Educational Interventions in Patients with Type-2 Diabetes Improve Clinical and Metabolic Outcomes and Optimize the Use of Treatment Resources in Argentina: The Prodiacor Study.

JOAQUIN CAPORALE; JORGE ELGART; LORENA GONZALEZ; ENZO RUCCI; SILVIA LAPERTOSA; JUAN J GAGLIARDINO

Mexico DF

Congreso; 3rd LATIN AMERICA CONFERENCE; 2011

OBJECTIVES: To evaluate the efficacy of educational interventions in thePRODIACOR study and estimate pharmacological treatment costs. METHODS:PRODIACOR is a 3-year prospective and randomized controlled trial, aimed at improving the quality of care of people with type 2 diabetes, preventing complications and optimizing resource use. It includes 4 groups (control, educated patients, educated physicians and educated patients and physicians) with 9 physicians and 117 patients each. Clinical and metabolic changes were recorded in ad-hoc forms (annual and semiannual). Costs and utilization rates were obtained from the administrative dataset of the coverage institutions involved. We verified differences in means and proportions usingANOVAand Chi2. RESULTS: After the 3-year follow up we recorded significant improvements (p0.001) in all groups in systolic blood pressure (14217 vs. 13415 mmHg), HbA1c (7.81.5 vs. 7.10.8%) and total cholesterol (4.70.9 vs. 4.40.7 mmol/L). All these changes were significantly larger in the intervention groups. The percentage of patients at target for all these parameters was significantly larger (p0.01) in these groups. In the educated groups, we also recorded a significant increment in combined against oral monotheraphy (42 vs. 30%) and insulin use (15 vs. 9%). Drug consumption and strips for blood glucose represented 64 and 83% of the total care cost at baseline and 3-year follow up, respectively. This cost increased (113%) in the control group while it significantly decreased (11 to 20%) in the intervention groups, particularly in the patient/physician educated group. The cost to decrease HbA1c by 1% or SBP by 10 mmHg in the patient/physician educated group was lower than in the control group ($161 vs. $547, $16 vs. $77, respectively). CONCLUSIONS: Educational interventions implemented at primary care level improved the clinical and metabolic outcomes of people with Type 2 diabetes and optimized the use of resources.