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Published on: July 5, 2022
A multidisciplinary, shared care clinic using personalized medicine and coordinated care in patients with concomitant
Julie Rye Noer Pontoppidan1,2, Emil Eik Nielsen1, Michael Hecht Olsen1
1Department of Internal Medicine, Cardiology Section, Holbæk Sygehus, Denmark.
Insights
This pilot study explored a new shared care clinic for type 2 diabetes and cardiovascular disease patients. The multidisciplinary approach aims to improve risk factor control in this high-risk population.
Area of Science:
- Cardiology
- Endocrinology
- Public Health
Background:
- Concomitant type 2 diabetes (T2DM) and cardiovascular disease (CVD) presents a significant health challenge with poor prognosis and high comorbidity risk.
- Suboptimal risk factor control is common, potentially due to healthcare system complexity and patient vulnerability.
Purpose of the Study:
- To describe the protocol of a non-randomized interventional pilot study.
- To test the feasibility and effect of a multidisciplinary, shared care clinic for patients with T2DM and CVD.
- To evaluate personalized medicine and coordinated care strategies.
Main Methods:
- A pilot study involving 63 participants with T2DM and CVD from the Holbaek area, Denmark.
- Participants had dysregulated HbA1c, cholesterol, micro/macroalbuminuria, or blood pressure.
- A one-year intervention with thorough evaluations and quarterly consultations.
Main Results:
- The study enrolled 63 participants (mean age 69 years, BMI 30.9 kg/m²).
- High prevalence of comorbidities: 50% heart failure, 95% dyslipidemia, 91% hypertension.
- Medication use included GLP-1 agonists (54%) and SGLT-2 inhibitors (39%).
Conclusions:
- This study pioneers a multidisciplinary, shared care outpatient clinic model for T2DM and CVD.
- It will provide insights into the feasibility and efficacy of such a clinic.
- Outcomes will be assessed via changes in cardiovascular risk factors and medication management.
Background:
Concomitant type 2 diabetes (T2DM) and cardiovascular disease (CVD) is frequent with a poor prognosis with high risk of comorbidities. Strict risk factor control reduces the risk for complications - yet many people do not achieve treatment targets. The complexity and fragmentation of the healthcare system may, together with the vulnerability of these patients, be a reason.
Objective:
The purpose of this paper is to describe the protocol of a non-randomized interventional pilot study testing the feasibility and effect of a multidisciplinary, shared care clinic using personalized medicine and coordinated care in people living with concomitant T2D and CVD.
Methods:
Participants were included from the Holbaek area in Denmark. People suffered from T2DM and CVD and were dysregulated regarding to HbA1c, cholesterol, micro/macroalbuminuaria or blood pressure. Participants went through a thorough evaluation to identify their needs and resources and received consultations every three months for one year.
Results:
A total of 63 participants with T2DM and CVD were enrolled in the clinic. The participants had a mean age of 69 years and a BMI of 30.9 kg/m2. Almost 50 % had heart failure, 95 % dyslipidemia and 91 % hypertension. Around 54 % received GLP-1 agonists and 39 % received SGLT-2-inhibitors.
Perspectives:
To our knowledge, a similar study with a multidisciplinary, shared care, outpatient clinic treating people living with concomitant T2DM and CVD, has not been performed previously. This study will provide information about the feasibility and efficacy of a multidisciplinary clinic based on changes in cardiovascular risk factors and medication.
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