Please use this identifier to cite or link to this item: http://hdl.handle.net/10553/75542
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dc.contributor.authorRamallo Fariña, Yolandaen_US
dc.contributor.authorGarcía-Bello, Miguel Angelen_US
dc.contributor.authorGarcía-Pérez, Lidiaen_US
dc.contributor.authorBoronat Cortés, Mauroen_US
dc.contributor.authorWägner, Ana Maríaen_US
dc.contributor.authorRodríguez-Rodríguez, Leticiaen_US
dc.contributor.authorDe Pablos-Velasco, Pedroen_US
dc.contributor.authorLlorente Gómez de Segura, Ignacioen_US
dc.contributor.authorGonzález-Pacheco, Himaren_US
dc.contributor.authorCarmona Rodríguez, Montserraten_US
dc.contributor.authorSerrano-Aguilar, Pedroen_US
dc.date.accessioned2020-11-15T14:17:24Z-
dc.date.available2020-11-15T14:17:24Z-
dc.date.issued2020en_US
dc.identifier.issn2291-5222en_US
dc.identifier.otherScopus-
dc.identifier.urihttp://hdl.handle.net/10553/75542-
dc.description.abstractBackground: Type 2 diabetes mellitus (T2DM) is a chronic disease in which health outcomes are related to decision making by patients and health care professionals. Objective: This study aims to assess the effectiveness of internet-based multicomponent interventions to support decision making of all actors involved in the care of patients with T2DM in primary care. Methods: The INDICA study is an open, community-based, multicenter trial with random allocation to usual care or the intervention for patients, the intervention for health care professionals in primary care, or the combined intervention for both. In the intervention for patients, participants received an educational group program and were monitored and supported by logs, a web-based platform, and automated SMS. Those in the intervention for professionals also received an educational program, a decision support tool embedded in the electronic clinical record, and periodic feedback about patients' results. A total of 2334 people with T2DM, regardless of glycated hemoglobin (HbA1c) levels and without diabetes-related complications, were included. The primary end point was change in HbA1c level. The main analysis was performed using multilevel mixed models. Results: For the overall sample, the intervention for patients attained a significant mean reduction in HbA1c levels of 0.27 (95% CI 0.45 to 0.10) at month 3 and 0.26 (95% CI 0.44 to 0.08) at month 6 compared with usual care, which remained marginally significant at month 12. A clinically relevant reduction in HbA1c level was observed in 35.6% (191/537) of patients in the intervention for patients and 26.0% (152/586) of those in usual care at month 12 (P=.006). In the combined intervention, HbA1c reduction was significant until month 18 (181/557, 32.6% vs 140/586, 23.9%; P=.009). Considering the subgroup of patients uncontrolled at baseline, all interventions produced significant reductions in HbA1c levels across the entire study period: 0.49 (95% CI 0.70 to 0.27) for the intervention for patients, 0.35 (95% CI 0.59 to 0.14) for the intervention for professionals, and 0.35 (95% CI 0.57 to 0.13) for the combined intervention. Differences in HbA1c for the area under the curve considering the entire period were significant for the intervention for patients and the combined intervention compared with usual care (P=.03 for both). Compared with usual care, the intervention for professionals and the combined intervention had significant longer-term reductions in systolic and diastolic blood pressure. Conclusions: In uncontrolled patients, the intervention for patients at baseline provided clinically relevant and significant longer-term reductions of HbA1c levels. The intervention for professionals and combined intervention also improved the cardiovascular risk profile of patients.en_US
dc.languageengen_US
dc.relation.ispartofJMIR mHealth and uHealthen_US
dc.sourceJMIR mHealth and uHealth [EISSN 2291-5222], v. 8 (11), e18922, (Noviembre 2020)en_US
dc.subject320104 Patología clínicaen_US
dc.subject320502 Endocrinologíaen_US
dc.subject320610 Enfermedades de la nutriciónen_US
dc.subject240208 Hábitos alimentariosen_US
dc.subject3212 Salud públicaen_US
dc.subject.otherBehavior Modificationen_US
dc.subject.otherEhealthen_US
dc.subject.otherPatients Adherenceen_US
dc.subject.otherPrimary Careen_US
dc.subject.otherType 2 Diabetes Mellitusen_US
dc.titleEffectiveness of internet-based multicomponent interventions for patients and health care professionals to improve clinical outcomes in type 2 diabetes evaluated through the indica study: Multiarm cluster randomized controlled trialen_US
dc.typeinfo:eu-repo/semantics/Articleen_US
dc.typeArticleen_US
dc.identifier.doi10.2196/18922en_US
dc.identifier.pmid33136059-
dc.identifier.scopus85095399483-
dc.contributor.authorscopusid25823987800-
dc.contributor.authorscopusid36099016000-
dc.contributor.authorscopusid26021172500-
dc.contributor.authorscopusid7003952293-
dc.contributor.authorscopusid7401456520-
dc.contributor.authorscopusid57217824470-
dc.contributor.authorscopusid6603805479-
dc.contributor.authorscopusid56204180800-
dc.contributor.authorscopusid57219771546-
dc.contributor.authorscopusid57219877976-
dc.contributor.authorscopusid6602510866-
dc.identifier.eissn2291-5222-
dc.identifier.issue11-
dc.relation.volume8en_US
dc.investigacionCiencias de la Saluden_US
dc.type2Artículoen_US
dc.description.numberofpages15en_US
dc.utils.revisionen_US
dc.date.coverdateNoviembre 2020en_US
dc.identifier.ulpgcen_US
dc.contributor.buulpgcBU-MEDen_US
dc.description.sjr1,356
dc.description.jcr4,773
dc.description.sjrqQ1
dc.description.jcrqQ1
dc.description.scieSCIE
item.grantfulltextopen-
item.fulltextCon texto completo-
crisitem.author.deptGIR Diabetes y endocrinología aplicada-
crisitem.author.deptIU de Investigaciones Biomédicas y Sanitarias-
crisitem.author.deptDepartamento de Ciencias Médicas y Quirúrgicas-
crisitem.author.deptGIR Diabetes y endocrinología aplicada-
crisitem.author.deptIU de Investigaciones Biomédicas y Sanitarias-
crisitem.author.deptDepartamento de Ciencias Médicas y Quirúrgicas-
crisitem.author.deptGIR Rendimiento humano, ejercicio físico y salud-
crisitem.author.deptIU de Investigaciones Biomédicas y Sanitarias-
crisitem.author.deptDepartamento de Ciencias Médicas y Quirúrgicas-
crisitem.author.orcid0000-0001-8535-8543-
crisitem.author.orcid0000-0002-7663-9308-
crisitem.author.orcid0000-0002-9190-2581-
crisitem.author.parentorgIU de Investigaciones Biomédicas y Sanitarias-
crisitem.author.parentorgIU de Investigaciones Biomédicas y Sanitarias-
crisitem.author.parentorgIU de Investigaciones Biomédicas y Sanitarias-
crisitem.author.fullNameRamallo Fariña, Yolanda-
crisitem.author.fullNameBoronat Cortés, Mauro-
crisitem.author.fullNameWägner, Anna Maria Claudia-
crisitem.author.fullNameDe Pablos Velasco, Pedro Luis-
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