scholarly journals The management of type 2 diabetes care: the challenge within primary care

2008 ◽  
Vol 25 (1) ◽  
pp. 28-36 ◽  
Author(s):  
F Mold ◽  
A While ◽  
A Forbes
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Diabetes Care

scholarly journals Comparative Effectiveness of a Technology-Facilitated Depression Care Management Model in Safety-Net Primary Care Patients With Type 2 Diabetes: 6-Month Outcomes of a Large Clinical Trial (Preprint)

2017 ◽  
Author(s):  
Shinyi Wu ◽  
Kathleen Ell ◽  
Haomiao Jin ◽  
Irene Vidyanti ◽  
Chih-Ping Chou ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Usual Care ◽  
Diabetes Care ◽  
Functional Disability ◽  
Safety Net ◽  
P Value ◽  
Depression Care ◽  
Care Model

BACKGROUND Comorbid depression is a significant challenge for safety-net primary care systems. Team-based collaborative depression care is effective, but complex system factors in safety-net organizations impede adoption and result in persistent disparities in outcomes. Diabetes-Depression Care-management Adoption Trial (DCAT) evaluated whether depression care could be significantly improved by harnessing information and communication technologies to automate routine screening and monitoring of patient symptoms and treatment adherence and allow timely communication with providers. OBJECTIVE The aim of this study was to compare 6-month outcomes of a technology-facilitated care model with a usual care model and a supported care model that involved team-based collaborative depression care for safety-net primary care adult patients with type 2 diabetes. METHODS DCAT is a translational study in collaboration with Los Angeles County Department of Health Services, the second largest safety-net care system in the United States. A comparative effectiveness study with quasi-experimental design was conducted in three groups of adult patients with type 2 diabetes to compare three delivery models: usual care, supported care, and technology-facilitated care. Six-month outcomes included depression and diabetes care measures and patient-reported outcomes. Comparative treatment effects were estimated by linear or logistic regression models that used generalized propensity scores to adjust for sampling bias inherent in the nonrandomized design. RESULTS DCAT enrolled 1406 patients (484 in usual care, 480 in supported care, and 442 in technology-facilitated care), most of whom were Hispanic or Latino and female. Compared with usual care, both the supported care and technology-facilitated care groups were associated with significant reduction in depressive symptoms measured by scores on the 9-item Patient Health Questionnaire (least squares estimate, LSE: usual care=6.35, supported care=5.05, technology-facilitated care=5.16; P value: supported care vs usual care=.02, technology-facilitated care vs usual care=.02); decreased prevalence of major depression (odds ratio, OR: supported care vs usual care=0.45, technology-facilitated care vs usual care=0.33; P value: supported care vs usual care=.02, technology-facilitated care vs usual care=.007); and reduced functional disability as measured by Sheehan Disability Scale scores (LSE: usual care=3.21, supported care=2.61, technology-facilitated care=2.59; P value: supported care vs usual care=.04, technology-facilitated care vs usual care=.03). Technology-facilitated care was significantly associated with depression remission (technology-facilitated care vs usual care: OR=2.98, P=.04); increased satisfaction with care for emotional problems among depressed patients (LSE: usual care=3.20, technology-facilitated care=3.70; P=.05); reduced total cholesterol level (LSE: usual care=176.40, technology-facilitated care=160.46; P=.01); improved satisfaction with diabetes care (LSE: usual care=4.01, technology-facilitated care=4.20; P=.05); and increased odds of taking an glycated hemoglobin test (technology-facilitated care vs usual care: OR=3.40, P<.001). CONCLUSIONS Both the technology-facilitated care and supported care delivery models showed potential to improve 6-month depression and functional disability outcomes. The technology-facilitated care model has a greater likelihood to improve depression remission, patient satisfaction, and diabetes care quality.

