scholarly journals INTERVENTION OF CLINICAL PHARMACIST IN THE MANAGEMENT OF TYPE 2 DIABETES MELLITUS IN OUTPATIENTS

2021 ◽  
pp. 31-34
Author(s):  
ANJU SARAH MATHEWS
Keyword(s):  
Blood Glucose ◽  
Clinical Pharmacist ◽  
Tertiary Care ◽  
Fasting Blood Glucose ◽  
Intervention Group ◽  
Care Group ◽  
Control Group ◽  
Healthcare Team ◽  
Care Hospital ◽  
Interventional Group

Objective: The purpose of the study was to analyze the effect of clinical pharmacist intervention on glycemic control based on fasting blood glucose and glycosylated blood glucose level.  Methods: A randomized prospective interventional study was conducted in the outpatient department of a tertiary care hospital. Patients suffering from diabetes for a least 2 y were selected for the study based on the inclusion and exclusion criteria. The control group was not given any special pharmacist care, while the interventional group had a face-to-face interview, counseling, and telephonic follow-up during the study period. Based on the baseline values and endpoint parametric values, the result of the study was analyzed.  Results: The study was analyzed based on the difference in the glycemic index, using HbA1c and FBS values. The basal values of HbA1c were similar for both groups (8.5%), but a marked reduction to 7.2% was observed in the interventional group. FBS values reduced from 208 mg/dl to 186 mg/dl in the intervention group, while in the usual care group, the reduction was from 211 mg/dl to 198 mg/dl. Conclusion: The inclusion of clinical pharmacists in the healthcare team can offer a remarkable improvement in patient's condition by providing more support in the therapy.

scholarly journals The effect of oat bran consumption on gestational diabetes: a randomized controlled clinical trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zahra Barati ◽  
Mina Iravani ◽  
Majid Karandish ◽  
Mohammad Hosein Haghighizadeh ◽  
Sara Masihi
Keyword(s):  
Clinical Trial ◽  
Blood Glucose ◽  
Gestational Diabetes ◽  
Fasting Blood Glucose ◽  
Intervention Group ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Standard Diet ◽  
Oat Bran ◽  
Significant Difference

Abstract Background Gestational diabetes is the most common medical complication in pregnancy, and it has many side effects for the mother and the fetus. The aim of this study was to evaluate the effect of oat bran consumption on gestational diabetes. Methods This study is a randomized clinical trial that was performed on 112 women with gestational diabetes treated with diet. Participants were randomly divided into two groups of 56. Participants in both groups were given a diet for gestational diabetes. In addition to the diet, the intervention group received 30 g of oat bran daily for 4 weeks at lunch and dinner. Tests of fasting blood glucose and two-hour postprandial (2hpp) glucose were taken from both groups: before the intervention, and 2 and 4 weeks after the start of the intervention. Data analysis was performed using SPSS statistical software (version 22) using independent t-test, as well as Chi-square and Mann-Whitney tests. P values less than 0.05 were considered statistically significant. Results There was no statistically significant difference between the two groups in terms of mean blood glucose before the intervention, while 2 and 4 weeks after the intervention, mean fasting blood glucose and two-hour postprandial (2hpp) glucose decreased significantly in the intervention group compared with the control group (P < 0.001). Conclusion Based on the results of this study, the addition of oat bran to the standard diet for pregnant women with gestational diabetes reduced fasting blood glucose and two-hour postprandial (2hpp) glucose. More detailed studies with higher sample sizes are recommended to prove the effectiveness of this valuable dietary supplement. Trial registration IRCT registration number:IRCT20191220045828N1. Registration date: 2020-04-18. Registered while recruiting.

scholarly journals Effects of an Outpatient Diabetes Self-Management Education on Patients with Type 2 Diabetes in China: A Randomized Controlled Trial

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Fan Zheng ◽  
Suixin Liu ◽  
Yuan Liu ◽  
Lihua Deng
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Diabetes Education ◽  
Fasting Blood Glucose ◽  
Intervention Group ◽  
Self Care ◽  
Education Programme ◽  
Self Management ◽  
Control Group

