A Personalized Care Plan Is Positively Associated With Better Clinical Outcomes in the Care of Patients With Type 2 Diabetes: A Cross-Sectional Real-Life Study

Can J Diabetes. 2020 Mar;44(2):133-138. doi: 10.1016/j.jcjd.2019.05.003. Epub 2019 May 15.

Abstract

Objectives: Our aim in this study was to determine whether the use of a personalized care plan is associated with better clinical outcomes of type 2 diabetes treatment in the real world.

Methods: Quality of treatment was assessed using data from a yearly sample of patients with type 2 diabetes visiting primary care health centres in 2012-2016. Patients were divided into 3 groups as follows: 1) the patient has a copy of their personalized care plan, 2) the care plan exists in the patient record only or 3) the patient has no care plan. Data on smoking, laboratory tests, systolic blood pressure (sBP) and statin use were collected. We compared the outcomes between the 3 groups in terms of proportions of patients achieving the clinical targets recommended by international guidelines.

Results: Evaluable data were available for 10,403 patients. Of these, 1,711 (16%) had a copy of their personalized care plan, and 3,623 (35%) had no care plan. Those patients who had a copy of their care plan were significantly more likely than those without to achieve the sBP target (odds ratio [OR], 1.39; 95% confidence interval [CI], 1.29 to 1.51; p<0.001; adjusted for age and gender) and low-density lipoprotein target (OR, 1.46; 95% CI, 1.34 to 1.58; p<0.001), and to use statins (OR, 1.70; 95% CI, 1.57 to 1.85; p<0.001).

Conclusions: Patients who had a copy of their care plan had a better control of sBP and low-density lipoprotein, and were more likely to use statins than patients without a care plan.

Keywords: FINRISK; cardiovascular risk; dossier du patient; détermination des cibles; entretien motivationnel; motivational interviewing; patient record; patient-centric care; risque cardiovasculaire; soins axés sur le patient; target setting.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Blood Pressure / physiology
  • Cholesterol, LDL / blood
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2* / epidemiology
  • Diabetes Mellitus, Type 2* / therapy
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Male
  • Middle Aged
  • Patient-Centered Care*
  • Risk Factors
  • Smoking
  • Treatment Outcome

Substances

  • Cholesterol, LDL
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors