Socio-demographic determinants and effect of structured personal diabetes care: a 19-year follow-up of the randomized controlled study diabetes Care in General Practice (DCGP)

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Socio-demographic determinants and effect of structured personal diabetes care : a 19-year follow-up of the randomized controlled study diabetes Care in General Practice (DCGP). / Heltberg, Andreas; Siersma, Volkert; Andersen, John Sahl; Ellervik, Christina; Brønnum-Hansen, Henrik; Kragstrup, Jakob; Olivarius, Niels de Fine.

In: B M C Endocrine Disorders, Vol. 17, 75, 08.12.2017, p. 1-11.

Research output: Contribution to journalJournal articleResearchpeer-review

Harvard

Heltberg, A, Siersma, V, Andersen, JS, Ellervik, C, Brønnum-Hansen, H, Kragstrup, J & Olivarius, NDF 2017, 'Socio-demographic determinants and effect of structured personal diabetes care: a 19-year follow-up of the randomized controlled study diabetes Care in General Practice (DCGP)', B M C Endocrine Disorders, vol. 17, 75, pp. 1-11. https://doi.org/10.1186/s12902-017-0227-x

APA

Heltberg, A., Siersma, V., Andersen, J. S., Ellervik, C., Brønnum-Hansen, H., Kragstrup, J., & Olivarius, N. D. F. (2017). Socio-demographic determinants and effect of structured personal diabetes care: a 19-year follow-up of the randomized controlled study diabetes Care in General Practice (DCGP). B M C Endocrine Disorders, 17, 1-11. [75]. https://doi.org/10.1186/s12902-017-0227-x

Vancouver

Heltberg A, Siersma V, Andersen JS, Ellervik C, Brønnum-Hansen H, Kragstrup J et al. Socio-demographic determinants and effect of structured personal diabetes care: a 19-year follow-up of the randomized controlled study diabetes Care in General Practice (DCGP). B M C Endocrine Disorders. 2017 Dec 8;17:1-11. 75. https://doi.org/10.1186/s12902-017-0227-x

Author

Heltberg, Andreas ; Siersma, Volkert ; Andersen, John Sahl ; Ellervik, Christina ; Brønnum-Hansen, Henrik ; Kragstrup, Jakob ; Olivarius, Niels de Fine. / Socio-demographic determinants and effect of structured personal diabetes care : a 19-year follow-up of the randomized controlled study diabetes Care in General Practice (DCGP). In: B M C Endocrine Disorders. 2017 ; Vol. 17. pp. 1-11.

Bibtex

@article{b2ffd2d93a0949599221475252268cfe,
title = "Socio-demographic determinants and effect of structured personal diabetes care: a 19-year follow-up of the randomized controlled study diabetes Care in General Practice (DCGP)",
abstract = "Background: We investigated how four aspects of socio-demography influence the effectiveness of an intervention with structured personal diabetes care on long-term outcomes.Methods: The Diabetes Care in General Practice (DCGP) study is a cluster-randomized trial involving a population-based sample of 1381 patients with newly diagnosed type 2-diabetes mellitus. We investigated how education, employment, cohabitation status and residence influenced the effectiveness of 6 years of intervention with structured personal diabetes care, resembling present day recommendations. Outcomes were incidence of any diabetes-related endpoint and death during 19 years after diagnosis, and cardiovascular risk factors, behaviour, attitudes and process-of-care variables 6 years after diagnosis.Results: Structured personal care reduced the risk of any diabetes-related endpoint and the effect of the intervention was modified by geographical area (interaction p = 0.034) with HR of 0.71 (95{\%}CI: 0.60–0.85) and of 1.07 (95{\%}CI: 0.77–1.48), for patients in urban and rural areas, respectively. Otherwise, there was no effect modification of education, employment and civil status on the intervention for the final endpoints. There were no noticeable socio-demographic differences in the effect of the intervention on cardiovascular risk factors, behaviour, attitudes, and process-of-care.Conclusion: Structured personal care reduced the aggregate outcome of any diabetes-related endpoint and independent of socio-demographic factors similar effect on cardiovascular risk factors, behaviour, attitudes and process of care, but the intervention did not change the existing inequity in mortality and morbidity. Residence modified the uptake of the intervention with patients living in urban areas having more to gain of the intervention than rural patients, further investigations is warranted.Trial registration: ClinicalTrials.gov registration no. NCT01074762 (February 24, 2010).",
keywords = "Type 2 diabetes mellitus, Social inequalities, Intervention, Clinical outcomes",
author = "Andreas Heltberg and Volkert Siersma and Andersen, {John Sahl} and Christina Ellervik and Henrik Br{\o}nnum-Hansen and Jakob Kragstrup and Olivarius, {Niels de Fine}",
year = "2017",
month = "12",
day = "8",
doi = "10.1186/s12902-017-0227-x",
language = "English",
volume = "17",
pages = "1--11",
journal = "B M C Endocrine Disorders",
issn = "1472-6823",
publisher = "BioMed Central Ltd.",

