Implementation of "Chronic Care Model" for Diabetes Care in Iranian Primary Health Care: Does it work?

Objective: Traditional health care systems were not capable to face successfully with chronic diseases including diabetes mellitus. In this regard, the Chronic Care Model or CCM was created to promote quality of care. The aim of this study was to examine whether establishment of chronic care model, with focus on diabetic patients, has led to clinically significant outcomes in Iran. Materials and Methods: The samples were confirmed type ۲ diabetes patients who had been attending to ۲۰ CCM-based clinics in Tehran for at least one year. Repeated measurements of the same variable (including demographic, anthropometric and biochemical variables) on the same individual in ۵ serial time points were used. Results: Totally, ۷۱۹۰ patients (۴۷۹۳ females and ۲۳۹۷ males) with the mean age of ۵۶ years old fulfilled inclusion criteria and entered the study. HbA۱c (P-value: ۰.۰۰۱), fasting blood sugar (P-value: ۰.۰۰۱), systolic and diastolic blood pressures (P-value: ۰.۰۰۱), low density lipoprotein (P-value: ۰.۰۰۱), total cholesterol (P-value: ۰.۰۰۱), triglyceride (P-value: ۰.۰۰۱), and body mass index (P-value: ۰.۰۰۱) have significantly decreased during ۴ measurement intervals. Conclusion: Implementation of CCM frame in primary health care clinics as the first model-based participatory care has been relatively successful in the field of diabetes management in Iran. Our findings support the idea that multifaceted interventions provided through a collaborative team work could relieve various health risk factors in diabetics.

کلیدواژه ها:

Chronic care model ، Diabetes ، Repeated measure analysis