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management of diabetes in primary care

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https://www.readbyqxmd.com/read/29789318/impact-of-a-pharmacist-physician-collaborative-care-model-on-patient-outcomes-and-health-services-utilization
#1
Gary R Matzke, Leticia R Moczygemba, Karen J Williams, Michael J Czar, William T Lee
PURPOSE: The impact of a pharmacist-physician collaborative care model on patient outcomes and health services utilization is described. METHODS: Six hospitals from the Carilion Clinic health system in southwest Virginia, along with 22 patient-centered medical home (PCMH) practices affiliated with Carilion Clinic, participated in this project. Eligibility criteria included documented diagnosis of 2 or more of the 7 targeted chronic conditions (congestive heart failure, hypertension, hyperlipidemia, diabetes mellitus, asthma, chronic obstructive pulmonary disease, and depression), prescriptions for 4 or more medications, and having a primary care physician in the Carilion Clinic health system...
May 22, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29788908/perceptions-of-insulin-use-in-type-2-diabetes-in-primary-care-a-thematic-synthesis
#2
Kathy Ellis, Henrietta Mulnier, Angus Forbes
BACKGROUND: Increasing numbers of patients with type 2 diabetes mellitus are progressing to insulin therapy, and despite its potency many such individuals still have suboptimal glycaemic control. Insulin initiation and intensification is now often conducted by Practice Nurses and General Practitioners in many parts of the UK. Therefore, gaining insight into perspectives of patients and primary care clinicians is important in determining self-management and engagement with insulin. A thematic synthesis of studies was conducted exploring the views and experiences of people with type 2 diabetes and of healthcare professionals on insulin use and management in the context of primary care...
May 22, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29784635/acceptability-of-an-mhealth-app-intervention-for-persons-with-type-2-diabetes-and-its-associations-with-initial-self-management-randomized-controlled-trial
#3
Astrid Torbjørnsen, Milada Cvancarova Småstuen, Anne Karen Jenum, Eirik Årsand, Lis Ribu
BACKGROUND: Mobile health interventions are increasingly used in health care. The level of acceptability may indicate whether and how such digital solutions will be used. OBJECTIVE: This study aimed to explore associations between the level of acceptability of a mobile diabetes app and initial ability of self-management for patients with type 2 diabetes. METHODS: Participants with type 2 diabetes were recruited from primary health care settings to a 3-armed randomized controlled trial in the Norwegian study in the RENEWING HEALTH project...
May 21, 2018: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/29784059/diabetes-intervention-accentuating-diet-and-enhancing-metabolism-diadem-i-a-randomised-controlled-trial-to-examine-the-impact-of-an-intensive-lifestyle-intervention-consisting-of-a-low-energy-diet-and-physical-activity-on-body-weight-and-metabolism-in-early
#4
Shahrad Taheri, Odette Chagoury, Hadeel Zaghloul, Sara Elhadad, Salma Hayder Ahmed, Omar Omar, Sherryl Payra, Salma Ahmed, Neda El Khatib, Rasha Abou Amona, Katie El Nahas, Matthew Bolton, Henem Chaar, Noor Suleiman, Amin Jayyousi, Mahmoud Zirie, Ibrahim Janahi, Wahiba Elhag, Abdulla Alnaama, Abduljaleel Zainel, Dahlia Hassan, Tim Cable, Mary Charlson, Martin Wells, Abdulla Al-Hamaq, Samya Al-Abdulla, Abdul Badi Abou-Samra
BACKGROUND: Type 2 diabetes mellitus (T2DM) and obesity are syndemic and will have a significant impact on affected individuals and healthcare services worldwide. Evidence shows that T2DM remission can be achieved with significant weight loss in those who are younger with early diabetes and requiring fewer medications for glycaemic control. DIADEM-I aims to examine the impact of an intensive lifestyle intervention (ILI) using a low-energy diet (LED) meal replacement approach combined with physical activity in younger individuals with early T2DM...
