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management of diabetes in primary care

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https://www.readbyqxmd.com/read/29138274/five-year-effectiveness-of-the-multidisciplinary-risk-assessment-and-management-program-for-primary-care-patients-with-type-2-diabetes-mellitus%C3%A2-ramp-dm-on-dm-related-complications-and-health-service-uses-a-population-based-and-propensity-matched-cohort-study
#1
Eric Yuk Fai Wan, Colman Siu Cheung Fung, Fang Fang Jiao, Esther Yee Tak Yu, Weng Yee Chin, Daniel Yee Tak Fong, Carlos King Ho Wong, Anca Ka Chun Chan, Karina Hiu Yen Chan, Ruby Lai Ping Kwok, Cindy Lo Kuen Lam
OBJECTIVE: To evaluate the 5-year effectiveness of a multidisciplinary Risk Assessment and Management Program for primary care patients with type 2 Diabetes Mellitus (RAMP-DM)‎. RESEARCH DESIGN AND METHODS: A 5-year prospective cohort study was conducted with 121,584 Chinese primary care patients with type 2 DM who were recruited between August 2009 and June 2011. Missing data were dealt with multiple imputations. After excluding patients with prior DM-related complications and one-to-one propensity score matching on all patient characteristics, 26,718 RAMP-DM participants and 26,718 matched usual-care patients were followed up for a median time of 4...
November 14, 2017: Diabetes Care
https://www.readbyqxmd.com/read/29137504/avoidable-hospital-admissions-from-diabetes-complications-in-japan-singapore-hong-kong-and-communities-outside-beijing
#2
Jianchao Quan, Huyang Zhang, Deanette Pang, Brian K Chen, Janice M Johnston, Weiyan Jian, Zheng Yi Lau, Toshiaki Iizuka, Gabriel M Leung, Hai Fang, Kelvin B Tan, Karen Eggleston
Improving the quality of primary care may reduce avoidable hospital admissions. Avoidable admissions for conditions such as diabetes are used as a quality metric in the Health Care Quality Indicators of the Organization for Economic Cooperation and Development (OECD). Using the OECD indicators, we compared avoidable admission rates and spending for diabetes-related complications in Japan, Singapore, Hong Kong, and rural and peri-urban Beijing, China, in the period 2008-14. We found that spending on diabetes-related avoidable hospital admissions was substantial and increased from 2006 to 2014...
November 2017: Health Affairs
https://www.readbyqxmd.com/read/29129980/quality-of-care-of-patients-with-diabetes-in-primary-health-services-in-southeast-brazil
#3
Christiane Chaves Augusto Leite Simão, Mônica Barros Costa, Fernando Antônio Basile Colugnati, Elaine Amaral de Paula, Chislene Pereira Vanelli, Rogério Baumgratz de Paula
Background: Diabetes management involves multiple aspects that go beyond drug therapy as a way of providing high quality care. The objective of this study was to describe quality of care indicators for individuals with diabetes in southeast Brazil and to explore associations among these indicators. Methods: In this cross-sectional, observational study, health care providers filled out a questionnaire addressing health care structure and processes at 14 primary health care units (PHCUs)...
2017: Journal of Environmental and Public Health
https://www.readbyqxmd.com/read/29122782/study-protocol-for-the-cities-changing-diabetes-programme-a-global-mixed-methods-approach
#4
A David Napier, John J Nolan, Malene Bagger, Louise Hesseldal, Anna-Maria Volkmann
INTRODUCTION: Urban living has been shown to affect health in various ways. As the world is becoming more urbanised and almost two-thirds of people with diabetes now live in cities, research into the relationship between urban living, health and diabetes is key to improving the lives of many. The majority of people with diabetes have type 2 diabetes, a subset linked to overweight and obesity, decreased physical activity and unhealthy diets. Diabetes has significant consequences for those living with the condition as well as their families, relationships and wider society...
November 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/29116993/development-of-a-diabetes-mellitus-knowledge-resource-for-clinical-decision-support-assisting-primary-care-physicians-with-work-related-issues
#5
Anna Allen, Laura Welch, Katherine Kirkland, Douglas Trout, Sherry Baron
OBJECTIVE: The aim of this study was to describe the process by which a group of subject matter experts (SMEs) in the area of occupational health and primary care developed a clinical decision support (CDS) tool addressing work-related issues, which are important in the care of patients with diabetes mellitus (DM). The CDS is intended for primary care clinicians caring for employed adults with DM. METHODS: The SME's selected guidelines for the management of DM in working adults, reviewed pertinent literature, and developed specific recommendations for action in the clinical setting...
