Einfluss des Disease-Management-Programms auf den HbA1c-Wert bei Typ-2-Diabetes-mellitus-Patienten: Ein retrospektiver Vergleich zwischen Disease Management Programm und Regelversorgung

Wiefarn, Stefan; Kostev, Karel; Heumann, Christian und Rettelbach, Anja (2017): Einfluss des Disease-Management-Programms auf den HbA1c-Wert bei Typ-2-Diabetes-mellitus-Patienten: Ein retrospektiver Vergleich zwischen Disease Management Programm und Regelversorgung. In: Deutsche Medizinische Wochenschrift, Bd. 142, Nr. 21, E148-E155

Abstract

Background This retrospective study aims to measure the effect of the disease management program (DMP) for type 2 diabetes mellitus (T2DM) patients on HbA(1c) value within Germany. Methods This study is based on patient data from the Disease Analyzer panel (IMS Health). An adequate control group was created using 2: 1 propensity score matching. After matching, the analysis included 14 759 patients. Of these, 5875 participated in a DMP while 8884 received standard care. The DMP effect was estimated on the basis of the matched data, using an unpaired t-test. In addition, subgroups were considered from the perspective of personalized medicine. Results The reduction in HbA(1c) values in the DMP group amounted to an average of 1.0 percentage point (baseline HbA(1c) = 8.1 vs. final HbA(1c) = 7.1), while the SC group was able to achieve an average reduction in HbA(1c) values of 0.9 percentage point (baseline HbA1c = 8.1 vs. final HbA(1c) = 7.2). The DMP group thus achieved an average reduction in HbA(1c) values that exceeded that of the SC group by only 0.1 percentage point (95 % CI: 0.04 - 0.16). Descriptively, it also became apparent that patients from the DMP group received a greater average number of annual prescriptions and had more HbA(1c) measurements. The subgroup analysis identified groups of patients who benefit more from DMPs than others. Thus, young patients or patients who are being treated by diabetologists are able to benefit most from a DMP. Furthermore, the baseline HbA(1c) value has an influence on the DMP effect. Conclusion T2DM patients in the DMP exhibit a significantly higher reduction in HbA(1c) value. However, it is questionable whether this effect is clinically relevant. Certain groups of patients benefit more from DMPs than others. Nevertheless, further studies are needed in order to better understand the impact of the DMP on HbA(1c) value and the reasons for the subgroup effects. Such studies should be carried out using a randomized controlled design.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Mathematik, Informatik und Statistik > Statistik
• Themengebiete: 500 Naturwissenschaften und Mathematik > 510 Mathematik
• ISSN: 0012-0472
• Sprache: Deutsch