Are elements of the chronic care model associated with cardiovascular risk factor control in type 2 diabetes?
GROUND: Control of modifiable risk factors for cardiovascular (CV) disease, the most common cause of morbidity and mortality among people with Type 2 diabetes is dependent on both patient self-care behaviors and the characteristics of the clinic in which care is delivered. The relationship between control of CV risk factors, patient self-care behaviors, and the presence of CCM (Chronic Care Model) components across multiple primary care clinic settings was examined. METHODS: Thirty consecutive patients presenting with Type 2 diabetes were enrolled from each of 20 primary care clinics from across South Texas. Patients were asked about their stage of change for four self-care behaviors: diet, exercise, glucose monitoring, and medication adherence. CV risk factors included the most recent values of glycosolated hemoglobin (A1C), blood pressure, and (low-density lipoprotein) cholesterol. Clinicians in each clinic completed the Assessment of Chronic Illness Care (ACIC) survey, a validated m