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Effectiveness of the EMPOWER-PAR Intervention in Improving Clinical Outcomes of Type 2 Diabetes Mellitus in Primary Care: A Pragmatic Cluster Randomised Controlled Trial

Ramli AS 1 , Selvarajah S 2 , Daud MH 3 , Haniff J 4 , Abdul-Razak S 3 , Tg-Abu-Bakar-Sidik TM 4 Show all authors , Bujang MA 4 , Chew BH 5 , Rahman T 6 , Tong SF 7 , Shafie AA 8 , Lee VK 9 , Ng KK 10 , Ariffin F 3 , Abdul-Hamid H 3 , Mazapuspavina MY 3 , Mat-Nasir N 3 , Chan CW 9 , Yong-Rafidah AR 11 , Ismail M 12 , Lakshmanan S 4 , Low WH 13 , EMPOWER-PAR Investigators

Affiliations 

  • 1 Discipline of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Selayang Campus, Jalan Prima Selayang 7, 68100, Batu Caves, Selangor, Malaysia. [email protected]
  • 2 Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, Netherlands
  • 3 Discipline of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Selayang Campus, Jalan Prima Selayang 7, 68100, Batu Caves, Selangor, Malaysia
  • 4 Clinical Epidemiology Unit, National Clinical Research Centre, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
  • 5 Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
  • 6 Institute for Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA (UiTM), Sungai Buloh Campus, Jalan Hospital, 47000, Sungai Buloh, Selangor, Malaysia
  • 7 Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
  • 8 School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
  • 9 Department of Family Medicine, School of Medicine, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia
  • 10 Faculty of Medicine & Defense Health, National Defense University of Malaysia, Sungai Besi Camp, Kuala Lumpur, Malaysia
  • 11 Discipline of Family Medicine, Faculty of Medicine, Cyberjaya University College of Medical Sciences, Cyberjaya, Selangor, Malaysia
  • 12 Klinik Kesihatan Seremban 2, Seremban, Negeri Sembilan, Malaysia
  • 13 Monash Health, Monash Medical Centre, Clayton Campus, Clayton, VIC, Australia
BMC Fam Pract, 2016 11 14;17(1):157.
PMID: 27842495

Abstract

BACKGROUND: The chronic care model was proven effective in improving clinical outcomes of diabetes in developed countries. However, evidence in developing countries is scarce. The objective of this study was to evaluate the effectiveness of EMPOWER-PAR intervention (based on the chronic care model) in improving clinical outcomes for type 2 diabetes mellitus using readily available resources in the Malaysian public primary care setting.

METHODS: This was a pragmatic, cluster-randomised, parallel, matched pair, controlled trial using participatory action research approach, conducted in 10 public primary care clinics in Malaysia. Five clinics were randomly selected to provide the EMPOWER-PAR intervention for 1 year and another five clinics continued with usual care. Patients who fulfilled the criteria were recruited over a 2-week period by each clinic. The obligatory intervention components were designed based on four elements of the chronic care model i.e. healthcare organisation, delivery system design, self-management support and decision support. The primary outcome was the change in the proportion of patients achieving HbA1c 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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