Efecto de un modelo de apoyo telefónico en el auto-manejo y control metabólico de la Diabetes tipo 2, en un Centro de Atención Primaria, Santiago, Chile / Effect of a tele-care model on self-management and metabolic control among patients with type 2 diabetes in primary care centers in Santiago, Chile
Rev. méd. Chile
; 138(6): 729-737, jun. 2010. ilus, tab
Article
em Es
| LILACS
| ID: lil-567568
Biblioteca responsável:
CL1.1
ABSTRACT
Background:
Telephone based self-management support may improve the metabolic control of patients with type 2 (DM2) diabetes if it is coordinated with primary care centers, if telephone protocols and clinical guidelines are used and if it is provided by nurses trained in motivational interviewing.Aim:
To assess the efficacy ofi a tele-care self-management support model (ATAS) on metabolic control of patients with DM2 attending primary care centers in a low income area in Santiago, Chile. Material andMethods:
Two primary care centers were randomly assigned to continue with usual care (control group, CG) or to receive additionally 6 telecare self-management support interventions (IG) during a 15 month period. Glycosylated hemoglobin (HbA1c) was used to measure metabolic control of DM2; the Summary of Diabetes Self-care Activities Measure and the Spanish Diabetes Self-efficacy scale were used to measure self-management and self efficacy, respectively. Changes in the use of health services were also evaluated.Results:
The IG maintained its HbA1c level (baseline and final levels of 8.3 ± 2.3 percent and 8.5 ± 2.2 percent respectively) whereas it deteriorated in the CG (baseline and final levels of 7.4 ± 2.3 and 8.8 ± 2.3 percent respectively, p < 0.001). The perception of self-efficacy in the IG improved while remaining unchanged in the CG (p < 0.001). Adherence to medication, physical activity and foot care did not change in either group. In the IG, compliance to clinic visits increased while emergency care visits decreased.Conclusions:
The ATAS intervention, in low income primary care centers, significantly increased the probability of stabilizing the metabolic control of patients with DM2 and improved their use of health services.Palavras-chave
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Índice:
LILACS
Assunto principal:
Autocuidado
/
Telefone
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Assistência Centrada no Paciente
Tipo de estudo:
Clinical_trials
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Guideline
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Qualitative_research
Limite:
Adult
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Female
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Humans
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Male
País/Região como assunto:
America do sul
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Chile
Idioma:
Es
Revista:
Rev. méd. Chile
Assunto da revista:
MEDICINA
Ano de publicação:
2010
Tipo de documento:
Article
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Project document