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The Effectiveness of Enhanced Primary Healthcare (EnPHC) interventions on Type 2 diabetes management in Malaysia: Difference-in-differences (DID) analysis.

Authors :
Husin, Masliyana
Teh, Xin Rou
Ong, Su Miin
Lim, Yvonne Mei Fong
Ang, Swee Hung
Chan, Chee Lee
Lim, Ming Tsuey
Shanmugam, Sunita
Khamis, Noraziani
Jaafar, Faeiz Syezri Adzmin
Ibrahim, Nor Idawaty
Nasir, Nazrila Hairizan
Kusuma, Dian
Wagner, Anita Katharina
Ross-Degnan, Dennis
Atun, Rifat
Sivasampu, Sheamini
Source :
Primary Care Diabetes; Jun2023, Vol. 17 Issue 3, p260-266, 7p
Publication Year :
2023

Abstract

To evaluate the effectiveness of the Enhanced Primary Healthcare (EnPHC) interventions on process of care and intermediate clinical outcomes among type 2 diabetes patients. This was a quasi-experimental controlled study conducted in 20 intervention and 20 control public primary care clinics in Malaysia from November 2016 to June 2019. Type 2 diabetes patients aged 30 years and above were selected via systematic random sampling. Outcomes include process of care and intermediate clinical outcomes. Difference-in-differences analyses was conducted. We reviewed 12,017 medical records of patients with type 2 diabetes. Seven process of care measures improved: HbA1c tests (odds ratio (OR) 3.31, 95% CI 2.13, 5.13); lipid test (OR 4.59, 95% CI 2.64, 7.97), LDL (OR 4.33, 95% CI 2.16, 8.70), and urine albumin (OR 1.99, 95% CI 1.12, 3.55) tests; BMI measured (OR 15.80, 95% CI 4.78, 52.24); cardiovascular risk assessment (OR 174.65, 95% CI 16.84, 1810.80); and exercise counselling (OR 1.18, 95% CI 1.04, 1.33). We found no statistically significant changes in intermediate clinical outcomes (i.e. HbA1c, LDL, HDL and BP control). EnPHC interventions was successful in enhancing the quality of care, in terms of process of care, by changing healthcare providers behaviour. • EnPHC is a multifaceted intervention that exists as an integrated care mode. • It improved seven out of fourteen processes of care in diabetes management. • Intermediate clinical outcomes such as HbA1c, LDL, and HDL were also measured. • Targets were met for three out of four outcomes, but they were not statistically significant. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
17519918
Volume :
17
Issue :
3
Database :
Supplemental Index
Journal :
Primary Care Diabetes
Publication Type :
Academic Journal
Accession number :
163548870
Full Text :
https://doi.org/10.1016/j.pcd.2023.03.003