November 2017: Journal of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/29116992/enhancing-worker-health-through-clinical-decision-support-cds-an-introduction-to-a-compilation
#6
Margaret S Filios, Eileen Storey, Sherry Baron, Genevieve B Luensman, Richard N Shiffman
OBJECTIVE: This article outlines an approach to developing clinical decision support (CDS) for conditions related to work and health. When incorporated in electronic health records, such CDS will assist primary care providers (PCPs) care for working patients. METHODS: Three groups of Subject Matter Experts (SMEs) identified relevant clinical practice guidelines, best practices, and reviewed published literature concerning work-related asthma, return-to-work, and management of diabetes at work...
November 2017: Journal of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/29115072/emergency-department-visits-can-be-reduced-by-having-a-regular-doctor-for-adults-with-diabetes-mellitus-secondary-analysis-of-2013-korea-health-panel-data
#7
Clara Lee, Nak Jin Sung, Hyeong Seok Lim, Jae Ho Lee
Chronic diseases pose a major challenge to population health worldwide. Diabetes is a major chronic disease that is managed overwhelmingly in primary care. There is an increasing recognition of the role that primary care physicians play to achieve high-quality care for patients with diabetes. By analyzing 2013 Korean Health Panel data, the authors aimed to determine the current status of having a regular doctor (RD) for adults (aged 18 years or older) with diabetes. In addition, the association of having a RD with the experience of emergency department (ED) visits was determined in this study...
December 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29113634/pharmacy-diabetes-management-of-a-veteran-population-in-a-long-term-care-setting-a-program-evaluation
#8
Forest Hansen, Hilary Teeples, Jordan Csati, Suzanne M Gillespie
BACKGROUND: The benefits of an outpatient pharmacy diabetes clinic has been established, with improved patient outcomes and reduced total costs of care. We describe the benefits of an inpatient clinical pharmacy diabetes service within a Department of Veterans Affairs long-term care facility. METHODS: Patients were referred to the pharmacy diabetes monitoring program between February 2016 and August 2016. During this time, clinical pharmacy specialists managed all pharmacotherapy relating to diabetes care as well as all fingerstick monitoring frequencies and laboratory monitoring to achieve a prespecified, patient-specific A1C goal...
November 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/29109612/pilot-study-for-managing-complex-chronic-care-medicaid-patients-with-diabetes-using-a-mobile-health-application-achieves-triple-aim-improvement-in-a-primary-care-setting
#9
Marit L Bovbjerg, Jenney Lee, Rosa Wolff, Bobby Bangs, Michael A May
IN BRIEF Cost-effective innovations to improve health and health care in patients with complex chronic diseases are urgently needed. Mobile health (mHealth) remote monitoring applications (apps) are a promising technology to meet this need. This article reports on a study evaluating patients' use of a tablet device with an mHealth app and a cellular-enabled glucose meter that automatically uploaded blood glucose values to the app. Improvements were observed across all three components of the Patient Protection and Affordable Care Act's "triple aim...
October 2017: Clinical Diabetes: a Publication of the American Diabetes Association
https://www.readbyqxmd.com/read/29107565/rubber-stamp-templates-for-improving-clinical-documentation-a-paper-based-m-health-approach-for-quality-improvement-in-low-resource-settings
#10
Bernadette Kleczka, Anita Musiega, Grace Rabut, Phoebe Wekesa, Paul Mwaniki, Michael Marx, Pratap Kumar
BACKGROUND: The United Nations' Sustainable Development Goal #3.8 targets 'access to quality essential healthcare services'. Clinical practice guidelines are an important tool for ensuring quality of clinical care, but many challenges prevent their use in low-resource settings. Monitoring the use of guidelines relies on cumbersome clinical audits of paper records, and electronic systems face financial and other limitations. Here we describe a unique approach to generating digital data from paper using guideline-based templates, rubber stamps and mobile phones...
