ArticlePatient preference and adherence2026
Effects of the Integration of Medical Treatment and Prevention on Glycaemic Control Among Patients with Diabetes in Qianjiang District, China: A Difference-in-Differences Study.
Article in Patient preference and adherence, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Abstract
Background: The Integration of Medical Treatment and Prevention (IMTP) is one approach to integrated disease management within China's primary healthcare system. Evidence on its association with glycaemic control and potential behavioural pathways among patients with diabetes remains limited. Methods: We conducted a retrospective quasi-experimental study of 5676 adults with diabetes in Qianjiang District during 2023Q1-2024Q4. Four primary healthcare (PHC) facilities implemented IMTP in January 2024 (treatment group), while 26 formed the control group. Patient-level propensity score matching via the Super Learner machine learning algorithm (PSM-SLMLA) at the 2023Q4 baseline retained 1240 patients per group (19,840 patient-quarter observations). Weighted difference-in-differences (DID) models included facility and quarter fixed effects with facility-clustered inference. Results: IMTP was associated with a 3.73% relative reduction in HbA1c (95% CI, 0.04%-7.29%; β = -0.0380; 95% CI, -0.0757 to -0.0004; P = 0.048), equivalent to approximately 0.27 HbA1c percentage points at the pre-intervention mean. Pre-intervention coefficients were not jointly significant (P = 0.857), and sensitivity estimates remained negative. Exploratory indirect associations were -0.0021 through active follow-up behaviour (95% bootstrap CI, -0.0037 to -0.0007; P = 0.004) and -0.0006 through staple-food intake behaviour (95% bootstrap CI, -0.0026 to -0.0001; P = 0.014); the exercise adherence estimate included zero. Formal interaction tests did not identify heterogeneity (all P for interaction > 0.05). Conclusion: IMTP was associated with modest short-term glycaemic improvement. Active follow-up behaviour may be a potential pathway. Increased staple-food intake raises a dietary-compensation hypothesis, but concurrent behavioural and HbA1c measurements preclude causal interpretation.
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