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

Abstract

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 2 diabetes patients who had been attending to 20 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 5 serial time points were used. Results: Totally, 7190 patients (4793 females and 2397 males) with the mean age of 56 years old fulfilled inclusion criteria and entered the study. HbA1c (P-value: 0.001), fasting blood sugar (P-value: 0.001), systolic and diastolic blood pressures (P-value: 0.001), low density lipoprotein (P-value: 0.001), total cholesterol (P-value: 0.001), triglyceride (P-value: 0.001), and body mass index (P-value: 0.001) have significantly decreased during 4 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.

Keywords

• Chronic care model
• Diabetes
• Repeated measure analysis