科研之友
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摘要
Rationale, aims and objectivesThe efficacy of diabetes self-management education on glycaemic control, self-care behaviour and knowledge has been established by short-term studies in experimental settings. The objective of this study was to assess its effectiveness to improve quality of care and reduce the risk of long-term diabetes complications in unselected older patients with recently diagnosed diabetes in routine clinical care. MethodsUsing population-level health care administrative databases and registries, all patients aged 66 years in Ontario, Canada with diabetes for <5 years were identified. Self-management education programme attendees (n=8485) in 2006 were matched with non-attendees using high-dimensional propensity scores, creating extremely well-balanced study arms. Quality of care measures and the long-term risk of diabetes complications were compared. ResultsSelf-management programme attendees were more likely than non-attendees to achieve process measures of quality of care such as retinal screening examinations (75.3% versus 70.3%, adjusted relative risk 1.05, 99% confidence interval 1.03-1.08), and 2 glycated haemoglobin tests (57.5% versus 53.3%, adjusted relative risk 1.08, 99% confidence interval 1.05-1.11). However, with a median follow-up of 5.3 years, diabetes complications and mortality were not different between arms. ConclusionsIn real-world clinical care, self-management education for older patients with recently diagnosed diabetes was associated with modest improvements in quality of care, but no reductions in long-term clinical events.
- 出版日期2015-8
