Integrated care for diabetes: clinical, psychosocial, and economic evaluation. Diabetes Integrated Care Evaluation Team.

Abstract:

OBJECTIVES:To evaluate integrated care for diabetes in clinical, psychosocial, and economic terms. DESIGN:Pragmatic randomised trial. SETTING:Hospital diabetic clinic and three general practice groups in Grampian. PATIENTS:274 adult diabetic patients attending a hospital clinic and registered with one of three general practices. INTERVENTION:Random allocation to conventional hospital clinic care or integrated care. Integrated care patients seen in general practice every three or four months and in the hospital clinic annually. General practitioners were given written guidelines for integrated care. MAIN OUTCOME MEASURES:Metabolic control, psychosocial status, knowledge of diabetes, beliefs about control of diabetes, satisfaction with treatment, disruption of normal activities, numbers of consultations and admissions, frequency of metabolic monitoring, costs to patients and NHS. RESULTS:A higher proportion of patients defaulted from conventional care (14 (10%)) than from integrated care (4 (3%), 95% confidence interval of difference 2% to 13%). After two years no significant differences were found between the groups in metabolic control, psychosocial status, knowledge, beliefs about control, satisfaction with treatment, unscheduled admissions, or disruption of normal activities. Integrated care was as effective for insulin dependent as non-insulin dependent patients. Patients in integrated care had more visits and higher frequencies of examination. Costs to patients were lower in integrated care (mean 1.70 pounds) than in conventional care (8 pounds). 88% of patients who experienced integrated care wished to continue with it. CONCLUSIONS:This model of integrated care for diabetes was at least as effective as conventional hospital clinic care.

journal_name

BMJ

authors

subject

Has Abstract

pub_date

1994-05-07 00:00:00

pages

1208-12

issue

6938

eissn

0959-8138

issn

1756-1833

journal_volume

308

pub_type

临床试验,杂志文章,随机对照试验
  • Perinatal outcomes after bariatric surgery: nationwide population based matched cohort study.

    abstract:OBJECTIVE:To compare perinatal outcomes in births of women with versus without a history of bariatric surgery. DESIGN:Population based matched cohort study. SETTING:Swedish national health service. PARTICIPANTS:1,742,702 singleton births identified in the Swedish medical birth register between 1992 and 2009. For eac...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.f6460

    authors: Roos N,Neovius M,Cnattingius S,Trolle Lagerros Y,Sääf M,Granath F,Stephansson O

    更新日期:2013-11-12 00:00:00

  • Robots in operating theatres.

    abstract::Robots designed for surgery have three main advantages over humans. They have greater three dimensional spatial accuracy, are more reliable, and can achieve much greater precision. Although few surgical robots are yet in clinical trials one or two have advanced to the stage of seeking approval from the UK's Medical De...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,评审

    doi:10.1136/bmj.311.7018.1479

    authors: Buckingham RA,Buckingham RO

    更新日期:1995-12-02 00:00:00

  • Cancer patients' information needs and information seeking behaviour: in depth interview study.

    abstract:OBJECTIVES:To explore why cancer patients do not want or seek information about their condition beyond that volunteered by their physicians at times during their illness. DESIGN:Qualitative study based on in-depth interviews. SETTING:Outpatient oncology clinics at a London cancer centre. PARTICIPANTS:17 patients wit...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.320.7239.909

    authors: Leydon GM,Boulton M,Moynihan C,Jones A,Mossman J,Boudioni M,McPherson K

    更新日期:2000-04-01 00:00:00

  • Association between conflicts of interest and favourable recommendations in clinical guidelines, advisory committee reports, opinion pieces, and narrative reviews: systematic review.

    abstract:OBJECTIVE:To investigate the association between conflicts of interest and favourable recommendations in clinical guidelines, advisory committee reports, opinion pieces, and narrative reviews. DESIGN:Systematic review. ELIGIBILITY CRITERIA:Studies that compared the association between conflicts of interest and favour...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.m4234

    authors: Nejstgaard CH,Bero L,Hróbjartsson A,Jørgensen AW,Jørgensen KJ,Le M,Lundh A

