Why the study?
Identifying individual and neighborhood-level factors linked to worsening cardiometabolic risks despite clinic-based care coordination may help identify candidates for supplementary team-based care.
What individual and neighborhood-level factors are associated with worsening cardiometabolic measures in adults participating in a clinic-based care coordination program?
What individual and neighborhood-level factors are associated with worsening cardiometabolic measures in adults participating in a clinic-based care coordination program?
Women and patients with higher baseline cardiometabolic risks experienced worsening of HbA1c, LDL, and blood pressure despite a care coordination program, highlighting the need for tailored, gender-specific interventions.
Higher baseline risks linked to worsening despite coordination; hypothesis-generating for targeted supplementary care in high-risk subgroups.
Background: Identifying individual and neighborhood-level factors associated with worsening cardiometabolic risks despite clinic-based care coordination may help identify candidates for supplementary team-based care. Methods: Secondary data analysis of data from a two-year nurse-led care coordination program cohort of Medicare, Medicaid, dual-eligible adults, Leveraging Information Technology to Guide High Tech, High Touch Care (LIGHT2), from ten Midwestern primary care clinics in the U.S. Outcome Measures: Hemoglobin A1C, low-density-lipoprotein (LDL) cholesterol, and blood pressure. Multivariable generalized linear regression models assessed individual and neighborhood-level factors associated with changes in outcome measures from before to after completion of the LIGHT2 program. Results: 6378 participants had pre-and post-intervention levels reported for at least one outcome measure. In adjusted models, higher pre-intervention cardiometabolic measures were associated with worsening of all cardiometabolic measures. Women had worsening LDL-cholesterol compared with men. Women with pre-intervention HbA1c > 6.8% and systolic blood pressure > 131 mm of Hg had worse post-intervention HbA1c and systolic blood pressure compared with men. Adding individual’s neighborhood-level risks did not change effect sizes significantly. Conclusions: Increased cardiometabolic risks and gender were associated with worsening cardiometabolic outcomes. Understanding unresolved gender-specific needs and preferences of patients with increased cardiometabolic risks may aid in tailoring clinic-community-linked care planning.
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Patil et al. (2022) studied this question.
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