Participative decentralization of diabetes care in Davao City (Philippines) according to the Chronic Care Model: A program evaluation Sophie Pilleron a,b,c, *, Estelle Pasquier a , Ivy Boyoze-Nolasco d , Josephine Jasmin Villafuerte e , Davide Olchini a , Annick Fontbonne f a Prevention and Health Unit, Handicap International Federation, Lyon, France b INSERM UMR1094, Tropical Neuroepidemiology, Limoges, France c Univ Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France d Cardiovascular Project, Handicap International, Davao, Philippines e City Government of Davao, Philippines f INSERM-IRD, UMR 204 Nutripass, IRD/UM1/UM2/SupAgro, Montpellier, France d i a b e t e s r e s e a r c h a n d c l i n i c a l p r a c t i c e 1 0 4 ( 2 0 1 4 ) 1 8 9 – 1 9 5 a r t i c l e i n f o Article history: Received 4 June 2013 Received in revised form 16 September 2013 Accepted 17 January 2014 Available online 28 January 2014 Keywords: Diabetes mellitus Evaluation Chronic Care Model Developing countries Philippines a b s t r a c t Aim: To assess the effectiveness of the Diabetes Project in Davao City, Philippines, regarding diabetes care access, diabetes management and cardiovascular risk factors. The project was developed in accordance with the Chronic Care Model (CCM) framework. Methods: A non-randomized cross-sectional survey was conducted in nine intervention and five control Barangays (villages). People with diabetes aged 20 years were interviewed using a structured questionnaire; height, weight, waist circumference, and blood pressure were measured; HbA1c was tested with a NSGP-certified point-of-care device. Logistic regression models were used to compare the two groups. Results: The intervention group (n = 503) scored better than the controls (n = 136) on the following (OR, 95% CI): percentage of patients taking metformin (1.5, 1.0–2.2); and in the last 12 months: laboratory test for fasting blood sugar (1.6, 1.1–2.3), HbA1c (6.0, 2.4–15.1), lipid profile (1.7, 1.1–2.5), nutritionist visit (1.6, 1.0–2.5) and therapeutic education session (2.7, 1.8– 4.0). Glycemic control (HbA1c < 7%) was also better in the intervention Barangays (1.6, 1.0– 2.4). There were no statistical differences between the two groups for number of visits, and levels of other cardiovascular risk factors. Conclusions: Our findings support the effectiveness of implementing the CCM framework in a low-to-middle income country on glycemic control and diabetes management. # 2014 Elsevier Ireland Ltd. All rights reserved. * Corresponding author at: Handicap International, Domaine Pre ´ vention et Sante ´, Direction des Ressources Techniques, 14, Avenue Berthelot, 69007 Lyon, France. Tel.: +33 04 26 68 76 88; fax: +33 555435821. E-mail address: sophie_pilleron@hotmail.com (S. Pilleron). Contents available at ScienceDirect Diabetes Research and Clinical Practice journal homepage: www.elsevier.com/locate/diabres 0168-8227/$ – see front matter # 2014 Elsevier Ireland Ltd. All rights reserved. http://dx.doi.org/10.1016/j.diabres.2014.01.026