    更新日期:2020-12-09 00:00:00

  • Weighting in the dark: resource allocation in the new NHS.

    abstract::National allocation of resources to regional health authorities and by them to districts is now determined by a weighted capitation formula. The national formula was derived from regression analysis, with hospital utilisation as an index of need for health care--a method which has fundamental limitations. This paper a...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.306.6881.835

    authors: Sheldon TA,Smith GD,Bevan G

    更新日期:1993-03-27 00:00:00

  • Attendance at cultural events, reading books or periodicals, and making music or singing in a choir as determinants for survival: Swedish interview survey of living conditions.

    abstract:OBJECTIVES:To investigate the possible influence of attendance at cultural events, reading books or periodicals, making music or singing in a choir as determinants for survival. DESIGN:A simple random sample was drawn of 15,198 individuals aged 16-74 years. Of these, 85% (12,982) were interviewed by trained non-medica...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.313.7072.1577

    authors: Bygren LO,Konlaan BB,Johansson SE

    更新日期:1996-12-21 00:00:00

  • Comparison of three regimens for malaria prophylaxis in travellers to east, central, and southern Africa.

    abstract:OBJECTIVES:Confirmation of breakthroughs in three different malaria chemoprophylactic regimens (chloroquine 300 mg weekly and proguanil 100 mg daily; chloroquine 300 mg weekly and proguanil 200 mg daily; proguanil 200 mg daily) and assessment of compliance. DESIGN:Prospective, randomised multicentre trial. SETTING:Fi...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1136/bmj.307.6911.1041

    authors: Wetsteyn JC,de Geus A

    更新日期:1993-10-23 00:00:00

  • Balloon dilatation of the aortic valve for inoperable aortic stenosis.

    abstract::The place of balloon dilatation of the aortic valve in the treatment of calcific aortic stenosis is controversial. Thirty two patients (mean age 76) in whom valve replacement was contraindicated were followed up for three to 24 months (mean 8); 25 were in functional class III or IV according to the New York Heart Asso...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.297.6655.1007

    authors: Sprigings DC,Jackson G,Chambers JB,Monaghan MJ,Thomas SD,Meany TB,Jewitt DE

    更新日期:1988-10-22 00:00:00

  • Profile of young people's advice clinic in reproductive health, 1988-93.

    abstract::For an unprepared sexually active teenager the 1990s present a minefield of potential problems in addition to the most obvious problems of unplanned pregnancy and sexually transmitted disease. Promoting the importance of a healthy sexual and reproductive life to young people requires openness, better sex education, re...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.309.6957.786

    authors: Williams EC,Kirkman RJ,Elstein M

    更新日期:1994-09-24 00:00:00

  • Graduated compression stockings as adjuvant to pharmaco-thromboprophylaxis in elective surgical patients (GAPS study): randomised controlled trial.

    abstract:OBJECTIVES:To investigate whether the use of graduated compression stockings (GCS) offers any adjuvant benefit when pharmaco-thromboprophylaxis is used for venous thromboembolism prophylaxis in patients undergoing elective surgery. DESIGN:Open, multicentre, randomised, controlled, non-inferiority trial. SETTING:Seven...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1136/bmj.m1309

    authors: Shalhoub J,Lawton R,Hudson J,Baker C,Bradbury A,Dhillon K,Everington T,Gohel MS,Hamady Z,Hunt BJ,Stansby G,Warwick D,Norrie J,Davies AH,GAPS trial investigators.

