فهرست نشریات علمی دسترسی آزاد ایران

BACKGROUND: The purpose of this study was to evaluate diabetes control, as measured byhemoglobin A1c (HbA1c) improvements among African American and Hispanic patients receivingconventional clinical treatment combined with a bilingual diabetes educator using culturally andlinguistically appropriate educational materials. This study also sought to estimate the healthcare costsavings resulting from any A1c improvements and assess the cost‑effectiveness of this approach.MATERIALS AND METHODS: This was a multistage, face‑to‑face observational study undertakenin Texas, United States and focused on 153 African American and Hispanic patients with poorblood glucose control (baseline A1c >8.0%). For two years, a bilingual care coordinator motivatedpatient behavior changes that could lead to improvements in glucose control. The primaryevaluation measure was change in %HbA1c, with secondary measures being change in bloodpressure (BP) and low‑density lipoprotein (LDL). We also sought to gauge the program’s potentialcost‑effectiveness.RESULTS: Within the study group, A1c levels decreased over the study period from a mean of10.0% to 8.4%. The same group saw no statistically significant improvement (reduction) in bloodconcentrations of LDL. The African American subgroup had a small reduction in systolic BP whilechanges for non‑White Hispanics were not statistically significant. The average A1c reductionrealized in this observational study provided estimated cost savings that are nearly twice pilotexpenditures.CONCLUSIONS: Combining standard diabetes care with a bilingual educational care coordinatorresults in significant reductions in mean A1c (−1.6% HbA1c) in patients with poorly controlled bloodglucose and African American/non‑White Hispanic heritage, an intervention that also was shown tobe cost‑effective. This may be an effective model for improving diabetes care in provider practices.