May 21, 2018: Trials
https://www.readbyqxmd.com/read/29780030/effect-of-multimorbidity-on-survival-of-patients-diagnosed-with-heart-failure-a-retrospective-cohort-study-in-singapore
#5
Palvinder Kaur, Nakul Saxena, Alex Xiaobin You, Raymond C C Wong, Choon Pin Lim, Seet Yoong Loh, Pradeep Paul George
OBJECTIVE: Multimorbidity in patients with heart failure (HF) results in poor prognosis and is an increasing public health concern. We aim to examine the effect of multimorbidity focusing on type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) on all-cause and cardiovascular disease (CVD)-specific mortality among patients diagnosed with HF in Singapore. DESIGN: Retrospective cohort study. SETTING: Primary and tertiary care in three (out of six) Regional Health Systems in Singapore...
May 20, 2018: BMJ Open
https://www.readbyqxmd.com/read/29777519/combination-glucose-lowering-therapy-plans-in-t2dm-case-based-considerations
#6
REVIEW
Lawrence Blonde, Susana Dipp, Daniel Cadena
Type 2 diabetes mellitus (T2DM) is a complex disease, and while lifestyle interventions remain the cornerstone of therapy, most patients will also require pharmacotherapy. Current diabetes treatment guidelines and algorithms recommend an individualized approach to setting glycemic goals and selecting treatment. Although a single antihyperglycemic agent may be appropriate as the initial T2DM pharmacotherapy, the progressive nature of the disease due to declining pancreatic β-cell function will result in the vast majority of T2DM patients eventually requiring two or more antihyperglycemic agents...
May 18, 2018: Advances in Therapy
https://www.readbyqxmd.com/read/29776663/barriers-and-facilitators-to-diabetes-self-management-in-a-primary-care-setting-patient-perspectives
#7
Rahul Khairnar, Khalid M Kamal, Vincent Giannetti, Nilanjana Dwibedi, Jamie McConaha
BACKGROUND: Diabetes self-management (DSM) is a key element in the overall management of type-2 diabetes (T2DM). Identifying barriers and facilitators to DSM and addressing them is a critical step in achieving improved health outcomes in this population. OBJECTIVE: To assess patient reported barriers and facilitators to self-management of T2DM in a primary care setting. METHODS: This cross sectional study combined patient survey data with electronic medical record (EMR) data...
May 9, 2018: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/29775774/hospital-admissions-2000-2014-a-retrospective-analysis-of-288-096-events-in-patients-with-dementia
#8
Catarina Bernardes, João Massano, Alberto Freitas
INTRODUCTION: Dementia is a leading cause of disability worldwide. It is associated with an increased risk of hospitalization, imposing a significant burden on healthcare systems. The evidence on the long-term evolution of this issue and broadly on healthcare systems is currently limited. This study aims to describe the hospitalizations of people who received a diagnosis of dementia admitted to public general hospitals in a western European country with universal health coverage, over more than a decade...
May 8, 2018: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29775079/improved-glycemic-control-with-minimal-change-in-medication-regimen-complexity-in-a-pharmacist-endocrinologist-diabetes-intense-medical-management-dimm-tune-up-clinic
#9
Candis M Morello, Taylor Rotunno, John Khoan, Jan D Hirsch
BACKGROUND: Gaining glycemic control in patients with type 2 diabetes (T2D) usually requires more complicated medication regimens. Increased medication regimen complexity (MRC) negatively impacts adherence and clinical outcomes. OBJECTIVE: Compare MRC change in patients with uncontrolled T2D referred to a collaborative pharmacist-endocrinologist Diabetes Intense Medical Management (DIMM) clinic "tune up" model versus similar patients receiving usual primary care provider (PCP) care over 6 months...
May 1, 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29773539/effectiveness-of-text-message-based-diabetes-self-management-support-programme-sms4bg-two-arm-parallel-randomised-controlled-trial
#10
Rosie Dobson, Robyn Whittaker, Yannan Jiang, Ralph Maddison, Matthew Shepherd, Catherine McNamara, Richard Cutfield, Manish Khanolkar, Rinki Murphy
OBJECTIVE: To determine the effectiveness of a theoretically based and individually tailored, text message based, diabetes self management support intervention (SMS4BG) in adults with poorly controlled diabetes. DESIGN: Nine month, two arm, parallel randomised controlled trial. SETTING: Primary and secondary healthcare services in New Zealand. PARTICIPANTS: 366 participants aged 16 years and over with poorly controlled type 1 or type 2 diabetes (HbA1c ≥65 mmol/mol or 8%) randomised between June 2015 and November 2016 (n=183 intervention, n=183 control)...
