Effectiveness of monthly and bimonthly follow-up of patients with well-controlled type 2 diabetes: a propensity score matched cohort study
Abstract Background On average, patients in Japan with type 2 diabetes mellitus have a clinical consultation every month, although evidence for a favorable follow-up interval is lacking. This study investigated whether the follow-up interval can be extended by comparing the clinical outcomes and cos...
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| Format: | Article |
| Language: | English |
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BMC
2019-05-01
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| Series: | BMC Endocrine Disorders |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12902-019-0372-5 |
| _version_ | 1811270271868338176 |
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| author | Tomohiko Ukai Shuhei Ichikawa Miho Sekimoto Satoru Shikata Yousuke Takemura |
| author_facet | Tomohiko Ukai Shuhei Ichikawa Miho Sekimoto Satoru Shikata Yousuke Takemura |
| author_sort | Tomohiko Ukai |
| collection | DOAJ |
| description | Abstract Background On average, patients in Japan with type 2 diabetes mellitus have a clinical consultation every month, although evidence for a favorable follow-up interval is lacking. This study investigated whether the follow-up interval can be extended by comparing the clinical outcomes and cost for monthly versus bimonthly follow-up of patients with well-controlled diabetes mellitus. Methods We combined administrative claims data from the National Health Insurance and the Health Checkups Program data of Tsu city, Japan between 2011 and 2014 to conduct a retrospective cohort study of patients with well-controlled type 2 diabetes mellitus. Propensity scores were used to assemble a matched-pairs cohort from patients who had monthly and bimonthly follow-up. Equivalence between two groups was assessed by designating the proportion of patients who maintained good control of their diabetes in the subsequent year as a primary outcome. The proportion achieving target blood pressure and lipid levels, favorable lifestyle, and annual cost were compared as secondary outcomes. Results Of 12,145 participants, 693 with monthly follow-up and 693 with bimonthly follow-up were matched using propensity scores. In the monthly follow-up group 654 (94.4%) remained under good diabetic control, versus 658 (95.0%) in the bimonthly group (difference: 0.6%; 95% confidence interval: − 1.8 to 2.9%). All secondary outcomes were equivalent for the monthly and bimonthly follow-up groups except the proportion achieving target blood pressure, the proportion engaging in regular exercise, and annual cost. Conclusions For patients with well-controlled diabetes mellitus, although frequent follow-up by a physician does not affect the control of blood glucose level in the subsequent year, the annual treatment cost becomes much higher. We suggest that patients with well-controlled diabetes can be followed up less often. |
| first_indexed | 2024-04-12T21:57:47Z |
| format | Article |
| id | doaj.art-e450da130fd84ad2883b604a83409716 |
| institution | Directory Open Access Journal |
| issn | 1472-6823 |
| language | English |
| last_indexed | 2024-04-12T21:57:47Z |
| publishDate | 2019-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Endocrine Disorders |
| spelling | doaj.art-e450da130fd84ad2883b604a834097162022-12-22T03:15:16ZengBMCBMC Endocrine Disorders1472-68232019-05-011911910.1186/s12902-019-0372-5Effectiveness of monthly and bimonthly follow-up of patients with well-controlled type 2 diabetes: a propensity score matched cohort studyTomohiko Ukai0Shuhei Ichikawa1Miho Sekimoto2Satoru Shikata3Yousuke Takemura4Department of Community Medicine, TSU, Mie University School of MedicineDepartment of Education and Research in Family and Community Medicine, Mie University Graduate School of MedicineResearch Center for Health Policy and Economics, Hitotsubashi Institute for Advanced StudyDepartment of Family Medicine, Mie Prefectural Ichishi HospitalDepartment of Community Medicine, TSU, Mie University School of MedicineAbstract Background On average, patients in Japan with type 2 diabetes mellitus have a clinical consultation every month, although evidence for a favorable follow-up interval is lacking. This study investigated whether the follow-up interval can be extended by comparing the clinical outcomes and cost for monthly versus bimonthly follow-up of patients with well-controlled diabetes mellitus. Methods We combined administrative claims data from the National Health Insurance and the Health Checkups Program data of Tsu city, Japan between 2011 and 2014 to conduct a retrospective cohort study of patients with well-controlled type 2 diabetes mellitus. Propensity scores were used to assemble a matched-pairs cohort from patients who had monthly and bimonthly follow-up. Equivalence between two groups was assessed by designating the proportion of patients who maintained good control of their diabetes in the subsequent year as a primary outcome. The proportion achieving target blood pressure and lipid levels, favorable lifestyle, and annual cost were compared as secondary outcomes. Results Of 12,145 participants, 693 with monthly follow-up and 693 with bimonthly follow-up were matched using propensity scores. In the monthly follow-up group 654 (94.4%) remained under good diabetic control, versus 658 (95.0%) in the bimonthly group (difference: 0.6%; 95% confidence interval: − 1.8 to 2.9%). All secondary outcomes were equivalent for the monthly and bimonthly follow-up groups except the proportion achieving target blood pressure, the proportion engaging in regular exercise, and annual cost. Conclusions For patients with well-controlled diabetes mellitus, although frequent follow-up by a physician does not affect the control of blood glucose level in the subsequent year, the annual treatment cost becomes much higher. We suggest that patients with well-controlled diabetes can be followed up less often.http://link.springer.com/article/10.1186/s12902-019-0372-5Diabetes mellitusFollow-up intervalPropensity score |
| spellingShingle | Tomohiko Ukai Shuhei Ichikawa Miho Sekimoto Satoru Shikata Yousuke Takemura Effectiveness of monthly and bimonthly follow-up of patients with well-controlled type 2 diabetes: a propensity score matched cohort study BMC Endocrine Disorders Diabetes mellitus Follow-up interval Propensity score |
| title | Effectiveness of monthly and bimonthly follow-up of patients with well-controlled type 2 diabetes: a propensity score matched cohort study |
| title_full | Effectiveness of monthly and bimonthly follow-up of patients with well-controlled type 2 diabetes: a propensity score matched cohort study |
| title_fullStr | Effectiveness of monthly and bimonthly follow-up of patients with well-controlled type 2 diabetes: a propensity score matched cohort study |
| title_full_unstemmed | Effectiveness of monthly and bimonthly follow-up of patients with well-controlled type 2 diabetes: a propensity score matched cohort study |
| title_short | Effectiveness of monthly and bimonthly follow-up of patients with well-controlled type 2 diabetes: a propensity score matched cohort study |
| title_sort | effectiveness of monthly and bimonthly follow up of patients with well controlled type 2 diabetes a propensity score matched cohort study |
| topic | Diabetes mellitus Follow-up interval Propensity score |
| url | http://link.springer.com/article/10.1186/s12902-019-0372-5 |
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