824-P: Quality of Behavior Change Action Plans Created in Primary Care Settings as a Tool for Patient Involvement in Type 2 Diabetes Care

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 824-P
Author(s):  
PERNILLE H. KJAER ◽  
MANSI DEDHIA ◽  
JOSÉ PARRA ◽  
LAWRENCE FISHER ◽  
MICHAEL B. POTTER ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Behavior Change ◽  
Diabetes Care ◽  
Patient Involvement ◽  
Action Plans ◽  
Primary Care Settings

Patient Perspectives on Discharge from Specialist Type 2 Diabetes Care Back to Primary Care: A Qualitative Study

2014 ◽  
Vol 38 (3) ◽  
pp. 191-197 ◽  
Author(s):  
Heidi Dutton ◽  
Margo S. Rowan ◽  
Clare Liddy ◽  
Julie Maranger ◽  
Teik Chye Ooi ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Qualitative Study ◽  
Diabetes Care ◽  
Patient Perspectives

Type 2 diabetes in primary care

2017 ◽  
Vol 10 (12) ◽  
pp. 705-712
Author(s):  
Hermione Price
Keyword(s):  
Quality Of Life ◽  
Type 2 Diabetes ◽  
Primary Care ◽  
Diabetes Care ◽  
Cost Savings ◽  
Patients With Diabetes ◽  
The Uk

Type 2 diabetes is common, and its prevalence is increasing. Most patients with type 2 diabetes are managed entirely in primary care. The National Diabetes Audit has provided evidence of large variations across the UK in the standard of available care in the community for patients with diabetes. Good diabetes care can prevent or delay complications and, as well as cost savings, this results in a better quality of life for patients. This article provides an overview of type 2 diabetes and the National Institute for Health and Care Excellence guidance for treatment proposed in 2015.

scholarly journals A Qualitative Assessment of Educational Opportunities for Primary Care Providers in Type 2 Diabetes Care

2009 ◽  
Vol 22 (4) ◽  
pp. 248-253 ◽  
Author(s):  
K. N. Cytryn ◽  
W. T. Garvey ◽  
S. M. Hayes ◽  
L. Cann ◽  
S. Murray
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Diabetes Care ◽  
Primary Care Providers ◽  
Educational Opportunities ◽  
Qualitative Assessment ◽  
Care Providers

scholarly journals The Use of Antidepressants, Anxiolytics, and Hypnotics in People with Type 2 Diabetes and Patterns Associated with Use: The Hoorn Diabetes Care System Cohort

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
R. Mast ◽  
S. P. Rauh ◽  
L. Groeneveld ◽  
A. D. Koopman ◽  
J. W. J. Beulens ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Primary Care ◽  
Type 2 Diabetes Mellitus ◽  
Diabetes Care ◽  
Sociodemographic Characteristics ◽  
Prescription Data ◽  
Primary Care System ◽  
Care System

Objective. With depression being present in approximately 20% of people with type 2 diabetes mellitus (T2DM), we expect equally frequent prescription of antidepressants, anxiolytics, and hypnotics. Nevertheless, prescription data in people with T2DM is missing and the effect of depression on glycaemic control is contradictory. The aim of this study was to assess the prevalence of antidepressants, anxiolytics, and/or hypnotics use in a large, managed, primary care system cohort of people with T2DM and to determine the sociodemographic characteristics, comorbidities, T2DM medication, and metabolic control associated with its use. Method. The prevalence of antidepressants, anxiolytics, and/or hypnotics use in the years 2007–2012 was assessed in the Hoorn Diabetes Care System Cohort from the Netherlands. Results. From the 7016 people with T2DM, 500 people (7.1%) used antidepressants only, 456 people (6.5%) used anxiolytics and/or hypnotics only, and 254 people (3.6%) used a combination. Conclusion. We conclude that in our managed, primary care system 17% of all people with T2DM used antidepressants, anxiolytics, and/or hypnotics. Users of antidepressants, anxiolytics, and/or hypnotics were more often female, non-Caucasian, lower educated, and more often treated with insulin.

scholarly journals The Hoorn Diabetes Care System (DCS) cohort. A prospective cohort of persons with type 2 diabetes treated in primary care in the Netherlands

BMJ Open ◽  
2017 ◽  
Vol 7 (5) ◽  
pp. e015599 ◽  
Author(s):  
Amber AWA van der Heijden ◽  
Simone P Rauh ◽  
Jacqueline M Dekker ◽  
Joline W Beulens ◽  
Petra Elders ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
The Netherlands ◽  
Diabetes Care ◽  
Prospective Cohort ◽  
Care System
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