Evaluating the QUIT-PRIMO clinical practice ePortal to increase smoker engagement with online cessation interventions: a national hybrid type 2 implementation study

Abstract Background Recent European Society of Cardiology (ESC)/European Association for the Study of Diabetes (EASD) guidelines provide recommendations for detecting and treating chronic kidney disease (CKD) in diabetic patients. We compared clinical practice with guidelines to determine areas for improvement. Methods German database analysis of 675,628 patients with type 1 or type 2 diabetes, with 134,395 included in this analysis. Data were compared with ESC/EASD recommendations. Results This analysis included 17,649 and 116,747 patients with type 1 and type 2 diabetes, respectively. The analysis showed that 44.1 and 49.1 % patients with type 1 and type 2 diabetes, respectively, were annually screened for CKD. Despite anti-diabetic treatment, only 27.2 % patients with type 1 and 43.5 % patients with type 2 achieved a target HbA1c of < 7.0 %. Use of sodium-glucose transport protein 2 inhibitors (1.5 % type 1/8.7 % type 2 diabetes) and glucagon-like peptide-1 receptor agonists (0.6 % type 1/5.2 % type 2 diabetes) was limited. Hypertension was controlled according to guidelines in 41.1 and 67.7 % patients aged 18–65 years with type 1 and 2 diabetes, respectively, (62.4 vs. 68.4 % in patients > 65 years). Renin angiotensin aldosterone inhibitors were used in 24.0 and 40.9 % patients with type 1 diabetes (micro- vs. macroalbuminuria) and 39.9 and 47.7 %, respectively, in type 2 diabetes. Conclusions Data indicate there is room for improvement in caring for diabetic patients with respect to renal disease diagnosis and treatment. While specific and potentially clinically justified reasons for non-compliance exist, the data may serve well for a critical appraisal of clinical practice decisions.

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Sodium–glucose cotransporter 2 inhibitors in type 2 diabetes patients with renal function impairment slow the annual renal function decline, in a real clinical practice

Journal of Diabetes Investigation ◽

10.1111/jdi.13502 ◽

2021 ◽

Cited By ~ 1

Author(s):

Taro Hirai ◽

Munehiro Kitada ◽

Itaru Monno ◽

Erina Oda ◽

Yoshihiro Hayashi ◽

...

Keyword(s):

Type 2 Diabetes ◽

Renal Function ◽

Clinical Practice ◽

Renal Function Decline ◽

Renal Function Impairment ◽

Sodium Glucose Cotransporter ◽

Function Impairment ◽

Real Clinical Practice ◽

Diabetes Patients

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Effectiveness–implementation hybrid type 2 study evaluating an intervention to support ‘information work’ in dementia care: an implementation study protocol

BMJ Open ◽

10.1136/bmjopen-2020-038397 ◽

2020 ◽

Vol 10 (12) ◽

pp. e038397

Author(s):

Chiara De Poli ◽

Jan R Oyebode ◽

Christopher Binns ◽

Richard Glover ◽

Mara Airoldi

Keyword(s):

Service Providers ◽

Unmet Need ◽

Theory Of Change ◽

Family Carers ◽

Long Term Conditions ◽

Local Service ◽

Hybrid Type ◽

North East ◽

People With Dementia

IntroductionPatients with long-term conditions consistently report a lack of information around services and support available to them. This unmet need for information is significant among people with dementia and family carers. A quality improvement intervention is being carried out to tackle this issue as part of a co-creation initiative in the North East of England (UK). The intervention consists of the dissemination (via the local Community Mental Health Services for Older People) of a leaflet about services available to people with dementia and their family carers in the study site. This protocol is reported in accordance with the Standards for Reporting Implementation Studies.Methods and analysisThis effectiveness–implementation hybrid type 2 study aims at understanding (1) the unfolding and outcomes of the implementation strategy, (2) the outcomes of the intervention (for people with dementia and family carers, staff implementing the intervention and local service providers) and (3) the contribution of co-creation to the design and implementation of the intervention and its outcomes. The prospective theory of change of the intervention articulated by local stakeholders is used as a reference framework against which to assess the implementation and outcomes of the intervention. Evaluation data will be collected through in-depth interviews with people with dementia and family carers receiving the intervention, staff implementing the intervention and managers from local service providers. Referral data from local service providers will be collected to triangulate the interview data. A focus group with key stakeholders will support the sense-making of findings. The realist configuration of mechanism–context–outcome, operationalised using an information behaviour model, will inform data analysis and interpretation.Ethics and disseminationEthical and research governance approvals have been obtained from the West Midlands—South Birmingham Research Ethics Committee. The results of the study will be submitted for publication in peer-reviewed journals and disseminated through conferences.

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PDB36 Reduced Rates of Hypoglycemia Lead to Cost Savings for Type 2 Diabetic Patients Treated with Saxagliptin Versus Sulphonlyurea in Actual Clinical Practice

Value in Health ◽

10.1016/j.jval.2012.03.957 ◽

2012 ◽

Vol 15 (4) ◽

pp. A177

Author(s):

D.L. Becker ◽

S.W. Thayer ◽

B. Zhang ◽

M. Skornicki ◽

J.P. Graham ◽

...

Keyword(s):

Clinical Practice ◽

Cost Savings ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Actual Clinical Practice ◽

Type 2 Diabetic

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Reference Guide for Integrating Continuous Glucose Monitoring Into Clinical Practice

The Diabetes Educator ◽

10.1177/0145721718818066 ◽

2018 ◽

Vol 45 (1_suppl) ◽

pp. 3S-20S ◽

Cited By ~ 17

Author(s):

Davida F. Kruger ◽

Steve V. Edelman ◽

Deborah A. Hinnen ◽

Christopher G. Parkin

Keyword(s):

Clinical Practice ◽

Continuous Glucose Monitoring ◽

Glucose Monitoring ◽

Health Care Team ◽

Basic Knowledge ◽

Reference Guide ◽

Comprehensive Information ◽

Effective Use

Purpose Large randomized trials have demonstrated the efficacy of continuous glucose monitoring (CGM) in persons with type 1 diabetes and insulin-treated type 2 diabetes. The purpose of this article is to provide basic knowledge about CGM technology, discuss the use of CGM data in clinical practice, and direct clinicians to online resources that provide comprehensive information and tools relevant to patient selection, education/training, and reimbursement. Conclusions Effective use of CGM requires all members of the health care team to become knowledgeable and skilled in integrating CGM into their practices and in teaching their patients how to safely incorporate CGM use into their daily diabetes self-management.

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