scholarly journals Patient Markers of Successful Diabetes Management

2021 ◽  
Author(s):  
Amy T. Cunningham ◽  
Pouya Arefi ◽  
Alexzandra T. Gentsch ◽  
Geoffrey D. Mills ◽  
Marianna D. LaNoue ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Diabetes Management ◽  
Demographic Data ◽  
Secondary Analysis ◽  
Self Report ◽  
Structured Interviews ◽  
Successful Management ◽  
Patient Centered ◽  
Care Plans ◽  
Ed Visits

<b>Purpose.</b> For individuals with diabetes, diabetes health status may not align with A1C targets. Patients may use nonclinical targets when assessing their diabetes management success. Identifying these targets is important in developing patient-centered management plans. The purpose of this study was to identify patient markers of successful diabetes management among patients in an urban academic health system. <p><b>Methods. </b>A secondary analysis of semi-structured interviews was completed with 89 adults with type 1 or type 2 diabetes. Participants had a recent diabetes-related emergency department (ED) visits or hospitalization or were primary care patients with an A1C >7.5%. Interviews were conducted to saturation. Demographic data were collected via self-report and electronic medical records. Interviews were analyzed using conventional content analysis. This analysis focused on patient perceptions of successful management coded to “measuring management success.”</p> <p><b>Results.</b> Although most participants cited A1C or blood glucose as a marker of successful diabetes management, they had varied understanding of these metrics. Most used a combination of targets from the following categories: <i>1</i>) A1C, blood glucose, and numbers; <i>2</i>) engagement in medical care; <i>3</i>) taking medication and medication types; <i>4</i>) symptoms; <i>5</i>) diet, exercise, and weight; and <i>6</i>) stress management and social support.</p> <p><b>Conclusion. </b>Individuals not meeting glycemic goals and/or with recent diabetes-related ED visits or hospitalizations had varied understanding of A1C and blood glucose targets. They use multiple additional markers of successful management and had a desire for management discussions that incorporate these markers. These measures should be incorporated into their care plans along with clinical targets.</p>

scholarly journals Patient Markers of Successful Diabetes Management

2021 ◽  
Author(s):  
Amy T. Cunningham ◽  
Pouya Arefi ◽  
Alexzandra T. Gentsch ◽  
Geoffrey D. Mills ◽  
Marianna D. LaNoue ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Diabetes Management ◽  
Demographic Data ◽  
Secondary Analysis ◽  
Self Report ◽  
Structured Interviews ◽  
Successful Management ◽  
Patient Centered ◽  
Care Plans ◽  
Ed Visits

<b>Purpose.</b> For individuals with diabetes, diabetes health status may not align with A1C targets. Patients may use nonclinical targets when assessing their diabetes management success. Identifying these targets is important in developing patient-centered management plans. The purpose of this study was to identify patient markers of successful diabetes management among patients in an urban academic health system. <p><b>Methods. </b>A secondary analysis of semi-structured interviews was completed with 89 adults with type 1 or type 2 diabetes. Participants had a recent diabetes-related emergency department (ED) visits or hospitalization or were primary care patients with an A1C >7.5%. Interviews were conducted to saturation. Demographic data were collected via self-report and electronic medical records. Interviews were analyzed using conventional content analysis. This analysis focused on patient perceptions of successful management coded to “measuring management success.”</p> <p><b>Results.</b> Although most participants cited A1C or blood glucose as a marker of successful diabetes management, they had varied understanding of these metrics. Most used a combination of targets from the following categories: <i>1</i>) A1C, blood glucose, and numbers; <i>2</i>) engagement in medical care; <i>3</i>) taking medication and medication types; <i>4</i>) symptoms; <i>5</i>) diet, exercise, and weight; and <i>6</i>) stress management and social support.</p> <p><b>Conclusion. </b>Individuals not meeting glycemic goals and/or with recent diabetes-related ED visits or hospitalizations had varied understanding of A1C and blood glucose targets. They use multiple additional markers of successful management and had a desire for management discussions that incorporate these markers. These measures should be incorporated into their care plans along with clinical targets.</p>

scholarly journals Reframing the Medication Experience in Pharmacy Using Seminal Concepts of Patient-Centered Care—Implications for Practice

Pharmacy ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 9
Author(s):  
Brian Isetts ◽  
Anthony Olson ◽  
Jon Schommer
Keyword(s):  
Therapeutic Relationship ◽  
Secondary Analysis ◽  
Patient Centered Care ◽  
National Sample ◽  
Patient Specific ◽  
Structured Interviews ◽  
Patient Centeredness ◽  
Patient Centered ◽  
Centered Care ◽  
Medication Experience

