Case complexity and clinical outcome in diabetes mellitus. A prospective study using the INTERMED.

Details

Serval ID
serval:BIB_BC93E35EAB98
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Case complexity and clinical outcome in diabetes mellitus. A prospective study using the INTERMED.
Journal
Diabetes & metabolism
Author(s)
Fischer C.J., Stiefel F.C., De Jonge P., Guex P., Troendle A., Bulliard C., Huyse F.J., Gaillard R., Ruiz J.
ISSN
1262-3636
Publication state
Published
Issued date
2000
Peer-reviewed
Oui
Volume
26
Number
4
Pages
295-302
Language
english
Notes
Publication types: Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't - Publication Status: ppublish
Abstract
The aim of this study was to assess a population of patients with diabetes mellitus by means of the INTERMED, a classification system for case complexity integrating biological, psychosocial and health care related aspects of disease. The main hypothesis was that the INTERMED would identify distinct clusters of patients with different degrees of case complexity and different clinical outcomes. Patients (n=61) referred to a tertiary reference care centre were evaluated with the INTERMED and followed 9 months for HbA1c values and 6 months for health care utilisation. Cluster analysis revealed two clusters: cluster 1 (62%) consisting of complex patients with high INTERMED scores and cluster 2 (38%) consisting of less complex patients with lower INTERMED. Cluster 1 patients showed significantly higher HbA1c values and a tendency for increased health care utilisation. Total INTERMED scores were significantly related to HbA1c and explained 21% of its variance. In conclusion, different clusters of patients with different degrees of case complexity were identified by the INTERMED, allowing the detection of highly complex patients at risk for poor diabetes control. The INTERMED therefore provides an objective basis for clinical and scientific progress in diabetes mellitus. Ongoing intervention studies will have to confirm these preliminary data and to evaluate if management strategies based on the INTERMED profiles will improve outcomes.
Keywords
Adult, Biological Markers, Demography, Diabetes Mellitus, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Diabetic Angiopathies, Diabetic Nephropathies, Diabetic Neuropathies, Diabetic Retinopathy, Female, Health Care Surveys, Hemoglobin A, Glycosylated, Humans, Male, Medical History Taking, Socioeconomic Factors, Switzerland, Treatment Outcome
Pubmed
Web of science
Create date
15/02/2008 16:58
Last modification date
20/08/2019 15:30
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