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Interdisciplinary diabetes education team

Lyndsay A Nelson, Lindsay S Mayberry, Kenneth Wallston, Sunil Kripalani, Erin M Bergner, Chandra Y Osborn
BACKGROUND: Among adults with type 2 diabetes mellitus (T2DM), adherence to recommended self-care activities is suboptimal, especially among racial and ethnic minorities with low income. Self-care nonadherence is associated with having worse glycemic control and diabetes complications. Text messaging interventions are improving the self-care of adults with T2DM, but few have been tested with disadvantaged populations. OBJECTIVE: To develop Rapid Education/Encouragement And Communications for Health (REACH), a tailored, text messaging intervention to support the self-care adherence of disadvantaged patients with T2DM, based on the Information-Motivation-Behavioral skills model...
September 8, 2016: JMIR Human Factors
M G S Cavicchioli, C C L Guerbali, C Ochiai, R M Silva, G Camara, T B Z Petry
Diabetes has caused 5.1 million deaths, primarily from cardiovascular disease. Large clinical studies have proven the importance of intensive control of diabetes from diagnosis to prevent microvascular and macrovascular complications of the disease in the long term. Diabetes education conducted by an interdisciplinary team of doctors, nurses, nutritionists, psychologists, and others is a necessary tool to ensure effective behavioral change and help overcome the obstacles that may hinder self care. Several studies have been analyzed in this review, in which we find a variety of results...
July 2016: Current Atherosclerosis Reports
Kristin E Remus, Michael Honigberg, Sri Lekha Tummalapalli, Laura P Cohen, Sara Fazio, Amy R Weinstein
PROBLEM: In the current transformative health care landscape, it is imperative that clinician educators inspire future clinicians to practice primary care in a dynamic environment. A focus on patient-centered, goal-oriented care for patients with chronic conditions is critical. APPROACH: In 2009, Harvard Medical School founded the Crimson Care Collaborative, a student-faculty collaborative practice (SFCP) network. With the aim of expanding clinical and educational opportunities for medical students and improving patient control of chronic disease (i...
July 2016: Academic Medicine: Journal of the Association of American Medical Colleges
Sandra G Hardee, Kim Crickmore Osborne, Njeri Njuguna, Dustin Allis, Daphne Brewington, Shivajirao P Patil, Linda Hofler, Robert J Tanenberg
A patient-centered interdisciplinary diabetes care model was implemented at Vidant Medical Center in Greenville, N.C., a 909-bed tertiary care teaching hospital, for the purpose of providing all patients with diabetes clear and concise instructions on diabetes survival skills. Survival skills education during hospitalization is needed for safe transition to community resources for continued and expanded diabetes self-management education. This article describes the process used to develop, implement, and evaluate the model...
November 2015: Diabetes Spectrum: a Publication of the American Diabetes Association
Carolina Bonilla, Paula Brauer, Dawna Royall, Heather Keller, Rhona M Hanning, Alba DiCenso
BACKGROUND: Dietary assessment can be challenging for many reasons, including the wide variety of foods, eating patterns and nutrients to be considered. In team-based primary care practice, various disciplines may be involved in assessing diet. Electronic-based dietary assessment (e-DA) instruments available now through mobile apps or websites can potentially facilitate dietary assessment. Providers views of facilitators and barriers related to e-DA instruments and their recommendations for improvement can inform the further development of these tools...
2015: BMC Medical Informatics and Decision Making
Greg Maynard, Kristen Kulasa, Pedro Ramos, Diana Childers, Brian Clay, Meghan Sebasky, Ed Fink, Aaron Field, Marian Renvall, Patricia S Juang, Charles Choe, Diane Pearson, Brittany Serences, Suzanne Lohnes
OBJECTIVE: Uncontrolled hyperglycemia and iatrogenic hypoglycemia represent common and frequently preventable quality and safety issues. We sought to demonstrate the effectiveness of a hypoglycemia reduction bundle, proactive surveillance of glycemic outliers, and an interdisciplinary data-driven approach to glycemic management. METHODS: HASH(0x3b0edc0) POPULATION: all hospitalized adult non-intensive care unit (non-ICU) patients with hyperglycemia and/or a diagnosis of diabetes admitted to our 550-bed academic center across 5 calendar years (CYs)...
April 2015: Endocrine Practice
Elena V Varlamov, Mark E Kulaga, Akhil Khosla, Danille L Prime, Nancy J Rennert
Hypoglycemia causes immediate adverse reactions and is associated with unfavorable clinical outcomes and increased health care costs. It is also one of the barriers to optimization of inpatient glycemic control. Prioritizing quality improvement efforts to address hypoglycemia in hospitalized patients with diabetes is of critical importance. Acute illness, hospital routine, and gaps in quality care predispose patients to hypoglycemia. Many of these factors can be minimized when approached from a systems-based perspective...