Objective. This study is aimed at assessing the effectiveness of a simple outpatient diabetes self-management education programme. Methods. In the study, 60 patients with type 2 diabetes mellitus were randomly allocated into the control group (n=30) and intervention group (n=30). Regular and 2-session health education programmes were provided. The summary of diabetes self-care activity measure, problem areas in the diabetes scale, fasting blood glucose, postprandial 2 h blood glucose, and HbA1c were measured before and after the intervention to assess the effects of this 2-session diabetes education programme. Results. The total mean score of the summary of diabetes self-care activities measure was 17.60±6.63 points. The problem areas in the diabetes scale revealed that the total mean score was 29.82±15.22 points; 27% of the patients had diabetes-related distress, while 9% suffered from severe emotional distress. Compared with the control group, scores of the summary of diabetes self-care activities measure and problem areas in the diabetes scale, fasting blood glucose, postprandial 2 h blood glucose, and HbA1c were significantly improved in the intervention group after the intervention (P<0.01). Conclusion. This study showed that the 2-session diabetes education programme could effectively improve the level of self-reported self-management, psychological distress, and glycemic control in patients with type 2 diabetes mellitus.

scholarly journals Preliminary Results on the Effectiveness of a Nutrition Intervention in Lowering Diabetes Risk in Prediabetic People Living with HIV (PLWH) in MASH Cohort (OR36-06-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Alicia Sneij Perez ◽  
Adriana Campa ◽  
Leslie Seminario ◽  
Sabrina Martinez ◽  
Fatma Huffman ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Fasting Blood Glucose ◽  
Intervention Group ◽  
Nutrition Intervention ◽  
Control Group ◽  
Reactive Protein ◽  
Research Initiative ◽  
Significant Difference ◽  
Hs Crp

Abstract Objectives The objective of this study is to assess the effectiveness of a 6-month nutrition intervention to improve glycemic parameters and inflammation in prediabetic PLWH on stable ART with undetectable HIV viral load. Methods A 6-month randomized, controlled nutrition intervention was conducted in prediabetic PLWH. The study participants for the intervention were recruited from the Miami Adult Studies for HIV (MASH) cohort at the FIU-Borinquen Research Clinic. Upon their consent, the participants were randomized into the intervention group or the control group. Participants randomized in the intervention group met once a month for approximately 1 hour where they received medical nutrition therapy, nutrition counseling and nutrition education; participants randomized into the control group received educational material at baseline. Blood was drawn at baseline and at 6-month to measure fasting blood glucose (FBG) and high sensitivity C-reactive protein (hs-CRP). Results A total of 38 participants were recruited and randomized into either the intervention group (n = 20) or the control group (n = 18). We found that the FBG for the 6-month follow-up for the intervention group was significantly lower than the baseline FBG values of the same study group (paired t-test; P = 0.031). No significant difference was found in the control group between the baseline and 6-month fasting blood glucose values (P = 0.068). Moreover, no significant difference was found in pre/post C-reactive protein (CRP) levels in the intervention or control group (paired t-test; P = 0.404 and P = 0.117 respectively). There was a significant difference in CRP levels at baseline (P = 0.028) between the study groups but no difference at the 6-month follow up (Mann Whitney U test: P = 0.430). Conclusions The results from this intervention support the notion that a nutrition intervention is effective in prediabetic PLWH to lower diabetes risk by significantly lowering fasting blood glucose and may be implemented into larger scale interventions; however, no significant changes was seen in hs-CRP values between the 2 groups. Funding Sources National Institute of General Medical Sciences (NIGMS): Research Initiative for Scientific Enhancement (RISE), Biomedical Research Initiative (BRI) Grant, National Institute on Drug Abuse 5U01DA040381-03 and FIU-Dissertation Funding.

scholarly journals Pattern of drug utilization and factors influencing long term blood sugar control among diabetics in a tertiary care hospital- an observational study

2017 ◽  
Vol 6 (5) ◽  
pp. 1171
Author(s):  
Raghu Prasada M. S. ◽  
Deepa Patil ◽  
Vishwanath B. M. ◽  
Shankar A. S. ◽  
Umakant N. Patil ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Blood Sugar ◽  
Treatment Period ◽  
Drug Utilization ◽  
Tertiary Care ◽  
Fasting Blood Glucose ◽  
Care Hospital ◽  
Adherence To Treatment ◽  
Factors Influencing ◽  
Consultant Physician