    更新日期:2020-05-13 00:00:00

  • Role of peak bone mass and bone loss in postmenopausal osteoporosis: 12 year study.

    abstract:OBJECTIVE:To examine the role of peak bone mass and subsequent postmenopausal bone loss in the development of osteoporosis and the reliability of identifying women at risk from one bone mass measurement and one biochemical assessment of the future bone loss. DESIGN:Population based study. SETTING:Outpatient clinic fo...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.303.6808.961

    authors: Hansen MA,Overgaard K,Riis BJ,Christiansen C

    更新日期:1991-10-19 00:00:00

  • Association between contemporary hormonal contraception and ovarian cancer in women of reproductive age in Denmark: prospective, nationwide cohort study.

    abstract:OBJECTIVES:To investigate the association between contemporary combined hormonal contraceptives (including progestogen types in combined preparations and all progestogen-only products) and overall and specific types of ovarian cancer. DESIGN:Prospective, nationwide cohort study. SETTING:Denmark, 1995-2014. PARTICIPA...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.k3609

    authors: Iversen L,Fielding S,Lidegaard Ø,Mørch LS,Skovlund CW,Hannaford PC

    更新日期:2018-09-26 00:00:00

  • Angiotensin converting enzyme insertion or deletion polymorphism and coronary restenosis: meta-analysis of 16 studies.

    abstract:OBJECTIVE:To assess the association between genotype at the insertion or deletion polymorphism of the angiotensin converting enzyme gene and risk of coronary restenosis after percutaneous coronary intervention. DESIGN:Meta-analysis of studies before July 2001 that reported on these genotypes and risk of coronary reste...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,meta分析

    doi:10.1136/bmj.325.7363.517

    authors: Bonnici F,Keavney B,Collins R,Danesh J

    更新日期:2002-09-07 00:00:00

  • Evaluation of aid to diagnosis of pigmented skin lesions in general practice: controlled trial randomised by practice.

    abstract:OBJECTIVES:To determine whether an aid to the diagnosis of pigmented skin lesions reduces the ratio of benign lesions to melanomas excised in general practice. DESIGN:Controlled trial randomised by practice. SETTING:General practices in Perth, Western Australia. PARTICIPANTS:468 general practitioners in 223 practice...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1136/bmj.327.7411.375

    authors: English DR,Burton RC,del Mar CB,Donovan RJ,Ireland PD,Emery G

    更新日期:2003-08-16 00:00:00

  • Systematic review of day hospital care for elderly people. The Day Hospital Group.

    abstract:OBJECTIVE:To examine the effectiveness of day hospital attendance in prolonging independent living for elderly people. DESIGN:Systematic review of 12 controlled clinical trials (available by January 1997) comparing day hospital care with comprehensive care (five trials), domiciliary care (four trials), or no comprehen...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,meta分析

    doi:10.1136/bmj.318.7187.837

    authors: Forster A,Young J,Langhorne P

    更新日期:1999-03-27 00:00:00

  • Energy expenditure in children with type I diabetes: evidence for increased thermogenesis.

    abstract::The aim of the study was to assess whether increased energy expenditure causes the negative energy balance (tissue catabolism) commonly seen in children with insulin dependent (type I) diabetes. Resting metabolic rate and thermogenesis induced by adrenaline were measured in five healthy children and 14 children with t...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.299.6697.487

    authors: Müller MJ,von zur Mühlen A,Lautz HU,Schmidt FW,Daiber M,Hürter P

    更新日期:1989-08-19 00:00:00

  • Cardiac rehabilitation for heart failure can improve quality of life and fitness.

    abstract::The studyTaylor RS, Walker S, Ciani O, et al. Exercise-based cardiac rehabilitation for chronic heart failure: the EXTRAMATCH II individual participant data meta-analysis. Health Technol Assess 2019;23:1-98.This project was funded by the NIHR Health Technology Assessment Programme (project number 15/80/30).To read the...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 评论,杂志文章

    doi:10.1136/bmj.l5456

    authors: Cook R,Davidson P,Martin R,NIHR Dissemination Centre.