October 23, 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29102084/prevalence-awareness-treatment-and-control-of-hypertension-in-china-data-from-1%C3%A2-7-million-adults-in-a-population-based-screening-study-china-peace-million-persons-project
#11
Jiapeng Lu, Yuan Lu, Xiaochen Wang, Xinyue Li, George C Linderman, Chaoqun Wu, Xiuyuan Cheng, Lin Mu, Haibo Zhang, Jiamin Liu, Meng Su, Hongyu Zhao, Erica S Spatz, John A Spertus, Frederick A Masoudi, Harlan M Krumholz, Lixin Jiang
BACKGROUND: Hypertension is common in China and its prevalence is rising, yet it remains inadequately controlled. Few studies have the capacity to characterise the epidemiology and management of hypertension across many heterogeneous subgroups. We did a study of the prevalence, awareness, treatment, and control of hypertension in China and assessed their variations across many subpopulations. METHODS: We made use of data generated in the China Patient-Centered Evaluative Assessment of Cardiac Events (PEACE) Million Persons Project from Sept 15, 2014, to June 20, 2017, a population-based screening project that enrolled around 1·7 million community-dwelling adults aged 35-75 years from all 31 provinces in mainland China...
October 25, 2017: Lancet
https://www.readbyqxmd.com/read/29100717/primary-care-physician-perspectives-on-basal-insulin-initiation-and-maintenance-in-patients-with-type-2-diabetes-mellitus
#12
Samaneh Kalirai, Judith Stephenson, Magaly Perez-Nieves, Michael Grabner, Irene Hadjiyianni, Caroline Geremakis, Roy Daniel Pollom, Beverly Reed, Lawrence Fisher
AIMS: To describe primary care physicians' (PCPs) perceptions of patient reactions and concerns about insulin initiation and identify opportunities for increased support. METHODS: Cross-sectional, online survey of PCPs prescribing basal insulin to adults with type 2 diabetes mellitus (T2DM). PCPs were identified from administrative claims of a large commercial health plan and descriptive results of PCP responses were reported. RESULTS: PCPs (N=100) treated an average of 17 patients receiving insulin during a typical week...
October 31, 2017: Primary Care Diabetes
https://www.readbyqxmd.com/read/29094298/optimizing-glycemic-control-through-titration-of-insulin-glargine-100-u-ml-a-review-of-current-and-future-approaches-with-a-focus-on-asian-populations
#13
REVIEW
Chaicharn Deerochanawong, Shailendra Bajpai, I Made Pande Dwipayana, Zanariah Hussein, Maria Aileen Mabunay, Reynaldo Rosales, Shih-Tzer Tsai, Man Wo Tsang
Various data have demonstrated inadequate glycemic control amongst Asians with type 2 diabetes mellitus (T2DM), possibly on account of suboptimal titration of basal insulin-an issue which needs to be further examined. Here we review the available global and Asia-specific data on titration of basal insulin, with a focus on the use of insulin glargine 100 U/mL (Gla-100). We also discuss clinical evidence on the efficacy and safety of titrating Gla-100, different approaches to titration, including some of the latest technological advancements, and guidance on the titration of basal insulin from international and local Asian guidelines...
November 1, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/29089779/online-continuing-medical-education-as-a-key-link-for-successful-noncommunicable-disease-self-management-the-casalud%C3%A2-model
#14
Héctor Gallardo-Rincón, Rodrigo Saucedo-Martínez, Ricardo Mujica-Rosales, Evan M Lee, Amy Israel, Braulio Torres-Beltran, Úrsula Quijano-González, Elena Rose Atkinson, Pablo Kuri-Morales, Roberto Tapia-Conyer
PURPOSE: The purpose of this study is to evaluate how the benefits of online continuing medical education (CME) provided to health care professionals traveled along a patient "educational chain". In this study, the educational chain begins with the influence that CME can have on the quality of health care, with subsequent influence on patient knowledge, disease self-management, and disease biomarkers. METHODS: A total of 422 patients with at least one noncommunicable disease (NCD) treated in eight different Mexican public health clinics were followed over 3 years...
2017: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy
https://www.readbyqxmd.com/read/29080581/management-of-lipids-in-patients-with-diabetes
#15
REVIEW
Ngozi D Mbue, John E Mbue, Jane A Anderson
Abnormal lipids, sometimes referred to as diabetes dyslipidemia, is a common condition in patients with diabetes. With the increasing number of patients with abnormal lipids, especially those with type 2 diabetes, health care practitioners, including nurses, have to properly manage patients with diabetes as well as abnormal lipids. This article examines the pathophysiology of abnormal lipids, the management of abnormal lipids, and the lipid goals for patients with diabetes. Lastly, this article discusses pharmacologic and nonpharmacologic therapies and the role of primary care providers and nurses in the management of abnormal lipids...
