title: Participative decentralization of diabetes care in Davao City (Philippines) according to the Chronic Care Model: a program evaluation.
abstract: OBJECTIVE
  To assess the effectiveness of the Diabetes Project in Davao City, Philippines, regarding diabetes care access, diabetes management and cardiovascular risk factors. The project was developed in accordance with the Chronic Care Model (CCM) framework.
  
  
  METHODS
  A non-randomized cross-sectional survey was conducted in nine intervention and five control Barangays (villages). People with diabetes aged ≥20 years were interviewed using a structured questionnaire; height, weight, waist circumference, and blood pressure were measured; HbA1c was tested with a NSGP-certified point-of-care device. Logistic regression models were used to compare the two groups.
  
  
  RESULTS
  The intervention group (n=503) scored better than the controls (n=136) on the following (OR, 95% CI): percentage of patients taking metformin (1.5, 1.0-2.2); and in the last 12 months: laboratory test for fasting blood sugar (1.6, 1.1-2.3), HbA1c (6.0, 2.4-15.1), lipid profile (1.7, 1.1-2.5), nutritionist visit (1.6, 1.0-2.5) and therapeutic education session (2.7, 1.8-4.0). Glycemic control (HbA1c<7%) was also better in the intervention Barangays (1.6, 1.0-2.4). There were no statistical differences between the two groups for number of visits, and levels of other cardiovascular risk factors.
  
  
  CONCLUSIONS
  Our findings support the effectiveness of implementing the CCM framework in a low-to-middle income country on glycemic control and diabetes management.
authors.affiliation: Prevention and Health Unit, Handicap International Federation, Lyon, France; INSERM UMR1094, Tropical Neuroepidemiology, Limoges, France; Univ Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France. Electronic address: sophie_pilleron@hotmail.com.
authors.forename: Sophie
authors.initials: S
authors.lastname: Pilleron
authors.affiliation: Prevention and Health Unit, Handicap International Federation, Lyon, France.
authors.forename: Estelle
authors.initials: E
authors.lastname: Pasquier
authors.affiliation: Cardiovascular Project, Handicap International, Davao, Philippines.
authors.forename: Ivy
authors.initials: I
authors.lastname: Boyoze-Nolasco
authors.affiliation: City Government of Davao, Philippines.
authors.forename: Josephine Jasmin
authors.initials: JJ
authors.lastname: Villafuerte
authors.affiliation: Prevention and Health Unit, Handicap International Federation, Lyon, France.
authors.forename: Davide
authors.initials: D
authors.lastname: Olchini
authors.affiliation: INSERM-IRD, UMR 204 Nutripass, IRD/UM1/UM2/SupAgro, Montpellier, France.
authors.forename: Annick
authors.initials: A
authors.lastname: Fontbonne
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D001795:Blood Pressure Determination; D001835:Body Weight; D003430:Cross-Sectional Studies; D003906:Developing Countries; D003920:Diabetes Mellitus / Q000097:blood / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008134:Long-Term Care / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010679:Philippines / Q000453:epidemiology; D011057:Politics; D015995:Prevalence; D015397:Program Evaluation; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D001786:Blood Glucose
keywords: Chronic Care Model; Developing countries; Diabetes mellitus; Evaluation; Philippines