    更新日期:2019-10-01 00:00:00

  • Use of non-orthodox and conventional health care in Great Britain.

    abstract:OBJECTIVE:To describe the characteristics of patients using non-orthodox health care and their pattern of use of conventional health care with respect to a particular problem. DESIGN:Postal survey of all 2152 practitioners of acupuncture, chiropractic, homeopathy, naturopathy, and osteopathy identified from 11 nationa...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.302.6770.207

    authors: Thomas KJ,Carr J,Westlake L,Williams BT

    更新日期:1991-01-26 00:00:00

  • Industry funding of patient and health consumer organisations: systematic review with meta-analysis.

    abstract:OBJECTIVE:To investigate pharmaceutical or medical device industry funding of patient groups. DESIGN:Systematic review with meta-analysis. DATA SOURCES:Ovid Medline, Embase, Web of Science, Scopus, and Google Scholar from inception to January 2018; reference lists of eligible studies and experts in the field. ELIGIB...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,meta分析

    doi:10.1136/bmj.l6925

    authors: Fabbri A,Parker L,Colombo C,Mosconi P,Barbara G,Frattaruolo MP,Lau E,Kroeger CM,Lunny C,Salzwedel DM,Mintzes B

    更新日期:2020-01-22 00:00:00

  • Prevalence of microcephaly in Europe: population based study.

    abstract:OBJECTIVES: To provide contemporary estimates of the prevalence of microcephaly in Europe, determine if the diagnosis of microcephaly is consistent across Europe, and evaluate whether changes in prevalence would be detected using the current European surveillance performed by EUROCAT (the European Surveillance of Conge...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.i4721

    authors: Morris JK,Rankin J,Garne E,Loane M,Greenlees R,Addor MC,Arriola L,Barisic I,Bergman JE,Csaky-Szunyogh M,Dias C,Draper ES,Gatt M,Khoshnood B,Klungsoyr K,Kurinczuk JJ,Lynch C,McDonnell R,Nelen V,Neville AJ,O'Mahony

    更新日期:2016-09-13 00:00:00

  • Using clinicopathological analysis of general practitioner skin surgery to determine educational requirements and guidelines.

    abstract:OBJECTIVE:To study the impact of skin surgery in general practice on the workload of a pathology laboratory and to identify what further training might be helpful. DESIGN:Analysis of skin biopsy specimens from general practitioners before and after their new contract to determine numbers of specimens, changes in diagn...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.304.6819.93

    authors: Cox NH,Wagstaff R,Popple AW

    更新日期:1992-01-11 00:00:00

  • Prevalence of asthma in Finnish young men.

    abstract:OBJECTIVE:To determine the prevalence of asthma in cohorts of Finnish young men in the period 1926-89. DESIGN:A retrospective analysis using reports and statistics of Finnish defence forces. SETTING:Call up examinations of candidates for military conscription and examination of conscripts discharged because of poor h...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.301.6746.266

    authors: Haahtela T,Lindholm H,Björkstén F,Koskenvuo K,Laitinen LA

    更新日期:1990-08-04 00:00:00

  • Safety and effectiveness of first line eflornithine for Trypanosoma brucei gambiense sleeping sickness in Sudan: cohort study.

    abstract:OBJECTIVE:To assess the safety and effectiveness of eflornithine as first line treatment for human African trypanosomiasis. DESIGN:Cohort study. SETTING:Control programme in Ibba, southern Sudan. PARTICIPANTS:1055 adults and children newly diagnosed with second stage disease in a 16 month period. MAIN OUTCOME MEASU...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.39485.592674.BE

    authors: Priotto G,Pinoges L,Fursa IB,Burke B,Nicolay N,Grillet G,Hewison C,Balasegaram M

    更新日期:2008-03-29 00:00:00

  • A decision aid to support informed choices about bowel cancer screening among adults with low education: randomised controlled trial.

    abstract:OBJECTIVE:To determine whether a decision aid designed for adults with low education and literacy can support informed choice and involvement in decisions about screening for bowel cancer. DESIGN:Randomised controlled trial. SETTING:Areas in New South Wales, Australia identified as socioeconomically disadvantaged (lo...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,随机对照试验

    doi:10.1136/bmj.c5370

    authors: Smith SK,Trevena L,Simpson JM,Barratt A,Nutbeam D,McCaffery KJ

    更新日期:2010-10-26 00:00:00

  • Referral for menstrual problems: cross sectional survey of symptoms, reasons for referral, and management.