Background: To study the Pattern of drug prescribing, utilization, analyse effectives of different therapies and factors influencing medication failure and adherence to treatment among diabetics.Methods: The clinical study was conducted in JJM Medical College and Karuna Trust, Davangere, Karnataka. The patients with diabetes as diagnosed by consultant physician were observed for the pattern of blood glucose control. The fasting blood glucose of the patients were recorded at the end of 1st month, 6th month and 12th month of their treatment period. The study period was from June 2012 till August 2014. The study was conducted after institutional ethical clearance and informed consent was taken from all the patients. The pattern of drugs prescribed for the patients were also analysed. The pattern of control among patients with co morbidities were also analysed using paired sample t test.Results: The results showed that the prescribed drugs were able to control the blood glucose levels of the patients. The percentage of patients with FBS in controlled, mild to moderate control and uncontrolled group were 21%, 33.3% and 45.5% in early treatment period and 36%, 40.9%, and 22.7% after one year treatment period (Significant p value). The pattern of drug utilization showed that the most commonly used drugs were the combination of pioglitazone+glimipride+metformin (19%), combination of glibenclamide+ metformin (18%), only insulin (9%), combination of glimipride+metformin (8%) and combination of gliclazide+metformin (5%).Conclusions: The results show that the intervention by the consultant physician was successful in controlling the blood sugar levels and the reasons for failure of treatment and adherence to treatment were helpful for further treatment of patients. Further such studies in a larger sample will help the consultants in their treatment methods.

scholarly journals A Structured Maternity Case Record to Improve Quality of Documentation in a Tertiary Care Hospital, Delhi

2021 ◽  
Author(s):  
AG Radhika ◽  
Chetna Dengri ◽  
Abhishek Kumar ◽  
Shalini Singh
Keyword(s):  
Tertiary Care ◽  
Intervention Group ◽  
Control Group ◽  
Care Hospital ◽  
Case Record ◽  
Hospital Case ◽  
Sequence Of Events ◽  
Significant Difference ◽  
Time Of Admission

Introduction: India contributes to about 18% of global maternal deaths and 22.6% of still births. Efforts to improve the quality of care are challenged by the lack of reliable documentation of data. Hence, a concise, structured maternity case sheet (PrasavRecord) was designed with the aim to bring about an improvement in documentation of treatment and events related to woman in labour from the time of admission till her discharge from the hospital. Aim: To study the improvement in quality of documentation from the time of admission till discharge of a woman in labour with the help of structured format i.e., PrasavRecord. Materials and Methods: The study was conducted in February 2017. A quasi experimental study design was used, and the completeness of data recorded by the resident doctors in the existing hospital case sheet (control group) with those recorded in PrasavRecord (intervention group) were assessed in a total of 65 deliveries in each arm. Details of the patient from admission to the labour room followed by the entire sequence of events during labour as well as hospital stay in postpartum period were recorded over 130 parameters under different sections in PrasavRecord. Statistical analysis was done by using SPSS version 21.0. Results: Completeness of the documentation in terms of history, investigations and findings at examination including those at labour, nearly, 92% of the doctors rated PrasavRecord as “good and very good” for appearance, recommended its routine use, and 75% agreed that the format will be useful for conversion to electronic medical record. There was highly significant difference between the average percentage of completeness in PrasavRecord 75.8 {95% CI (74.2-77.4)} and hospital case sheets 42.2 {95% CI (40.9-43.6)} i.e., z=5.38 p-value <0.001. Conclusion: PrasavRecord is a simple, acceptable and user-friendly data entry format which improves the quality of documentation of the processes and practices during childbirth. Larger trials are required to finetune it to facilitate its widespread use thereby, ensuring a uniform documentation process of labour and postpartum.

scholarly journals Circulating MicroRNAs predict glycemic improvement and response to a behavioral intervention

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Elena Flowers ◽  
Isabel Elaine Allen ◽  
Alka M. Kanaya ◽  
Bradley E. Aouizerat
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Linear Models ◽  
Longitudinal Design ◽  
Fasting Blood Glucose ◽  
Intervention Group ◽  
Control Group ◽  
Behavioral Risk ◽  
Circulating Micrornas

Abstract Background MicroRNAs may be important regulators of risk for type 2 diabetes. The purpose of this longitudinal observational study was to assess whether circulating microRNAs predicted improvements in fasting blood glucose, a major risk factor for type 2 diabetes, over 12 months. Methods The study included participants (n = 82) from a previously completed trial that tested the effect of restorative yoga on individuals with prediabetes. Circulating microRNAs were measured using a flow cytometry miRNA assay. Linear models were used to determine the optimal sets of microRNA predictors overall and by intervention group. Results Subsets of microRNAs were significant predictors of final fasting blood glucose after 12-months (R2 = 0.754, p < 0.001) and changes in fasting blood glucose over 12-months (R2 = 0.731, p < 0.001). Three microRNAs (let-7c, miR-363, miR-374b) were significant for the control group only, however there was no significant interaction by intervention group. Conclusions Circulating microRNAs are significant predictors of fasting blood glucose in individuals with prediabetes. Among the identified microRNAs, several have previously been associated with risk for type 2 diabetes. This is one of the first studies to use a longitudinal design to assess whether microRNAs predict changes in fasting blood glucose over time. Further exploration of the function of the microRNAs included in these models may provide new insights about the complex etiology of type 2 diabetes and responses to behavioral risk reduction interventions. Trial registration This study was a secondary analysis of a previously completed clinical trial that is registered at clinicaltrials.gov (NCT01024816) on December 3, 2009.

