervention's effectiveness across diverse Asia-Pacific countries, including those with varying income levels.
Main Methods:
- A 12-month multinational, open-label, randomized clinical trial involving over 20,000 patients with type 2 diabetes across 8 Asia-Pacific countries.
- Participants were randomized to an intervention group (ICT-guided structured evaluation, personalized reports, nurse contacts) or a control group.
- Data were analyzed using intention-to-treat and per-protocol methods.
Main Results:
- The intervention did not significantly alter the incidence of primary composite clinical outcomes.
- Patients in the intervention group showed a significantly increased likelihood of achieving key diabetes management targets (glycated hemoglobin A1c, blood pressure, LDL cholesterol) and performance indices.
- Greater improvements in achieving targets were observed in low- and middle-income countries compared to high-income countries.
Conclusions:
- The intervention, combining ICT and nurse engagement, effectively reduced cardiometabolic risk factors in patients with type 2 diabetes.
- The positive effects were more pronounced in low- and middle-income countries, highlighting its potential for resource-limited settings.
- While not impacting clinical events, the intervention improved risk factor control, suggesting a valuable approach for diabetes management.
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