Team-based, Patient-Centered Care is essential to chronic disease prevention and management but there are differing ideas about the concept’s meaning across healthcare populations, settings and professions. This commentary’s objective is to empirically evaluate the theoretical relationships of the [a] Medication Experience, [b] Patient-Centeredness and other relevant component concepts from pharmaceutical care (i.e., [c] Therapeutic Relationship, [d] Patient-specific preferences for achieving goals of therapy and resolving drug therapy problems) so as to provide practice-based insights. This is achieved using a secondary analysis of 213 excerpts generated from in-depth semi-structured interviews with a national sample of pharmacists and patients about Patient-Centeredness in pharmacist practice. The four component concepts (i.e., a–d) related to the objective were examined and interpreted using a novel 3-archetype heuristic (i.e., Partner, Client and Customer) revealing common practice-based themes related to care preferences and expectations in collaborative goal setting, enduring relationships, value co-creation and evolving patient expectations during challenging medical circumstances. Most practice-based insights were generated within the Partner archetype, likely reflecting high congruence with pharmacist and patient responses related to the Medication Experience and Therapeutic Relationship. The practice-based insights may be especially useful for new practitioners and students accelerating their advancement in providing effective and efficient Patient-Centered Care.

scholarly journals Blood glucose control and compliance of diabetic children

Curationis ◽  
1997 ◽  
Vol 20 (2) ◽  
Author(s):  
F. P. R. De Villiers ◽  
E. Chester ◽  
K. E. C. Meyers
Keyword(s):  
Blood Glucose ◽  
Diabetes Management ◽  
Demographic Data ◽  
Blood Glucose Control ◽  
Good Control ◽  
Glycosylated Haemoglobin ◽  
Diabetes Clinic ◽  
Paediatric Diabetes ◽  
The Past ◽  
Diabetic Children

Non-compliance is an important factor hindering good control in diabetics. The aim of this study was to identify areas of poor compliance with the diabetes management regimen in the children attending our clinic. A questionnaire was administered to 57 patients who attend the Paediatric Diabetes Clinic. It was designed to elicit socio-demographic data and information about the diabetic regimen. Prior to the administration of the questionnaire, patients were classified as being well, satisfactorily or poorly controlled, based on their average glycosylated Haemoglobin results over the past year.

scholarly journals Awareness of Functional Status: People with Alzheimer’s Disease Abilities to Self-Report Impairment in Activities of Daily Living

2020 ◽  
Vol 4 (1) ◽  
pp. 405-415
Author(s):  
Paula Gasparini Emery Trindade ◽  
Raquel Luiza Santos ◽  
Aud Johannessen ◽  
Jose Pedro Simões Neto ◽  
Marcia Cristina Nascimento Dourado
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Functional Status ◽  
Negative Impact ◽  
Demographic Data ◽  
Self Report ◽  
Structured Interviews ◽  
Functional Deficits ◽  
Qualitative Part ◽  
The Impact

Background: Awareness of functional status may underlie specific profiles and differences related to stage severity in individuals with Alzheimer’s disease (AD). Objective: This study aimed to assess self-reported experiences of awareness of functional activity in people with mild and moderate AD. Methods: This is a mixed methods approach. The qualitative part was conducted through semi-structured interviews concerning the experiences and awareness of deficits in 38 older adults with mild or moderate AD. The quantitative approach included a comparison between groups with regard to concerns of awareness and clinic and demographic data. Results: Impairment on awareness of disease and awareness of functional deficits was observed even in the mild stages of AD. There was also a noticeable progression of impairments of both kinds of awareness from mild to moderate stage of disease. The majority of participants with mild and moderate AD were partially aware of their functional deficits. Both groups of participants reported some negative impact; however, they were not able to entirely describe their functional status. Also, deficits to recognize the need for help with hygiene and general tasks were observed. Significant differences were found in awareness of need for help with general tasks and awareness of need for help with hygiene tasks. Conclusion: People with mild and moderate AD may describe their aware of the disease better than specific functional deficits, and most of them can provide some reports concerning to the impact of the disease.