}

RIS

TY - JOUR

T1 - Socio-demographic determinants and effect of structured personal diabetes care

T2 - a 19-year follow-up of the randomized controlled study diabetes Care in General Practice (DCGP)

AU - Heltberg, Andreas

AU - Siersma, Volkert

AU - Andersen, John Sahl

AU - Ellervik, Christina

AU - Brønnum-Hansen, Henrik

AU - Kragstrup, Jakob

AU - Olivarius, Niels de Fine

PY - 2017/12/8

Y1 - 2017/12/8

N2 - Background: We investigated how four aspects of socio-demography influence the effectiveness of an intervention with structured personal diabetes care on long-term outcomes.Methods: The Diabetes Care in General Practice (DCGP) study is a cluster-randomized trial involving a population-based sample of 1381 patients with newly diagnosed type 2-diabetes mellitus. We investigated how education, employment, cohabitation status and residence influenced the effectiveness of 6 years of intervention with structured personal diabetes care, resembling present day recommendations. Outcomes were incidence of any diabetes-related endpoint and death during 19 years after diagnosis, and cardiovascular risk factors, behaviour, attitudes and process-of-care variables 6 years after diagnosis.Results: Structured personal care reduced the risk of any diabetes-related endpoint and the effect of the intervention was modified by geographical area (interaction p = 0.034) with HR of 0.71 (95%CI: 0.60–0.85) and of 1.07 (95%CI: 0.77–1.48), for patients in urban and rural areas, respectively. Otherwise, there was no effect modification of education, employment and civil status on the intervention for the final endpoints. There were no noticeable socio-demographic differences in the effect of the intervention on cardiovascular risk factors, behaviour, attitudes, and process-of-care.Conclusion: Structured personal care reduced the aggregate outcome of any diabetes-related endpoint and independent of socio-demographic factors similar effect on cardiovascular risk factors, behaviour, attitudes and process of care, but the intervention did not change the existing inequity in mortality and morbidity. Residence modified the uptake of the intervention with patients living in urban areas having more to gain of the intervention than rural patients, further investigations is warranted.Trial registration: ClinicalTrials.gov registration no. NCT01074762 (February 24, 2010).

AB - Background: We investigated how four aspects of socio-demography influence the effectiveness of an intervention with structured personal diabetes care on long-term outcomes.Methods: The Diabetes Care in General Practice (DCGP) study is a cluster-randomized trial involving a population-based sample of 1381 patients with newly diagnosed type 2-diabetes mellitus. We investigated how education, employment, cohabitation status and residence influenced the effectiveness of 6 years of intervention with structured personal diabetes care, resembling present day recommendations. Outcomes were incidence of any diabetes-related endpoint and death during 19 years after diagnosis, and cardiovascular risk factors, behaviour, attitudes and process-of-care variables 6 years after diagnosis.Results: Structured personal care reduced the risk of any diabetes-related endpoint and the effect of the intervention was modified by geographical area (interaction p = 0.034) with HR of 0.71 (95%CI: 0.60–0.85) and of 1.07 (95%CI: 0.77–1.48), for patients in urban and rural areas, respectively. Otherwise, there was no effect modification of education, employment and civil status on the intervention for the final endpoints. There were no noticeable socio-demographic differences in the effect of the intervention on cardiovascular risk factors, behaviour, attitudes, and process-of-care.Conclusion: Structured personal care reduced the aggregate outcome of any diabetes-related endpoint and independent of socio-demographic factors similar effect on cardiovascular risk factors, behaviour, attitudes and process of care, but the intervention did not change the existing inequity in mortality and morbidity. Residence modified the uptake of the intervention with patients living in urban areas having more to gain of the intervention than rural patients, further investigations is warranted.Trial registration: ClinicalTrials.gov registration no. NCT01074762 (February 24, 2010).

KW - Type 2 diabetes mellitus

KW - Social inequalities

KW - Intervention

KW - Clinical outcomes

U2 - 10.1186/s12902-017-0227-x

DO - 10.1186/s12902-017-0227-x

M3 - Journal article

VL - 17

SP - 1

EP - 11

JO - B M C Endocrine Disorders

JF - B M C Endocrine Disorders

SN - 1472-6823

M1 - 75

ER -

ID: 188194183