Evaluating Effectiveness of Outpatient Monitoring in Type 2 Diabetes: The One-Year Experience in an Italian Group of Primary Care

Francesca Lazzarini, Luca Barbacane, Giuseppe Scoleri, Rosanna I. Comoretto, Gianni Cogno, Benedetta Disarò, Luigi Gomirato, Francesca Stocco, Alessandro Suppa, Gianluca Toninato, Clara Minto, Danila Azzolina, Sabino Iliceto and Dario Gregori
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Francesca Lazzarini: Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35131 Padua, Italy
Luca Barbacane: Group of Primary Care of Martellago, Unità Locale Socio-Sanitaria ULSS 3 Serenissima, 30030 Martellago, Italy
Giuseppe Scoleri: Group of Primary Care of Martellago, Unità Locale Socio-Sanitaria ULSS 3 Serenissima, 30030 Martellago, Italy
Rosanna I. Comoretto: Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35131 Padua, Italy
Gianni Cogno: Group of Primary Care of Martellago, Unità Locale Socio-Sanitaria ULSS 3 Serenissima, 30030 Martellago, Italy
Benedetta Disarò: Group of Primary Care of Martellago, Unità Locale Socio-Sanitaria ULSS 3 Serenissima, 30030 Martellago, Italy
Luigi Gomirato: Group of Primary Care of Martellago, Unità Locale Socio-Sanitaria ULSS 3 Serenissima, 30030 Martellago, Italy
Francesca Stocco: Group of Primary Care of Martellago, Unità Locale Socio-Sanitaria ULSS 3 Serenissima, 30030 Martellago, Italy
Alessandro Suppa: Group of Primary Care of Martellago, Unità Locale Socio-Sanitaria ULSS 3 Serenissima, 30030 Martellago, Italy
Gianluca Toninato: Group of Primary Care of Martellago, Unità Locale Socio-Sanitaria ULSS 3 Serenissima, 30030 Martellago, Italy
Clara Minto: Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35131 Padua, Italy
Danila Azzolina: Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35131 Padua, Italy
Sabino Iliceto: Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35131 Padua, Italy
Dario Gregori: Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35131 Padua, Italy

IJERPH, 2021, vol. 18, issue 21, 1-10

Abstract: Nowadays, chronic disease management is the primary challenge of the healthcare system. From 2015, in the Veneto region (Italy), patients with a diagnosis of type 2 diabetes mellitus (T2DM) have been included in the diagnostic-therapeutic pathway (PDTA) program, and their clinical condition has been continuously monitored. The aim of this retrospective study is to determine the effectiveness of PDTA intervention, alone or in combination with a specialized one, in subjects with diagnosis of T2DM. Clinical and behavioral characteristics were collected at baseline and after 1 year of follow-up. Two subgroups were considered: subjects enrolled in PDTA only and subjects enrolled in both the PDTA program and in the care plan proposed by the specialized medical center (CAD group). Longitudinal analysis showed a relevant positive effect of time on diastolic blood pressure, while CAD enrollment appears to be related to higher levels of glycated hemoglobin. When included together in the same model, interaction between time and CAD covariates results in completely nonsignificant effects. As long-term management of chronic disorders, such as T2DM, is often difficult due to disease characteristics and problems in healthcare organization, monitoring programs, such as PDTA, and specialized care programs, such as CAD, do not show a clinically relevant effect in the first year of follow-up. Therefore, they should be analyzed over a longer period. However, they should also carefully consider the need for adequate tools for data collection and sharing, in addition to the context of application, patient expectations and the need for a long-term educational program.

Keywords: type 2 diabetes mellitus; primary care; care plan; effectiveness; chronic disease management; longitudinal analysis (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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