Exploring the Cost and Clinical Outcomes of Integrating the Registered Nurse–Certified Diabetes Educator Into the Patient-Centered Medical Home

2011 ◽  
Vol 37 (6) ◽  
pp. 780-793 ◽  
Author(s):  
Katherine Moran ◽  
Rosanne Burson ◽  
John Critchett ◽  
Phillip Olla
Keyword(s):  
Blood Glucose ◽  
Clinical Outcomes ◽  
Medical Home ◽  
Registered Nurse ◽  
Diabetes Management ◽  
Diabetes Education ◽  
Fasting Blood Glucose ◽  
Patient Centered Medical Home ◽  
Patient Centered ◽  
Diabetes Educator

Purpose The purpose of this study was to implement and evaluate a care delivery model integrating the registered nurse–certified diabetes educator into the patient-centered medical home to assist in achieving positive clinical and cost outcomes in diabetes care. Methods A 1-group pretest-posttest research design was used. Patients were recruited from 2 patient-centered medical home designated/nominated primary care offices. Inclusion criteria were as follows: diagnosis of type 1 or type 2 diabetes, aged 18 to 80 years, A1C ≥ 8%, English speaking, and no diabetes education within 6 months. There were 34 participants (men, n = 22; women, n = 12) with a mean age of 53.24. The intervention incorporated an assessment, 4 patient-centered monthly group sessions, and 4 individual follow-up sessions. Study measures included program surveys, participation and satisfaction rates, Healthcare Effectiveness Data and Information Set attainment rates, and the following physiologic measures obtained from the medical record: A1C, fasting blood glucose, LDL, urine microalbumin, blood pressure, retinal eye exam, and body mass index. Cost-effectiveness measures included program costs, performance incentives, revenue, provider time saved, and patient health care utilization. Results Paired-samples t tests identified significant improvements in A1C, fasting blood glucose, and LDL. Patients and providers were highly satisfied with the program. Cost-benefit analysis revealed a net pretax program benefit. Conclusions Results of the study indicated that integrating the registered nurse–certified diabetes educator in the patient-centered medical home improves clinical outcomes and is cost-effective. Diabetes education and support are integral components of diabetes management.

QEEG, Self-Report Scales & Structured Interviews in the Comparative Experimental Assessment of Trauma Therapies

2007 ◽  
Author(s):  
Karen Williams ◽  
Rick Bradshaw ◽  
Marvin McDonald ◽  
Michael Mariano ◽  
Nadia Larsen
Keyword(s):  
Self Report ◽  
Structured Interviews ◽  
Experimental Assessment

"Taming the Monster aka Uncontrolled Diabetes: A Viewpoint" (Preprint)

2020 ◽  
Author(s):  
Swati Anand ◽  
Amardeep Kalsi ◽  
Jonathan Figueroa ◽  
Parag Mehta
Keyword(s):  
Blood Glucose ◽  
Diabetes Management ◽  
Positive Impact ◽  
The United States ◽  
Phone Call ◽  
Diabetic Patients ◽  
Dietary Compliance ◽  
Glucose Levels ◽  
Uncontrolled Diabetes ◽  
Number Of Patients

BACKGROUND HbA1c between 6% and 6.9% is associated with the lowest incidence of all‐cause and CVD mortality, with a stepwise increase in all‐cause and cardiovascular mortality in those with an HbA1c >7%. • There are 30 million individuals in the United States (9.4% of the population) currently living with Diabetes Mellitus. OBJECTIVE Improving HbA1C levels in patients with uncontrolled Diabetes with a focused and collaborative effort. METHODS Our baseline data for Diabetic patients attending the outpatient department from July 2018 to July 2019 in a University-affiliated hospital showed a total of 217 patients for one physician. • Of 217 patients, 17 had HbA1C 9 and above. We contacted these patients and discussed the need for tight control of their blood glucose levels. We intended to ensure them that we care and encourage them to participate in our efforts to improve their outcome. • We referred 13 patients that agreed to participate to the Diabetic educator who would schedule an appointment with the patients, discuss their diet, exercise, how to take medications, self-monitoring, and psychosocial factors. • If needed, she would refer them to the Nutritionist based on patients’ dietary compliance. • The patients were followed up in the next two weeks via telemedicine or a phone call by the PCP to confirm and reinforce the education provided by the diabetes educator. RESULTS Number of patients that showed an improvement in HbA1C values: 11 Cumulative decrease in HbA1C values for 13 patients: 25.3 The average reduction in HbA1C: 1.94 CONCLUSIONS Our initiative to exclusively target the blood glucose level with our multidisciplinary approach has made a positive impact, which is reflected in the outcome. • It leads to an improvement in patient compliance and facilitates diabetes management to reduce the risk for complications CLINICALTRIAL NA

scholarly journals Care-seeking and managing diabetes in rural Bangladesh: a mixed methods study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hannah Maria Jennings ◽  
Joanna Morrison ◽  
Kohenour Akter ◽  
Hassan Haghparast-Bidgoli ◽  
Carina King ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Health Care Providers ◽  
Low Income ◽  
Diabetes Management ◽  
Local Health ◽  
Care Seeking ◽  
Care Providers ◽  
Structured Interviews ◽  
Rural Bangladesh

