Web-based support for patients with type 2 diabetes in West Norfolk primary care trust. A district model of diabetes care

2005 ◽  
Vol 22 (8) ◽  
pp. 302-302
Author(s):  
Jacqueline Kingston ◽  
2017 ◽  
Author(s):  
Shinyi Wu ◽  
Kathleen Ell ◽  
Haomiao Jin ◽  
Irene Vidyanti ◽  
Chih-Ping Chou ◽  
...  

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.


2008 ◽  
Vol 25 (1) ◽  
pp. 28-36 ◽  
Author(s):  
F Mold ◽  
A While ◽  
A Forbes

2013 ◽  
Vol 13 (1) ◽  
Author(s):  
Michael van Vugt ◽  
Maartje de Wit ◽  
Steven H Hendriks ◽  
Yvonne Roelofsen ◽  
Henk JG Bilo ◽  
...  

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 824-P
Author(s):  
PERNILLE H. KJAER ◽  
MANSI DEDHIA ◽  
JOSÉ PARRA ◽  
LAWRENCE FISHER ◽  
MICHAEL B. POTTER ◽  
...  

2014 ◽  
Vol 38 (3) ◽  
pp. 191-197 ◽  
Author(s):  
Heidi Dutton ◽  
Margo S. Rowan ◽  
Clare Liddy ◽  
Julie Maranger ◽  
Teik Chye Ooi ◽  
...  

2017 ◽  
Vol 10 (12) ◽  
pp. 705-712
Author(s):  
Hermione Price

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.


2009 ◽  
Vol 22 (4) ◽  
pp. 248-253 ◽  
Author(s):  
K. N. Cytryn ◽  
W. T. Garvey ◽  
S. M. Hayes ◽  
L. Cann ◽  
S. Murray

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