Improving Timely Annual Ocular Examinations for Patients With Diabetes Mellitus in a Primary Care Office

Introduction There is a widening discrepancy between the increasing number of patients with diabetes mellitus and the health care resources available to manage these patients. Telemedicine has been used in a number of instances to improve and deliver health care where traditional care delivery methods may encounter difficulty. We conducted a cluster randomised controlled trial of telemedicine consultation to manage patients with diabetes mellitus. Methods Eleven primary care centres attached to one Veteran Administration tertiary care centre were randomised to provide patients with diabetes consultation referral either by usual consultation in diabetes clinic or telemedicine consultations via videoconference. Results Altogether, 199 patients were managed by telemedicine consultation and 83 by usual consultation. Patients in both groups showed a small decrease in haemoglobin A1c, with no statistical difference between the groups (telemedicine consultation −1.01% vs usual consultation −0.68%, p = 0.19). Surveys of patients and semi-structured interviews with primary care providers showed better response and satisfaction with telemedicine consultations. Discussion This study shows similar clinical outcomes as measured by glycaemic control for patients with diabetes mellitus having a specialist consultation using real-time telemedicine consultation as compared to in-clinic consultation. Telemedicine consultation was also associated with better patient and primary care provider satisfaction.

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The Prevalence and Risk for Herpes Zoster Infection in Adult Patients With Diabetes Mellitus in the Canadian Primary Care Sentinel Surveillance Network

Canadian Journal of Diabetes ◽

10.1016/j.jcjd.2017.10.060 ◽

2018 ◽

Vol 42 (5) ◽

pp. 465-469 ◽

Cited By ~ 8

Author(s):

John A. Queenan ◽

Pendar Farahani ◽

Behrouz Ehsani-Moghadam ◽

Richard V. Birtwhistle

Keyword(s):

Diabetes Mellitus ◽

Primary Care ◽

Herpes Zoster ◽

Sentinel Surveillance ◽

Adult Patients ◽

Herpes Zoster Infection ◽

Surveillance Network ◽

Patients With Diabetes

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Implementation of a Diabetes Management Program for Patients in a Rural Primary Care Office

Journal of Primary Care & Community Health ◽

10.1177/2150131911421347 ◽

2011 ◽

Vol 3 (2) ◽

pp. 88-98

Author(s):

Jeanette M. Daly ◽

Yinghui Xu ◽

Barcey T. Levy ◽

David A. Bedell ◽

Michael D. Marquardt ◽

...

Keyword(s):

Primary Care ◽

Diabetes Management ◽

Glycosylated Hemoglobin ◽

Self Care ◽

Management Program ◽

Rural Primary Care ◽

Patients With Diabetes ◽

Primary Care Office ◽

Diabetes Management Program ◽

Record Review

Objective: A diabetes management program was implemented in a rural primary care office for those who did not choose to consult a multidisciplinary specialty care. The purposes of this study were to describe the current practices and health care provider management of patients with diabetes in a rural primary care office and determine differences between Hispanic and non-Hispanic persons concerning diabetes self-care behaviors, barriers to self-care, and their association with glycosylated hemoglobin level. Methods: A retrospective medical record review of diabetes-related medical information was completed. Results: Sixty-one (74%) of the 83 patients with diabetes completed the questionnaire and had the diabetes management program implemented (problem summary and clinical summary generated). Medical record review was completed for 83 (100%) subjects. Glycosylated hemoglobin was significantly higher for the younger group and women. Hispanic women and married persons had significantly higher glycosylated hemoglobin than did non-Hispanic and unmarried persons. Hispanic persons who were obese had significantly higher glycosylated hemoglobin. Self-care behaviors for managing diabetes were different by group. Non-Hispanic subjects reported taking their diabetes medications 99% of the time and Hispanic subjects 50% of the time. Discussion: It was feasible to implement a diabetes management program in a rural primary care setting, and its implementation highlighted the ethnic differences for Hispanics and non-Hispanics in diabetes self-care behavior, barriers to self-care, and family support for diabetes management. The implementation of the diabetes management program, though, was time-consuming and costly and was facilitated outside of the usual realm of practice.

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