May 17, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29771897/is-general-practice-identification-of-prior-cardiovascular-disease-at-the-time-of-cvd-risk-assessment-accurate-and-does-it-matter
#11
Sue Wells, Katrina Poppe, Vanessa Selak, Andrew Kerr, Romana Pylypchuk, Billy Wu, Wing Cheuk Chan, Corina Grey, Suneela Mehta, Dudley Gr Gentles, Rod Jackson
AIMS: To determine the accuracy of general practice recording of prior cardiovascular disease (CVD) at the time of CVD risk assessment and whether recording impacts on CVD management. METHODS: Prior CVD status entered at the time of a first CVD risk assessment from 2002-2015 was compared to prior ischaemic CVD hospitalisations from national datasets using anonymous linkage with an encrypted National Health Index identifier. Clinical factors associated with inaccurate recording of prior events were identified using multivariable logistic regression...
May 18, 2018: New Zealand Medical Journal
https://www.readbyqxmd.com/read/29768945/pharmacist-impact-on-treatment-intensification-and-hemoglobin-a-1c-in-patients-with-type-2-diabetes-mellitus-at-an-academic-health-center
#12
Kevin Cowart, Karen Sando
BACKGROUND: Achievement of treatment goals for patients with type 2 diabetes mellitus (T2DM) is suboptimal. This is in part driven by a lack of treatment intensification when warranted, termed "clinical inertia." OBJECTIVES: To investigate time to treatment intensification and changes in A1C among pharmacist-physician managed (PPM) patients compared to usual medical care (UMC) in patients with T2DM. METHODS: Retrospective matched cohort study at 2 academic family medicine clinics...
January 1, 2018: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29768354/feasibility-and-effectiveness-of-electrochemical-dermal-conductance-measurement-for-the-screening-of-diabetic-neuropathy-in-primary-care-decoding-study-dermal-electrochemical-conductance-in-diabetic-neuropathy-rationale-and-design
#13
Juan J Cabré, Teresa Mur, Bernardo Costa, Francisco Barrio, Charo López-Moya, Ramon Sagarra, Montserrat García-Barco, Jesús Vizcaíno, Immaculada Bonaventura, Nicolau Ortiz, Gemma Flores-Mateo
Diabetes mellitus is the leading cause of polyneuropathy in the Western world. Diabetic neuropathy is a frequent complication of diabetes and may have great clinical transcendence due to pain and possible ulceration of the lower extremities. It is also a relevant cause of morbidity and mortality in patients with diabetes. Although the cause of polyneuropathy in patients with diabetes is only partially known, it has been associated with chronic hyperglycemia suggesting the possible etiopathogenic implication of advanced glycosylation end products...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29764248/interprofessional-collaboration-and-the-care-and-management-of-type-2-diabetic-patients-in-the-middle-east-a-systematic-review
#14
J M Johnson, R Carragher
The World Health Organization has ranked the Middle East (ME) as the second most prevalent region globally for type 2 diabetes. Currently, treatment options initiated by physicians focus mainly on pharmaceuticals; however, lifestyle factors also have a tremendous impact on a patient's wellness or illness. A potential solution to this issue is to use an interprofessional team approach when caring for this patient population. The purpose of this systematic review is to look at the present literature involving the use of an interprofessional team approach to the care and maintenance of people with type 2 diabetes in the ME...
May 15, 2018: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/29763267/top-20-research-studies-of-2017-for-primary-care-physicians
#15
Mark H Ebell, Roland Grad
Based on systematic surveillance of more than 110 medical journals, 247 studies met criteria as POEMs (patient-oriented evidence that matters) in 2017. Members of the Canadian Medical Association identified 20 of these POEMs as most relevant to practice. This article reviews the clinical questions and bottom-line answers from these studies. Blood pressure should be measured after a period of rest, using a bare arm, and orthostatic blood pressure is more predictive when measured after one minute of standing rather than three minutes...