December 2017: Nursing Clinics of North America
https://www.readbyqxmd.com/read/29078730/barriers-to-engagement-in-collaborative-care-treatment-of-uncontrolled-diabetes-in-a-safety-net-clinic
#16
Brittaney Belyeu, Lydia Chwastiak, Joan Russo, Meghan Kiefer, Kathy Mertens, Lisa Chew, Sara L Jackson
Purpose The purpose of the study was to evaluate patient factors associated with nonengagement in a Diabetes Collaborative Care Team (DCCT) program in a safety-net clinic. Methods The first 18 months of a multidisciplinary care, team-based diabetes care management program in a safety-net primary care clinic were studied. Nonengagement was defined as fewer than 2 visits with a team member during the 18 months of the program. Patients who did not engage in the program were compared with those who did engage on demographics, comorbid medical and psychiatric diagnoses, and cardiovascular risk factors, using univariate and multivariable analyses...
December 2017: Diabetes Educator
https://www.readbyqxmd.com/read/29070640/does-the-behavioural-type-specific-approach-for-type-2-diabetes-promote-changes-in-lifestyle-protocol-of-a-cluster-randomised-trial-in-japan
#17
Misa Adachi, Kazue Yamaoka, Mariko Watanabe, Asuka Nemoto, Toshiro Tango
INTRODUCTION: Type 2 diabetes (T2D) is a significant problem, and lifestyle modifications including self-management are important. We have developed a structured individual-based lifestyle education (SILE) programme for T2D. With attention now being paid to techniques to change behaviour, we recently developed a behavioural type-specific SILE (BETSILE) programme. We aimed to evaluate the effectiveness of the BETSILE programme compared with the SILE programme for reducing glycated haemoglobin (HbA1c) in patients with T2D and special behavioural types by a cluster randomised controlled trial...
October 24, 2017: BMJ Open
https://www.readbyqxmd.com/read/29067248/the-effect-of-text-message-support-on-diabetes-self-management-in-developing-countries-a-randomised-trial
#18
Josefien Van Olmen, Guy Kegels, Catherine Korachais, Jeroen de Man, Kristien Van Acker, Jean Clovis Kalobu, Maurits van Pelt, Grace Marie Ku, Heang Hen, Dominique Kanda, Billy Malombo, Christian Darras, François Schellevis
OBJECTIVE: mHealth interventions have the potential to facilitate self-management. This TEXT4DSM study implemented a mobile phone intervention in existing diabetes programmes in three low- and middle-income countries (Democratic Republic of Congo, Cambodia, and the Philippines). RESEARCH DESIGN AND METHODS: Sub-studies with a similar randomised controlled trial design were conducted in three different countries. Each sub-study included 480 adults with diabetes. Subjects were randomised to receive either routine care or routine care plus text message self-management support...
March 2017: Journal of Clinical & Translational Endocrinology
https://www.readbyqxmd.com/read/29067150/care-standards-for-non-alcoholic-fatty-liver-disease-in-the-united-kingdom-2016-a-cross-sectional-survey
#19
David A Sheridan, Guru Aithal, William Alazawi, Michael Allison, Quentin Anstee, Jeremy Cobbold, Shahid Khan, Andrew Fowell, Stuart McPherson, Philip N Newsome, Jude Oben, Jeremy Tomlinson, Emmanouil Tsochatzis
OBJECTIVE: Guidelines for the assessment of non-alcoholic fatty liver disease (NAFLD) have been published in 2016 by National Institute for Health and Care Excellence and European Associations for the study of the Liver-European Association for the study of Diabetes-European Association for the study of Obesity. Prior to publication of these guidelines, we performed a cross-sectional survey of gastroenterologists and hepatologists regarding NAFLD diagnosis and management. DESIGN: An online survey was circulated to members of British Association for the Study of the Liver and British Society of Gastroenterology between February 2016 and May 2016...
October 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/29062395/implementing-quality-indicators-for-diabetes-and-hypertension-in-family-medicine-in-slovenia
#20
Zalika Klemenc-Ketiš, Igor Švab, Antonija Poplas Susič
INTRODUCTION: A new form of family practices was introduced in 2011 through a pilot project introducing nurse practitioners as members of team and determining a set of quality indicators. The aim of this article was to assess the quality of diabetes and hypertension management. METHODS: We included all family medicine practices that were participating in the project in December 2015 (N=584). The following data were extracted from automatic electronic reports on quality indicators: gender and specialisation of the family physician, status (public servant/self-contracted), duration of participation in the project, region of Slovenia, the number of inhabitants covered by a family medicine practice, the name of IT provider, and levels of selected quality indicators...
October 2017: Zdravstveno Varstvo
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