Comparing Glycemic Outcomes Between a Family Medicine–Led Modified NCD Clinic and a General Practice Clinic: A Retrospective Cohort Study
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Abstract
BACKGROUND Type 2 diabetes remains a significant health issue in Thailand, with many patients failing to achieve optimal glycemic targets and facing increased risks of complications. In 2022, Queen Savang Vadhana Memorial Hospital launched a Modified NCDs clinic led by family medicine physicians. This “one-stop” service model focuses on comprehensive management, personalized counseling, and care continuity, differing from the conventional general practice (GP) clinic in staffing structure, patient load, and follow-up approach.
OBJECTIVES: This study aimed to compare glycemic outcomes, measured by HbA1c, between patients managed at a Modified NCDs clinic and those at a GP clinic.
METHODS: This retrospective cohort study included 152 adult patients (85 from the Modified NCDs clinic and 67 from the GP clinic) with type 2 diabetes who received continuous care every three months from April 1st, 2023, to March 31st, 2024. Clinical and laboratory data, including demographics, comorbidities, treatments, complication screening, and HbA1c, were extracted from medical records.
RESULTS: Baseline characteristics, including age, sex, and comorbidities, were similar between the two groups. Glycemic control (HbA1c, FBS) showed no overall significant difference, except that the Modified NCDs clinic used more oral diabetes medications than the GP clinic. There was a significantly greater proportion of patients in the Modified NCDs clinic who achieved controlled HbA1c levels (49.4% vs. 31.3%, p=0.025) and also had a substantially higher rate of diabetic complication screening, retinopathy (97.7% vs. 79.1%, p< 0.001), nephropathy (91.8% vs. 74.6%, p=0.013), and neuropathy (81.1% vs. 0%, p< 0.001).
CONCLUSIONS: A family medicine–led, integrated NCD clinic achieved superior long-term glycemic control and a higher rate of diabetic complication screening compared with a GP clinic. These findings highlight the potential benefits of one-stop, holistic, and continuous care in improving diabetes management outcomes within the family medicine framework.
Thaiclinicaltrials.org number, TCTR20251117007
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