Abstract
Objective The Chronic Care Model, based on core elements of team-centered care in chronic diseases, has widely been accepted. This study was aimed at evaluating the effectiveness of the Chronic Care Model in type 2 diabetes management. Methods A group randomized experimental study was conducted. Twelve communities of the Zhaohui Community Health Service Center in Hangzhou, China, were randomly assigned into an intervention group (n = 6) receiving the Chronic Care Model-based intervention and a control group (n = 6) receiving conventional care. A total of three hundred patients, twenty-five for each community, aged ≥18 years with type 2 diabetes for at least 1-year duration, were recruited. Data of health behaviors, clinical outcomes, and health-related quality of life (Short-Form 36-item questionnaire) were collected before and after a 9-month intervention and analyzed using descriptive statistics, t-test, chi-square test, binary logistic regression, and linear mixed regression. A total of 258 patients (134 in intervention and 124 in control) who completed the baseline and follow-up evaluations and the entire intervention were included in the final analyses. Results Health behaviors such as drinking habit (OR = 0.07, 95% CI: 0.01, 0.75), physical activity (OR = 2.92, 95% CI: 1.18, 7.25), and diet habit (OR = 4.30, 95% CI: 1.49, 12.43) were improved. The intervention group had a remarkable reduction in glycated hemoglobin (from 7.17% to 6.60%, P < 0.001). The quality of life score changes of the role limitation due to physical problems (mean = 9.97, 95% CI: 3.33, 16.60), social functioning (mean = 6.50, 95% CI: 2.37, 10.64), role limitation due to emotional problems (mean = 8.06, 95% CI: 2.15, 13.96), and physical component summary score (mean = 3.31, 95% CI: 1.22, 5.39) were improved in the intervention group compared to the control group. Conclusion The Chronic Care Model-based intervention helped improve some health behaviors, clinical outcomes, and quality of life of type 2 diabetes patients in China in a short term.
Highlights
Diabetes is one of the most common metabolic disorders in the world and its prevalence in adults was increasing in the last decades [1, 2]
Health behaviors, clinical outcomes, and scores of the Short Form 36 (SF-36) were comparable for intervention and control groups except for the marital status, diabetes duration, diagnosis of other chronic diseases, the percentage of light diet, and the social functioning (SF) and RE scores (Table 1)
These results were in line with the findings of previous RCTs using the Chronic Care Model (CCM), where clinical and behavior outcomes in diabetes care were improved [23,24,25]
Summary
Diabetes is one of the most common metabolic disorders in the world and its prevalence in adults was increasing in the last decades [1, 2]. The International Diabetes Federation (IDF), Diabetes Atlas, shows that there are 425 million people with diabetes mellitus (DM) with a prevalence rate of 8.8% in adults [3]. As the largest developing country in the world, China experienced a sharp increase in the incidence of type 2 diabetes mellitus (T2DM) in the past years. Recent studies have shown that the prevalence of diabetes in China has reached nearly 11% among Chinese adults, which is much higher than the world average rate [3, 4]. China has become the top country with the largest number of people with diabetes in the world [3]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
