Enhancing the follow-up for patients with type 2 diabetes mellitus using a proactive scheduling computer tool: A paired cohort study in primary care.

Abstract

To assess the impact of an electronic scheduling tool (Planificat) on the management of type 2 diabetes mellitus (T2DM) in primary care settings. This paired cohort study used data from the Catalan primary care electronic health records. The intervention cohort, using Planificat, included all patients aged 15 years or older with T2DM and was matched 1:1 with a control cohort. The study period lasted one year. Mixed general linear models estimated Odds Ratios (OR) and 95 % confidence intervals (95 %CI) for primary outcomes, including T2DM clinical tests (LDL cholesterol, HbA1c), visit frequency, and non-attendance rates. A total of 51,619 patients (mean age 68.3 years, 42.1 % of female sex) and their paired controls were included. In the primary analysis, significant increases were observed in the Planificat group (N = 18,542) regarding several measures: cholesterol tests performed (83.5 % vs. 75.4 %; OR: 1.65 [95 %CI: 1.57-1.74]), HbA1c tests performed (83.7 % vs. 75.4 %; OR: 1.7 [95 %CI: 1.61-1.79]), and electrocardiograms (65 % vs. 52 %; OR: 1.72 [95 %CI: 1.65-1.8]). Additionally, there was a 36 % increase in patients achieving HbA1c levels < 8 % (OR: 1.36 [95 %CI: 1.3-1.42]). Statistically significant improvements of 30 % and 40 % were also observed in foot and retinopathy screenings, respectively. Face-to-face visits with general practitioners and non-attendance rates remained comparable between cohorts, while face-to-face nurse visits increased by 7 %. Planificat significantly improved T2DM management indicators, promoting proactive scheduling and enhancing follow-up in primary care without impacting face-to-face visits. These findings support its integration as a complementary strategy for optimizing chronic disease management.