TY - JOUR
T1 - Participative decentralization of diabetes care in Davao City (Philippines) according to the Chronic Care Model
T2 - A program evaluation
AU - Pilleron, Sophie
AU - Pasquier, Estelle
AU - Boyoze-Nolasco, Ivy
AU - Villafuerte, Josephine Jasmin
AU - Olchini, Davide
AU - Fontbonne, Annick
PY - 2014/4
Y1 - 2014/4
N2 - Aim: To assess the effectiveness of the Diabetes Project in Davao City, Philippines, regarding diabetes care access, diabetes management and cardiovascular risk factors. The project was developed in accordance with the Chronic Care Model (CCM) framework. Methods: A non-randomized cross-sectional survey was conducted in nine intervention and five control Barangays (villages). People with diabetes aged ≥20 years were interviewed using a structured questionnaire; height, weight, waist circumference, and blood pressure were measured; HbA1c was tested with a NSGP-certified point-of-care device. Logistic regression models were used to compare the two groups. Results: The intervention group (n= 503) scored better than the controls (n= 136) on the following (OR, 95% CI): percentage of patients taking metformin (1.5, 1.0-2.2); and in the last 12 months: laboratory test for fasting blood sugar (1.6, 1.1-2.3), HbA1c (6.0, 2.4-15.1), lipid profile (1.7, 1.1-2.5), nutritionist visit (1.6, 1.0-2.5) and therapeutic education session (2.7, 1.8-4.0). Glycemic control (HbA1c. < 7%) was also better in the intervention Barangays (1.6, 1.0-2.4). There were no statistical differences between the two groups for number of visits, and levels of other cardiovascular risk factors. Conclusions: Our findings support the effectiveness of implementing the CCM framework in a low-to-middle income country on glycemic control and diabetes management.
AB - Aim: To assess the effectiveness of the Diabetes Project in Davao City, Philippines, regarding diabetes care access, diabetes management and cardiovascular risk factors. The project was developed in accordance with the Chronic Care Model (CCM) framework. Methods: A non-randomized cross-sectional survey was conducted in nine intervention and five control Barangays (villages). People with diabetes aged ≥20 years were interviewed using a structured questionnaire; height, weight, waist circumference, and blood pressure were measured; HbA1c was tested with a NSGP-certified point-of-care device. Logistic regression models were used to compare the two groups. Results: The intervention group (n= 503) scored better than the controls (n= 136) on the following (OR, 95% CI): percentage of patients taking metformin (1.5, 1.0-2.2); and in the last 12 months: laboratory test for fasting blood sugar (1.6, 1.1-2.3), HbA1c (6.0, 2.4-15.1), lipid profile (1.7, 1.1-2.5), nutritionist visit (1.6, 1.0-2.5) and therapeutic education session (2.7, 1.8-4.0). Glycemic control (HbA1c. < 7%) was also better in the intervention Barangays (1.6, 1.0-2.4). There were no statistical differences between the two groups for number of visits, and levels of other cardiovascular risk factors. Conclusions: Our findings support the effectiveness of implementing the CCM framework in a low-to-middle income country on glycemic control and diabetes management.
KW - Chronic Care Model
KW - Developing countries
KW - Diabetes mellitus
KW - Evaluation
KW - Philippines
UR - http://www.scopus.com/inward/record.url?scp=84898540808&partnerID=8YFLogxK
U2 - 10.1016/j.diabres.2014.01.026
DO - 10.1016/j.diabres.2014.01.026
M3 - Article
C2 - 24560175
AN - SCOPUS:84898540808
SN - 0168-8227
VL - 104
SP - 189
EP - 195
JO - Diabetes Research and Clinical Practice
JF - Diabetes Research and Clinical Practice
IS - 1
ER -