Better balance: a randomised controlled trial of oculomotor and gaze stability exercises to reduce risk of falling after stroke

2020 ◽  
pp. 026921552095633
Author(s):  
Anabela Correia ◽  
Carla Pimenta ◽  
Marta Alves ◽  
Daniel Virella
Keyword(s):  
Controlled Trial ◽  
Tertiary Care ◽  
Intervention Group ◽  
Secondary Outcome ◽  
Control Group ◽  
Stroke Survivors ◽  
Care Hospital ◽  
Risk Of Falling ◽  
Gaze Stability ◽  
Estimated Risk

Objective: To assess the effect of a domiciliary program of oculomotor and gaze stability exercises on the incidence of falls and risk of fall in stroke survivors. Design: Two-arm, non-blinded parallel randomized controlled trial. Subjects: Stroke survivors older than 60 years, with positive Romberg test and autonomous gait after the stroke. Setting: Physiotherapy outpatient clinic of a tertiary care hospital. Interventions: Every participant accomplished the current rehabilitation program; the intervention group was randomly allocated into an additional three weeks intervention with a domiciliary program of oculomotor and gaze stability exercises. Main measures: Primary outcome was the incidence of falls through the three weeks after the intervention started; in addition, the variation of the estimated risk for falling assessed by both Berg Balance Scale (four points) and Timed Up and Go Test (four seconds) was the secondary outcome. Results: 79 patients were recruited and 68 completed the protocol (control group 35; intervention group 33). During the follow up, falls were registered in 4/35 participants in the control group and no event occurred in the intervention group ( P = 0.064). The estimated risk for falling decreased in 11/35 control group participants and in 28/33 intervention group participants (RR 0.37; 95%CI 0.22–0.62; P < 0.001). Conclusion: After three weeks of a domiciliary program of oculomotor and gaze stability exercises, the estimated risk of falling significantly diminished and no falls occurred among the intervention group. These findings encourage further exploration of this promising intervention. Trial Registration: ClinicalTrials.gov Identifier: NCT02280980.

scholarly journals The Use of Light Sensors in Alcohol Gel Dispensers to Improve Hand Hygiene Compliance of Health Care Workers

2020 ◽  
Vol 41 (S1) ◽  
pp. s411-s411
Author(s):  
Priscila Gonçalves ◽  
Fernando Gatti de Menezes ◽  
Ana Carolina Santiago ◽  
Laura Kataoka ◽  
Paula Fernanda Martineli ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Direct Observation ◽  
Tertiary Care ◽  
Intervention Group ◽  
Healthcare Personnel ◽  
Control Group ◽  
Care Hospital ◽  
The Impact ◽  
Perception Survey ◽  
Intervention Unit

Background: Improving adherence to hand hygiene (HH) of healthcare workers (HCWs) is a challenge for health institutions, and the use of technologies has been considered an important strategy within this process. Methods: To evaluate the impact of the use of alcohol-based hand rub gel (ABHR) dispensers with light sensors on the adherence to HH by HCWs. This is a prospective quasi-experimental study with comparative analysis between two 4-bed adult intensive care units at a private, tertiary-care hospital conducted over 22 weeks. An approach detection module with an LED lamp was attached to the ABHR dispenser. As a healthcare personnel approached it, the sensor was activated, and a red light turned on as a visual stimulus for HH. The color of the light changed to blue when HH was performed. All ABHR dispensers had electronic counters, but light sensors were installed only in the 4-bed dispensers of the intervention unit. Throughout the period, direct observation of adherence to HH was performed by 4 nurses who had previously been rated with an excellent coefficient of agreement (κ test = 0.951 and 0.902). At the end of the study, a perception survey was performed with the HCWs. Results: The median activation of ABHR dispensers per week was higher in the intervention unit with 1,004 (IQR, 706–1,455) versus 432 (IQR, 350–587) in the control group (P < .001). The same occurred when compared to the median activation per 1,000 patient days, with 53,069 (IQR, 47,575–67,275) versus 19,602 (IQR, 15,909–24,500) in the control group (P < .001). However, there was no evidence of difference in adherence to HH during direct observation between the 2 groups: 51.0% HH compliance (359 of 704) in the control group and 53.8% HH compliance (292 of 543) in the intervention group (P = .330). The same result emerged when we evaluated the “My Five Moments for HH” and by professional category. HCWs (N=66) answered the perception survey: 66.6% stated that lighting devices caught their attention regularly or most of the time and 59% agreed that the devices motivated HH. Conclusions: Using light sensors in ABHR dispensers can be an effective technology for improving HH. This finding was evident in the evaluation of the number of uses of the ABHR dispensers and in the HCW perceptions. Although direct observation did not show statistical evidence of difference between the groups, adherence was higher in the intervention group.Funding: NoneDisclosures: None