May 1, 2018: American Family Physician
https://www.readbyqxmd.com/read/29762737/postnatal-lifestyle-intervention-for-overweight-women-with-previous-gestational-diabetes-a-randomized-controlled-trial
#16
Valerie A Holmes, Claire R Draffin, Chris C Patterson, Loraine Francis, Joanne Irwin, Mae McConnell, Brid Farrell, Sarah F Brennan, Oonagh McSorley, Amy C Wotherspoon, Mark Davies, David R McCance
Background: Gestational diabetes mellitus (GDM) is associated with a 7-fold increased lifetime risk of type 2 diabetes. Excessive gestational weight gain and postpartum weight retention are established predictors of long-term obesity. Objective: To determine the impact of a postnatal lifestyle intervention programme for overweight women with previous gestational diabetes mellitus (PAIGE). Design: Postnatal overweight women with previous GDM participated in a multi-center randomized controlled trial between June 2013 and December 2014...
May 11, 2018: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29760272/physical-activity-assessment-and-counseling-in-quebec-family-medicine-groups
#17
Aurélie Baillot, Jean-Patrice Baillargeon, Alex Paré, Thomas G Poder, Christine Brown, Marie-France Langlois
OBJECTIVE: To determine how often primary health care providers (PHCPs) in family medicine groups (FMGs) assess physical activity (PA) levels, provide PA counseling (PAC), and refer patients to exercise professionals; to describe patients' PA levels, physical fitness, and satisfaction regarding their PA management in FMGs; to describe available PA materials in FMGs and PHCPs' PAC self-efficacy and PA knowledge; and to identify characteristics of patients and PHCPs that determine the assessment of PA and PAC provided by PHCPs...
May 2018: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29760025/association-of-the-social-determinants-of-health-with-quality-of-primary-care
#18
Alan Katz, Dan Chateau, Jennifer E Enns, Jeff Valdivia, Carole Taylor, Randy Walld, Scott McCulloch
PURPOSE: In primary care, there is increasing recognition of the difficulty of treating patients' immediate health concerns when their overall well-being is shaped by underlying social determinants of health. We assessed the association of social complexity factors with the quality of care patients received in primary care settings. METHODS: Eleven social complexity factors were defined using administrative data on poverty, mental health, newcomer status, and justice system involvement from the Manitoba Population Research Data Repository...
May 2018: Annals of Family Medicine
https://www.readbyqxmd.com/read/29756070/reducing-severe-hypoglycaemia-in-hospitalised-patients-with-diabetes-early-outcomes-of-standardised-reporting-and-management
#19
Katherine A Araque, Deepak K Kadayakkara, Nino Gigauri, Diane Sheehan, Sachin Majumdar, Gregory Buller, Clare A Flannery
Background: Severe hypoglycaemic events (HGEs) in hospitalised patients are associated with poor outcomes and prolonged hospitalization. Systematic, coordinated care is required for acute management and prevention of HGEs; however, studies evaluating quality control efforts are scarce. Objective: To investigate the effectiveness of system-based interventions to improve management response to HGEs. Methods: System-based interventions were designed and implemented following a root cause analysis of HGE in adult patients with diabetes from two general medical wards with the highest incidence of HGE...
2018: BMJ Open Quality
https://www.readbyqxmd.com/read/29755046/the-church-bridge-project-an-academic-community-perspective-of-a-church-based-weight-management-pilot-intervention-among-young-adult-african-americans
#20
Jennifer L Lemacks, Robert E James, Laurie Abbott, Hwanseok Choi, Ashley Parker, Ashley Bryant, Penny A Ralston, Annither Gilner Rigsby, Patricia Gilner
BACKGROUND: Churches are effective community partners and settings to address weight management among African Americans. There is limited information on the use of churches to reach young adult populations and church collaborations with primary care clinics. OBJECTIVES: The Church Bridge Project represents a community-academic partnership that presents the recruitment process of a church-based weight management intervention and describes baseline data of participants recruited from churches and primary care providers...
2018: Progress in Community Health Partnerships: Research, Education, and Action
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