Abstract Background Type 2 diabetes mellitus poses a major health challenge worldwide and in low-income countries such as Bangladesh, however little is known about the care-seeking of people with diabetes. We sought to understand the factors that affect care-seeking and diabetes management in rural Bangladesh in order to make recommendations as to how care could be better delivered. Methods Survey data from a community-based random sample of 12,047 adults aged 30 years and above identified 292 individuals with a self-reported prior diagnosis of diabetes. Data on health seeking practices regarding testing, medical advice, medication and use of non-allopathic medicine were gathered from these 292 individuals. Qualitative semi-structured interviews and focus group discussions with people with diabetes and semi-structured interviews with health workers explored care-seeking behaviour, management of diabetes and perceptions on quality of care. We explore quality of care using the WHO model with the following domains: safe, effective, patient-centred, timely, equitable and efficient. Results People with diabetes who are aware of their diabetic status do seek care but access, particularly to specialist diabetes services, is hindered by costs, time, crowded conditions and distance. Locally available services, while more accessible, lack infrastructure and expertise. Women are less likely to be diagnosed with diabetes and attend specialist services. Furthermore costs of care and dissatisfaction with health care providers affect medication adherence. Conclusion People with diabetes often make a trade-off between seeking locally available accessible care and specialised care which is more difficult to access. It is vital that health services respond to the needs of patients by building the capacity of local health providers and consider practical ways of supporting diabetes care. Trial registration ISRCTN41083256. Registered on 30/03/2016.

scholarly journals Family, social and cultural determinants of long-lasting insecticidal net (LLIN) use in Madagascar: secondary analysis of three qualitative studies focused on children aged 5–15 years

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Ammy Fiadanana Njatosoa ◽  
Chiarella Mattern ◽  
Dolorès Pourette ◽  
Thomas Kesteman ◽  
Elliot Rakotomanana ◽  
...  
Keyword(s):  
Effective Means ◽  
Secondary Analysis ◽  
Well Being ◽  
Malaria Prevalence ◽  
Qualitative Studies ◽  
Observation Data ◽  
Age Group ◽  
Structured Interviews ◽  
Mosquito Net ◽  
Llin Use

Abstract Background Although it is accepted that long-lasting insecticidal net (LLIN) use is an effective means to prevent malaria, children aged 5 to 15 years do not appear to be sufficiently protected in Madagascar; the malaria prevalence is highest in this age group. The purpose of this research is to summarize recent qualitative studies describing LLIN use among the Malagasy people with a focus on children aged 5–15 years. Methods Qualitative data from three studies on malaria conducted between 2012 and 2016 in 10 districts of Madagascar were analysed. These studies cover all malaria epidemiological profiles and 10 of the 18 existing ethnic groups in Madagascar. A thematic analysis was conducted on the collected data from semi-structured interviews, direct observation data, and informal interviews. Results A total of 192 semi-structured interviews were conducted. LLINs are generally perceived positively because they protect the health and well-being of users. However, regional representations of mosquito nets may contribute to LLIN lower use by children over 5 years of age including the association between married status and LLIN use, which leads to the refusal of unmarried young men to sleep under LLINs; the custom of covering the dead with a mosquito net, which leads to fear of LLIN use; and taboos governing sleeping spaces for siblings of opposite sexes, which leads to LLIN shortages in households. Children under 5 years of age are known to be the most vulnerable age group for acquiring malaria and, therefore, are prioritized for LLIN use when there are limited supplies in households. In contrast, children over 5 years of age, who are perceived to be at less risk for malaria, often sleep without LLINs. Conclusions Perceptions, social practices and regional beliefs regarding LLINs and vulnerability to malaria contribute to the nonuse of LLINs among children over 5 years of age in Madagascar. Modifying LLIN policies to account for these factors may increase LLIN use in this age group and reduce disease burden.

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