A pilot study of an integrated mental health, social and medical model for diabetes care in an inner‐city setting: Three Dimensions for Diabetes (3DFD)

• DOI: 10.1111/dme.13918
• Publication Date: 2019-02-01T11:16:39Z
• Authors: K. Ismail; K. Stewart; K. Ridge; E. Britneff; R. Freudenthal; D. Stahl; P. McCrone; C. Gayle; A. M. Doherty
• Keywords: Mental model

Abstract Aims We examined the effectiveness of a service innovation, Three Dimensions for Diabetes (3DFD), that consisted referral to an integrated mental health, social care and diabetes treatment model, compared with usual in improving biomedical health economic outcomes. Methods Using non‐randomized control design, 3DFD model was offered two inner‐city boroughs London, UK, where professionals could refer adult residents diabetes, suboptimal glycaemic [HbA 1c ≥ 75 mmol/mol (≥ 9.0%)] and/or problems. In group, there no pathway anonymized data on individuals HbA 9.0%) were collected from primary records. Change baseline 12 months outcome, change healthcare costs variables secondary Results participants had worse higher than at baseline. greater improvement [−14 (−1.3%) vs. −6 (−0.6%) respectively, P < 0.001], adjusted confounding. Total follow‐up remained group (mean difference £1715, 95% confidence intervals 591 2811), The incremental cost‐effectiveness ratio £398 per unit decrease , indicating intervention more effective costed care. Conclusions A biomedical, psychological criteria‐based system identifying managing high‐cost high‐risk poor can lead improved all three dimensions.