In the Journals

Chronic care model improved outcomes in Europeans with type 2 diabetes

Cardiovascular risk profiles of patients with type 2 diabetes improved when a chronic care approach was implemented in Switzerland, according to researchers there.

“Our study showed that care according to the [chronic care model] can be implemented even in small primary care practices, which still represent the usual structure for care in most European health care systems,” researchers wrote.

Unlike the United States, European countries seldom follow the approach outlined in the chronic care model, according to Anja Frei, PhD, of the University of Zurich in Switzerland, and colleagues.

“Many European health care systems, for example, in Germany, Austria, Switzerland, France, Italy and Spain, are physician-centered and do not involve practice nurses or other nonphysician professions in care,” researchers wrote.

They conducted the cluster randomized controlled trial of 326 adults with type 2 diabetes and an HbA1c of at least 7%, selected from 30 primary care practices.

Patients were randomly assigned to practice nurses who provided medical education, self-management support and behavioral goals.

One-year data indicated significant improvements to HbA1c levels in both groups, with no significant between-group differences (–0.05%; P=.708). In addition, significant improvements to systolic blood pressure (−3.63; P=.05), diastolic BP (−4.01; P<.001), LDL cholesterol (−0.21; P=.033), and patient assessment of chronic illness care subscores (P<.001 to P<.048) were observed in the intervention group compared with controls.

Disclosure: This study was supported by a grant from Menarini AG, Switzerland. The researchers report no relevant financial disclosures.