October 2014: Hospital Practice (Minneapolis)
Elizabeth Stephens
Although not curable, type 1 diabetes is eminently controllable. IIT, as guided by the results of landmark studies such as the DCCT, provides primary care providers with a blueprint for reducing the frequency of the devastating complications of diabetes that were all too common in the recent past. Considering the remarkable advances in contemporary therapy, including MDI and CSII, the likelihood of even greater future improvements in quality of life and survivability can be anticipated. Success requires patient engagement and education, an informed primary care provider, and an interdisciplinary team to maximize the benefits of insulin therapy and avoid the risks of hypoglycemia...
January 2015: Medical Clinics of North America
Joseph V Bonventre, L Ebony Boulware, Laura M Dember, Barry I Freedman, Susan L Furth, Lawrence B Holzman, Christian J Ketchum, Melissa H Little, Rajnish Mehrotra, Sharon M Moe, Jeff M Sands, John R Sedor, Stefan Somlo, Robert A Star, Krystyna E Rys-Sikora
The National Institute of Diabetes and Digestive and Kidney Diseases-supported Kidney Research National Dialogue asked the scientific community to formulate and prioritize research objectives that would improve our understanding of kidney function and disease; >1600 participants from >30 countries posted >300 ideas and >500 comments covering all areas of kidney research. Smaller groups of investigators interrogated the postings and published a series of commentaries in CJASN. Additional review of the entire series identified six cross-cutting themes: (1) increase training and team science opportunities to maintain/expand the nephrology workforce, (2) develop novel technologies to assess kidney function, (3) promote human discovery research to better understand normal and diseased kidney function, (4) establish integrative models of kidney function to inform diagnostic and treatment strategies, (5) promote interventional studies that incorporate more responsive outcomes and improved trial designs, and (6) foster translation from clinical investigation to community implementation...
October 7, 2014: Clinical Journal of the American Society of Nephrology: CJASN
Benjamin M Bluml, Lindsay L Watson, Jann B Skelton, Patti Gasdek Manolakis, Kelly A Brock
OBJECTIVE: To improve key indicators of diabetes care by expanding a proven community-based model of care throughout high-risk areas in the United States. DESIGN: Observational, multisite, pre-post comparison study. SETTING: Federally qualified health centers, free clinics, employer worksites, community pharmacies, departments of health, physician offices, and other care facilities in 25 communities in 17 states from June 2011 through January 2013...
September 2014: Journal of the American Pharmacists Association: JAPhA
Sharon E Connor, Margie E Snyder, Zachary J Snyder, Karen Pater Steinmetz
OBJECTIVE: The purpose of this report is to characterize the patient population served by the Grace Lamsam Pharmacy Program and to describe program outcomes. METHODS: A chart review was conducted for all patients (n=100) participating in the Grace Lamsam Pharmacy Program from January 1, 2007 to February 6, 2008. The primary outcome data collected were the medication related problems (unnecessary drug therapy, needs additional drug therapy, ineffective drug therapy, dosage too low, dosage too high, adverse drug reaction, noncompliance, and needs different drug product) identified by pharmacists, the number and type of pharmacist interventions made, estimated cost savings from perspective of the patient and clinical data (hemoglobin A1C, blood pressure measurements, and LDL-C) for patients with diabetes, hypertension, and hyperlipidemia, respectively...
April 2009: Pharmacy Practice
Valérie Santschi, Arnaud Chiolero, April L Colosimo, Robert W Platt, Patrick Taffé, Michel Burnier, Bernard Burnand, Gilles Paradis
BACKGROUND: Control of blood pressure (BP) remains a major challenge in primary care. Innovative interventions to improve BP control are therefore needed. By updating and combining data from 2 previous systematic reviews, we assess the effect of pharmacist interventions on BP and identify potential determinants of heterogeneity. METHODS AND RESULTS: Randomized controlled trials (RCTs) assessing the effect of pharmacist interventions on BP among outpatients with or without diabetes were identified from MEDLINE, EMBASE, CINAHL, and CENTRAL databases...
2014: Journal of the American Heart Association
Michael P Conley, Christine Chim, Chelsea E Magee, Daniel J Sullivan
The prevalence of diabetes in the United States is increasing and so is the need to provide diabetes care. Given the time commitment and complexity of diabetes management, an interdisciplinary approach is recommended. Pharmacists are integral members of the diabetes care team because of their accessibility and expertise in medication management. Pharmacists are receiving specialized training and becoming more involved in direct patient care through collaborative practice opportunities such as medication therapy management and collaborative drug therapy management...