    abstract:OBJECTIVES:To describe the menstrual experience of women referred for menstrual problems, in particular menorrhagia (excessive menstrual loss), and to assess associations with reasons for referral given by their general practitioners, the women's understanding of the reasons for their attendance at the hospital clinics...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,多中心研究

    doi:10.1136/bmj.323.7303.24

    authors: Warner P,Critchley HO,Lumsden MA,Campbell-Brown M,Douglas A,Murray G

    更新日期:2001-07-07 00:00:00

  • Heat and risk of myocardial infarction: hourly level case-crossover analysis of MINAP database.

    abstract:OBJECTIVE:To quantify the association between exposure to higher temperatures and the risk of myocardial infarction at an hourly temporal resolution. DESIGN:Case-crossover study. SETTING:England and Wales Myocardial Ischaemia National Audit Project (MINAP) database. PARTICIPANTS:24,861 hospital admissions for myocar...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.e8050

    authors: Bhaskaran K,Armstrong B,Hajat S,Haines A,Wilkinson P,Smeeth L

    更新日期:2012-12-13 00:00:00

  • Total hip arthroplasty versus resurfacing arthroplasty in the treatment of patients with arthritis of the hip joint: single centre, parallel group, assessor blinded, randomised controlled trial.

    abstract:OBJECTIVES:To compare the clinical and cost effectiveness of total hip arthroplasty with resurfacing arthroplasty in patients with severe arthritis of the hip. DESIGN:Single centre, two arm, parallel group, assessor blinded, randomised controlled trial with 1:1 treatment allocation. SETTING:One large teaching hospita...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章,随机对照试验

    doi:10.1136/bmj.e2147

    authors: Costa ML,Achten J,Parsons NR,Edlin RP,Foguet P,Prakash U,Griffin DR,Young Adult Hip Arthroplasty Team.

    更新日期:2012-04-19 00:00:00

  • Income inequality and 30 day outcomes after acute myocardial infarction, heart failure, and pneumonia: retrospective cohort study.

    abstract:OBJECTIVES:To examine the association between income inequality and the risk of mortality and readmission within 30 days of hospitalization. DESIGN:Retrospective cohort study of Medicare beneficiaries in the United States. Hierarchical, logistic regression models were developed to estimate the association between inco...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.f521

    authors: Lindenauer PK,Lagu T,Rothberg MB,Avrunin J,Pekow PS,Wang Y,Krumholz HM

    更新日期:2013-02-14 00:00:00

  • Dynamic contrast enhanced computed tomography: a precise technique for identifying and localising pancreatic necrosis.

    abstract:OBJECTIVE:To evaluate dynamic contrast enhanced computed tomography for detecting and localising pancreatic necrosis in acute pancreatitis. DESIGN:Prospective evaluation with blind reporting of scans. SETTING:Single teaching hospital. PATIENTS:60 Consecutive patients with acute pancreatitis suspected to have pancrea...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.300.6737.1425

    authors: Larvin M,Chalmers AG,McMahon MJ

    更新日期:1990-06-02 00:00:00

  • Empirical evidence of bias in treatment effect estimates in controlled trials with different interventions and outcomes: meta-epidemiological study.

    abstract:OBJECTIVE:To examine whether the association of inadequate or unclear allocation concealment and lack of blinding with biased estimates of intervention effects varies with the nature of the intervention or outcome. DESIGN:Combined analysis of data from three meta-epidemiological studies based on collections of meta-an...

    journal_title:BMJ (Clinical research ed.)

    pub_type: 杂志文章

    doi:10.1136/bmj.39465.451748.AD

    authors: Wood L,Egger M,Gluud LL,Schulz KF,Jüni P,Altman DG,Gluud C,Martin RM,Wood AJ,Sterne JA

    更新日期:2008-03-15 00:00:00