{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:58:14Z","timestamp":1747184294591,"version":"3.40.5"},"reference-count":20,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,9,28]],"date-time":"2019-09-28T00:00:00Z","timestamp":1569628800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["KL2TR002381","UL1TR002378"],"award-info":[{"award-number":["KL2TR002381","UL1TR002378"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["HHSN268200900026C"],"award-info":[{"award-number":["HHSN268200900026C"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","award":["1D43HD05249","5R24TW007988","D43TW008332"],"award-info":[{"award-number":["1D43HD05249","5R24TW007988","D43TW008332"]}],"id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["R01MH100390\u201004S1"],"award-info":[{"award-number":["R01MH100390\u201004S1"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet. Med."],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>To evaluate whether and what combinations of diabetes quality metrics were achieved in a multicentre trial in South Asia evaluating a multicomponent quality improvement intervention that included non\u2010physician care coordinators to promote adherence and clinical decision\u2010support software to enhance physician practices, in comparision with usual care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using data from the Centre for Cardiometabolic Risk Reduction in South Asia (<jats:styled-content style=\"fixed-case\">CARRS<\/jats:styled-content>) trial, we evaluated the proportions of trial participants achieving specific and combinations of five diabetes care targets (HbA<jats:sub>1c<\/jats:sub>&lt;53 mmol\/mol [7%], blood pressure &lt;130\/80 mmHg, <jats:styled-content style=\"fixed-case\">LDL<\/jats:styled-content> cholesterol &lt;2.6 mmol\/L, non\u2010smoking status, and aspirin use). Additionally, we examined the proportions of participants achieving the following risk factor improvements from baseline: \u226511\u2010mmol\/mol (1%) reduction in HbA<jats:sub>1c<\/jats:sub>, \u226510\u2010mmHg reduction in systolic blood pressure, and\/or \u22650.26\u2010mmol\/l reduction in <jats:styled-content style=\"fixed-case\">LDL<\/jats:styled-content> cholesterol.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Baseline characteristics were similar in the intervention and usual care arms. Overall, 12.3%, 29.4%, 36.5%, 19.5% and 2.2% of participants in the intervention group and 16.2%, 38.3%, 31.6%, 11.3% and 0.8% of participants in the usual care group achieved any one, two, three, four or five targets, respectively. We noted sizeable improvements in HbA<jats:sub>1c<\/jats:sub>, blood pressure and cholesterol, and found that participants in the intervention group were twice as likely to achieve improvements in all three indices at 12 months that were sustained over 28 months of the study [relative risk 2.1 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.5,2.8) and 1.8 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.5,2.3), respectively].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The intervention was associated with significantly higher achievement of and greater improvements in composite diabetes quality care goals. However, among these higher\u2010risk participants, very small proportions achieved the complete group of targets, which suggests that achievement of multiple quality\u2010of\u2010care goals is challenging and that other methods may be needed in closing care gaps.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.14124","type":"journal-article","created":{"date-parts":[[2019,9,3]],"date-time":"2019-09-03T19:44:38Z","timestamp":1567539878000},"page":"1825-1831","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Effect of a multicomponent intervention on achievement and improvements in quality\u2010of\u2010care indices among people with Type 2 diabetes in South Asia: the CARRS trial"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6722-7846","authenticated-orcid":false,"given":"M. K.","family":"Shah","sequence":"first","affiliation":[{"name":"Department of Family and Preventive Medicine Emory University School of Medicine Atlanta GA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Kondal","sequence":"additional","affiliation":[{"name":"Centre of Excellence Centre for Cardiometabolic Risk Reduction in South Asia Public Health Foundation of India Gurgaon India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. A.","family":"Patel","sequence":"additional","affiliation":[{"name":"Rollins School of Public Health Emory University Atlanta GA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4330-666X","authenticated-orcid":false,"given":"K.","family":"Singh","sequence":"additional","affiliation":[{"name":"Centre of Excellence Centre for Cardiometabolic Risk Reduction in South Asia Public Health Foundation of India Gurgaon India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Devarajan","sequence":"additional","affiliation":[{"name":"Centre of Excellence Centre for Cardiometabolic Risk Reduction in South Asia Public Health Foundation of India Gurgaon India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Shivashankar","sequence":"additional","affiliation":[{"name":"Centre for Chronic Disease Control India Public Health Foundation of India Gurgaon India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V. S.","family":"Ajay","sequence":"additional","affiliation":[{"name":"Centre of Excellence Centre for Cardiometabolic Risk Reduction in South Asia Public Health Foundation of India Gurgaon India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V. U.","family":"Menon","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Diabetes Amrita Institute of Medical Sciences Kerala India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P. K.","family":"Varthakavi","sequence":"additional","affiliation":[{"name":"Department of Endocrinology TNM College and BYL Nair Charity Hospital Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V.","family":"Viswanathan","sequence":"additional","affiliation":[{"name":"MV Hospital for Diabetes &amp; Diabetes Research Centre Chennai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Dharmalingam","sequence":"additional","affiliation":[{"name":"Bangalore Endocrinology and Diabetes Research Centre Karnataka India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Bantwal","sequence":"additional","affiliation":[{"name":"Department of Endocrinology St John's Medical College and Hospital Karnataka India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. 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Q.","family":"Masood","sequence":"additional","affiliation":[{"name":"Department of Medicine Section of Endocrinology and Diabetes Aga Khan University Karachi Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Khadgawat","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism All India Institute of Medical Sciences New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Desai","sequence":"additional","affiliation":[{"name":"Department of Medicine Endocrine Unit Goa Medical College Goa India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Prabhakaran","sequence":"additional","affiliation":[{"name":"Department of Medicine Endocrine Unit Goa Medical College Goa India"},{"name":"Centre for Control of Chronic Conditions Public Health Foundation of India Gurgaon India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K. M. 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