Implantación de la determinación de hemoglobina glucosilada capilar en un Área de Salud: estudio multicéntrico sobre evolución de pacientes con diabetes mellitus de tipo 2 / Introduction of capillary glycosylated haemoglobin determination in a Primary Care Health Area: Multicentre study of the evolution of patients with type 2 diabetes mellitus

Objetivo. Evaluar la eficiencia de una intervención mixta, para optimizar el control de la diabetes mediante la implantación de la determinación de la hemoglobina glucosilada (HbA1c) capilar instantánea en Atención Primaria. Material y métodos. Se llevó a cabo un estudio multicéntrico, descriptivo, prospectivo, a lo largo de 3años, en 10 centros de salud de Atención Primaria del Área VII Murcia Este. Se incluyó a 804 pacientes con diabetes mellitus de tipo 2 (DM2), que se repartieron en 4 grupos en función de los valores de HbA1c inicial y de la necesidad o no de intensificar su tratamiento farmacológico. Se controlaron los valores de HbA1c, índice de masa corporal y tensión arterial. Se realizó también una valoración económica de la implantación de un protocolo de determinación de HbA1c capilar instantánea. Resultados. La media inicial fue de 7,4±1,4%, que descendió significativamente hasta un valor medio de 6,9± 1,0% al final del estudio (p<0,001). Además, el 71,4% de los pacientes cumplían los objetivos de control de la diabetes tras 6 meses de tratamiento. El estudio económico demostró que la implantación de este sistema de control de la diabetes supuso un descenso del 24,7% en el gasto en el consumo de tiras de glucosa del Servicio Murciano de Salud en esta área durante el primer año. Conclusiones. La implantación de la HbA1c capilar en Atención Primaria supone una mejora en el control de la diabetes y en la eficiencia en la actuación del personal sanitario. Además, supone una reducción del coste sanitario del paciente con DM2 (AU)

Purpose. The aim of this study was to evaluate the efficiency of a joint intervention that included educational components, self-assessment, and information to optimise diabetes control through the introduction of instant capillary glycosylated haemoglobin (HbA1c) determination in Primary Care. Materials and methods. A multicentre prospective descriptive study was carried out over 3years in 10Primary Care Centres of the Area VII Murcia East. At the end of the study there were 804 patients with type 2 diabetes (DM2). Patients were divided into 4 groups based on initial values of HbA1c, and if changes in their treatment were needed. HbA1c, body mass index, and blood pressure were monitored. A financial assessment was also performed on the impact of the implementation of a protocol to measure instant capillary. Results. A significant reduction was observed in HbA1c values. The initial HbA1c mean value was 7.4±1.4%, which decreased to a final value of 6.9±1.0% (P<.001). At the end of the study, 71.4% of patients included reached diabetic control objectives. In addition, the financial assessment demonstrated that the implementation of this diabetes control system led to a decrease of the 24.7% in spending on glucose strips after the first year of study in Area VII Murcia Health Service. Conclusions. The introduction of capillary HbA1c determination in Primary Care has demonstrated to improve diabetes control and the efficiency of the health personnel. Furthermore, a reduction in the health costs of patients with DM2 was also shown (AU)

[Introduction of capillary glycosylated haemoglobin determination in a Primary Care Health Area: Multicentre study of the evolution of patients with type 2 diabetes mellitus]. / Implantación de la determinación de hemoglobina glucosilada capilar en un Área de Salud: estudio multicéntrico sobre evolución de pacientes con diabetes mellitus de tipo 2.

PURPOSE: The aim of this study was to evaluate the efficiency of a joint intervention that included educational components, self-assessment, and information to optimise diabetes control through the introduction of instant capillary glycosylated haemoglobin (HbA1c) determination in Primary Care. MATERIALS AND METHODS: A multicentre prospective descriptive study was carried out over 3years in 10Primary Care Centres of the Area VII Murcia East. At the end of the study there were 804 patients with type 2 diabetes (DM2). Patients were divided into 4 groups based on initial values of HbA1c, and if changes in their treatment were needed. HbA1c, body mass index, and blood pressure were monitored. A financial assessment was also performed on the impact of the implementation of a protocol to measure instant capillary RESULTS: A significant reduction was observed in HbA1c values. The initial HbA1c mean value was 7.4±1.4%, which decreased to a final value of 6.9±1.0% (P<.001). At the end of the study, 71.4% of patients included reached diabetic control objectives. In addition, the financial assessment demonstrated that the implementation of this diabetes control system led to a decrease of the 24.7% in spending on glucose strips after the first year of study in Area VII Murcia Health Service. CONCLUSIONS: The introduction of capillary HbA1c determination in Primary Care has demonstrated to improve diabetes control and the efficiency of the health personnel. Furthermore, a reduction in the health costs of patients with DM2 was also shown.