scholarly journals The Impact of Patient Education on the Quality of Inpatient Bowel Preparation for Colonoscopy

2010 ◽  
Vol 24 (9) ◽  
pp. 543-546 ◽  
Author(s):  
Greg Rosenfeld ◽  
Darin Krygier ◽  
Robert A Enns ◽  
Janakie Singham ◽  
Holly Wiesinger ◽  
...  
Keyword(s):  
Patient Education ◽  
Bowel Preparation ◽  
Rating Scale ◽  
Tertiary Care ◽  
Intervention Group ◽  
Control Group ◽  
Inpatient Setting ◽  
Care Hospital ◽  
Patient Counselling ◽  
The Impact

BACKGROUND: For patients requiring colonoscopy while admitted to hospital, achieving adequate cleansing of the colon is often difficult.OBJECTIVES: To assess the impact of patient education, in the form of both counselling and written instructions, on bowel cleanliness at colonoscopy.METHODS: A total of 38 inpatients at a tertiary care hospital in Vancouver, British Columbia, who were referred to the gastroenterology service for colonoscopy were enrolled in the present study. Sixteen patients were randomly assigned to the intervention group, while 22 patients comprised the control group. Both groups received a clear liquid diet and 4 L of a commercially available bowel preparation. The intervention group also received a brief counselling session and written instructions outlining the methods and rationale for bowel preparation before colonoscopy. Bowel cleanliness was assessed by the endoscopist using a five-point rating scale.RESULTS: The two groups were similar with respect to demographics, the indication for colonoscopy and findings at colonoscopy. The median bowel cleanliness scores in the control group and the enhanced-instruction group were 3.0 and 2.0, respectively (P=0.001).CONCLUSION: Patient counselling and written instructions are inexpensive, safe and simple interventions. Such interventions are an effective means of optimizing colonoscopy preparation in the inpatient setting.

scholarly journals Sociodemographic and clinical characteristics of a diabetic population at a tertiary care center in Assam, India

2017 ◽  
Vol 05 (01) ◽  
pp. 037-042 ◽  
Author(s):  
Meghna Borah ◽  
Rohini Goswami
Keyword(s):  
Blood Glucose ◽  
Glycemic Control ◽  
Clinical Characteristics ◽  
Care Center ◽  
Tertiary Care ◽  
Fasting Blood Glucose ◽  
Significant Proportion ◽  
The Body ◽  
Postprandial Blood Glucose ◽  
Care Hospital

Abstract Aims: To elucidate the sociodemographic and clinical characteristics of patients with type 2 diabetes mellitus (T2DM) attending a tertiary care hospital in Dibrugarh, Assam. Subjects and Methods: A total of 132 T2DM patients (74 males and 48 females) were included in the study. Patients were evaluated with detailed history, meticulous examination, and laboratory investigations and given a detailed interview questionnaire to fill out. Statistical Analysis Used: Graph Pad Prism, published by GraphPad Software, Inc., California. Results: The highest prevalence was found in the age group 41–50 years (28%). A large number of the study population (35%) was sedentary. It was observed that the body mass index was over the normal range in 42% of the study subjects. Central obesity was observed in 76 patients (58%). Only 9% of the patients had managed to achieve good glycemic control (<6.5%). In our study, 39% of the patients were taking the prescribed medications irregularly. A significant proportion of the study subjects had associated comorbidities such as hypertension (50%), obesity (42%), and dyslipidemia (37%). Fasting blood glucose, postprandial blood glucose, and glycated hemoglobin levels were elevated in both males and females. The values were higher in males, but statistically, the difference was not significant. Conclusions: The present study revealed that poor glycemic control, irregular medication intake, obesity, dyslipidemia, sedentary lifestyles, and hypertension were prevalent in T2DM patients. Hence, the overall risk profile in patients from Assam was very poor and needs improvement. These data can support health professionals' actions to effectively maintain and provide a more comprehensive approach to management of T2DM.

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