Initiative for a new diabetes therapeutic approach in a Mediterranean country: the INDEED study

被引:9
作者
Athyros, V. G. [2 ,3 ]
Hatzitolios, A. [4 ]
Karagiannis, A. [2 ,3 ]
Didangelos, T. P. [4 ]
Iliadis, F. [4 ]
Dolgyras, S. [5 ]
Vosnakidis, T. [6 ]
Vasiliadis, P. [7 ]
Malias, I. [8 ]
Tziomalos, K. [1 ]
Samouilidou, M. [9 ]
Mikhailidis, D. P. [1 ]
机构
[1] UCL, Sch Med, Dept Clin Biochem, London NW3 2QG, England
[2] Aristotle Univ Thessaloniki, Hippocrat Hosp, Propedeut Dept Internal Med 2, Atherosclerosis Unit, GR-54006 Thessaloniki, Greece
[3] Aristotle Univ Thessaloniki, Hippocrat Hosp, Propedeut Dept Internal Med 2, Metab Syndrome Unit, GR-54006 Thessaloniki, Greece
[4] Aristotle Univ Thessaloniki, AHEPA Hosp, Propedeut Dept Internal Med 1, Div Diabetol, GR-54006 Thessaloniki, Greece
[5] Edessa Hosp, Dept Internal Med, Edessa, Greece
[6] Agios Dimitrios Hosp, Internal Med Clin, Thessaloniki, Greece
[7] Hosp Psychiat, Dept Internal Med, Thessaloniki, Greece
[8] Serres Hosp, Dept Internal Med, Serres, Greece
[9] Hlth Ctr Agios Nikolaos, Chalkidiki, Greece
关键词
Awareness; Best practice; Cardiovascular risk calculation; Cardiovascular risk management; Diabetes mellitus; Public Health; CORONARY-HEART-DISEASE; CARDIOVASCULAR-DISEASE; MULTIFACTORIAL INTERVENTION; METABOLIC SYNDROME; VASCULAR-DISEASE; BLOOD-PRESSURE; RISK-FACTORS; TYPE-2; ADULTS; HYPERTENSION;
D O I
10.1185/03007990903073035
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aim: To assess the efficacy of a strategy to improve vascular risk management in patients with type 2 diabetes mellitus (T2DM). Methods: This was a pilot best practice implementation enhancement programme that enrolled 578 patients with T2DM. A baseline visit was followed by a concerted effort from previously trained physicians to improve adherence to lifestyle advice and optimise drug treatment for all vascular risk factors. The patients were followed-up for 6 months. The UKPDS risk engine was used to estimate vascular risk in patients without established coronary heart disease (CHD) (n = 279). Results: There was an improvement in compliance to lifestyle measures and increased prescription of evidence-based medication. In patients without established CHD there was a 37% reduction in estimated risk for CHD, 44% for fatal CHD, 10% for stroke and 25% for fatal stroke (p <= 0.003 for all comparisons vs. baseline). There was also a substantial increase in the proportion of patients with established CHD who achieved their vascular risk factor targets. Conclusions: This is the first study to increase the adherence to multiple interventions in patients with T2DM in both primary care and hospital settings. Education of physicians and patients, distribution of guidelines/brochures, and the completion of a one-page form, motivated both physicians and patients to achieve multiple vascular risk factor goals.
引用
收藏
页码:1931 / 1940
页数:10
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