March 2014: Current Diabetes Reports
Helena Wigert, Ewa Wikström
BACKGROUND: Type 1 diabetes is one of the most frequent long-term endocrine childhood disorders and the Swedish National Diabetes Register for children states that adolescents (12-18 years) constitute the most vulnerable patient group in terms of metabolic control. The aim of this study was to examine how a multidisciplinary team functions when caring for adolescents with type 1 diabetes. METHODS: Qualitative interviews were performed with 17 health professionals at a Paediatric Diabetes Care Unit in a Swedish university hospital...
2014: BMC Research Notes
Jianzhen Zhang, Letitia Burridge, Kimberley A Baxter, Maria Donald, Michele M Foster, Samantha A Hollingworth, Robert S Ware, Anthony W Russell, Claire L Jackson
BACKGROUND: A new model of complex diabetes care is provided by a multidisciplinary team which incorporates general practitioner (GP) Clinical Fellows supported by an Endocrinologist and diabetes educator within a community-based general practice setting. This study evaluates the health and clinical benefits of the new model of care, assesses the acceptability of the model to patients, GPs and other health professionals, and examines the cost-effectiveness of the model. METHODS/DESIGN: The study is an open, non-inferiority randomised controlled trial with data collected at baseline, 6 and 12 months...
2013: Trials
Eva Boström, Asa Hörnsten, Berit Lundman, Hans Stenlund, Ulf Isaksson
AIM: To explore diabetes specialist nurses (DSNs)' perceptions of their role in terms of clarity, conflict and other psychosocial work aspects. METHODS: A cross-sectional study was conducted among DSNs in a county in northern Sweden. The DSNs answered the Nordic Questionnaire of Psychological and Social Factors at Work (QPS Nordic) about psychosocial aspects of their work. Statistical analysis compared DSNs with a reference group of different health professionals...
October 2013: Primary Care Diabetes
Richard S Beaser, Julie A Brown
Competence and skills in overcoming clinical inertia for diabetes treatment, and actually supporting and assisting the patient through adherence and compliance (as opposed to just reiterating what they "should" be doing and then assigning them the blame if they fail) is a key component to success in addressing diabetes, and to date it is a component that has received little formal attention. To improve and systematize diabetes care, it is critical to move beyond the "traditional" continuing medical education (CME) model of imparting knowledge as the entirety of the educational effort, and move toward a focus on Performance Improvement CME...
April 2013: American Journal of Preventive Medicine
Camila Risso de Barros, Adriana Cezaretto, Emanuel Péricles Salvador, Tainá Carvalho dos Santos, Antonela Siqueira-Catania, Sandra R G Ferreira
The objective this study was to describe the methodology and implementation of lifestyle change program in individuals at cardiometabolic risk seen at the public health system in Sao Paulo. The Programa de Prevenção de Diabetes Mellitus (PDM) aims at improving the overall metabolic profile of individuals with prediabetes or metabolic syndrome without diabetes; its goals were > 5% weight loss, dietary fiber intake > 20 g per day, saturated fatty acids intake < 10% per day, and > 150 minutes of physical activity per week...
February 2013: Arquivos Brasileiros de Endocrinologia e Metabologia
Dan Kent, Gail D'Eramo Melkus, Patricia Mickey W Stuart, June M McKoy, Patti Urbanski, Suzanne Austin Boren, Lola Coke, Janis E Winters, Neil L Horsley, Dawn Sherr, Ruth Lipman
People with diabetes are at risk of developing complications that contribute to substantial morbidity and mortality. In 2011, the American Association of Diabetes Educators convened an invitational Reducing Risks Symposium, during which an interdisciplinary panel of 11 thought leaders examined current knowledge about the reduction and prevention of diabetes-related risks and translated evidence into diabetes care and self-management education. Symposium participants reviewed findings from the literature and engaged in a moderated roundtable discussion...
April 2013: Population Health Management
Margaret Zacharin, Jean Pierre Chanoine, Fernando Cassorla, Stuart Brink, Ragnar Hanas, Hugo L Fideleff, Abiola Oduwole, Nalini Shah, Ze'ev Hochberg
On behalf of the Global Pediatric Endocrinology and Diabetes group, the authors provide a perspective on the rights of a child as enshrined in the United Nations Convention on the Rights of the Child (1989) concerning the care of pediatric endocrine disorders and diabetes mellitus, throughout the world, with particular reference to care in resource-constrained settings. In this article, we define the spectrum of health care needs of the child with an endocrine disorder and how they may be addressed, in terms of education, research, and development of sustainable programs for improved health outcomes...
February 2013: Pediatrics
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