scholarly journals Effects of Patient-Initiated Visits on Patient Satisfaction and Clinical Outcomes in a Type 1 Diabetes Outpatient Clinic: A 2-Year Randomized Controlled Study

2021 ◽  
Author(s):  
Nina Drøjdahl Ryg ◽  
Jeppe Gram ◽  
Maryam Haghighi ◽  
Claus Bogh Juhl
Keyword(s):  
Type 1 Diabetes ◽  
Patient Satisfaction ◽  
Outpatient Clinic ◽  
Intervention Group ◽  
Controlled Study ◽  
Clinical Variables ◽  
Randomized Controlled ◽  
Outpatient Visits ◽  
Patient Reported

Objective: We investigated the effects of replacing regular outpatient follow-up through prescheduled visits with patient-initiated visits on patient satisfaction and clinical variables of type 1 diabetes (T1D). <p> </p> <p>Research Design and Methods: A 24-month randomized controlled trial, where adults with T1D were allocated to either patient-initiated unlimited access to outpatient visits, or usual care through regular prescheduled visits. The primary outcome was 7 patient-reported experience measures of patient satisfaction focused on benefit of consultation and accessibility of the outpatient clinic. Secondary outcomes included clinical variables of diabetes and use of staff resources.</p> <p> </p> <p>Results: We enrolled 357 outpatients (intervention, n=178; control, n=179). After 24 months, participants in the intervention group experienced more benefit from consultations compared to baseline within groups (p<0.05) and fewer unnecessary visits compared to controls (p<0.05). Patient needs covered and satisfaction with the outpatient clinic was high and unchanged in both groups, and accessibility was increased (3 questions, all p<0.05). A calculated 7-item patient satisfaction sum score favored the intervention group over controls (p<0.001). There were no significant changes in HbA1c, LDL, blood pressure, and complication status. The mean number of outpatient visits over 24 months (±SD) was lower in the intervention group compared to controls (4.4±2.8 vs. 6.3±2.7, p<0.001), while the number of telephone contacts was higher (3.1±3.4 vs. 2.5±3.2, p<0.001).</p> <p> </p> <p>Conclusions: Patient satisfaction remained high or improved with patient-initiated on-demand use of the diabetes outpatient clinic, with no decline in the quality of diabetes care, and a reduction in the use of staff resources.</p>

scholarly journals Effects of Patient-Initiated Visits on Patient Satisfaction and Clinical Outcomes in a Type 1 Diabetes Outpatient Clinic: A 2-Year Randomized Controlled Study

2021 ◽  
Author(s):  
Nina Drøjdahl Ryg ◽  
Jeppe Gram ◽  
Maryam Haghighi ◽  
Claus Bogh Juhl
Keyword(s):  
Type 1 Diabetes ◽  
Patient Satisfaction ◽  
Outpatient Clinic ◽  
Intervention Group ◽  
Controlled Study ◽  
Clinical Variables ◽  
Randomized Controlled ◽  
Outpatient Visits ◽  
Patient Reported

Objective: We investigated the effects of replacing regular outpatient follow-up through prescheduled visits with patient-initiated visits on patient satisfaction and clinical variables of type 1 diabetes (T1D). <p> </p> <p>Research Design and Methods: A 24-month randomized controlled trial, where adults with T1D were allocated to either patient-initiated unlimited access to outpatient visits, or usual care through regular prescheduled visits. The primary outcome was 7 patient-reported experience measures of patient satisfaction focused on benefit of consultation and accessibility of the outpatient clinic. Secondary outcomes included clinical variables of diabetes and use of staff resources.</p> <p> </p> <p>Results: We enrolled 357 outpatients (intervention, n=178; control, n=179). After 24 months, participants in the intervention group experienced more benefit from consultations compared to baseline within groups (p<0.05) and fewer unnecessary visits compared to controls (p<0.05). Patient needs covered and satisfaction with the outpatient clinic was high and unchanged in both groups, and accessibility was increased (3 questions, all p<0.05). A calculated 7-item patient satisfaction sum score favored the intervention group over controls (p<0.001). There were no significant changes in HbA1c, LDL, blood pressure, and complication status. The mean number of outpatient visits over 24 months (±SD) was lower in the intervention group compared to controls (4.4±2.8 vs. 6.3±2.7, p<0.001), while the number of telephone contacts was higher (3.1±3.4 vs. 2.5±3.2, p<0.001).</p> <p> </p> <p>Conclusions: Patient satisfaction remained high or improved with patient-initiated on-demand use of the diabetes outpatient clinic, with no decline in the quality of diabetes care, and a reduction in the use of staff resources.</p>

scholarly journals Text message reminders for adolescents with poorly controlled type 1 diabetes: A randomized controlled trial

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248549
Author(s):  
Nour Ibrahim ◽  
Jean-Marc Treluyer ◽  
Nelly Briand ◽  
Cécile Godot ◽  
Michel Polak ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Hba1c Level ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Baseline Hba1c ◽  
Randomized Controlled ◽  
Intent To Treat ◽  
Treat Analysis

Background Among adolescents with type 1 diabetes, some experience great difficulties with treatment adherence, putting them at high risk of complications. We assessed the effect of text messaging (Short Messaging Service [SMS]) on glycemic control. Methods A two-arm open label randomized controlled trial enrolled adolescents with type 1 diabetes aged 12–21 years with baseline HbA1c ≥ 69 mmol/mol (8.5%). The intervention group received daily SMS reminders at self-selected times about insulin injections while the control group received standard of care. The patients allocated to the control group were not aware of the intervention. Results 92 patients were randomized, 45 in the SMS arm and 47 in the control arm. After 6 months, median HbA1c level was significantly lower in the intervention arm: 73 mmol/mol (8.8%) in the SMS arm and 83 mmol/mol (9.7%) in the control arm in the intent-to-treat analysis (P = 0.03) but no longer in the per protocol analysis (P = 0.65). When we consider the proportions of patients whose HbA1c level decreased by at least 1% between baseline and 6 months, we find a significant difference among patients whose baseline HbA1c was ≥ 80 mmol/mol (9.5%) (n = 56): 60% in the SMS arm and 30.6% in the control arm had lowered their HbA1c level (P = 0.03) in the intent-to-treat analysis but not in the per-protocol analysis (P = 0.50). Patients in the SMS arm reported high satisfaction with the intervention. Conclusions While there is a trend to lower HbA1c in the intervention group, no firm conclusions can yet be drawn. Further studies are needed to address methodological issues as we believe these interventions can support behavior change among adolescents with poorly controlled type 1 diabetes. ClinicalTrials.gov identifier: NCT02230137.

Randomized Controlled Study to Evaluate the Impact of Flexible Patient‐controlled Visits in People with Type 1 Diabetes: The DiabetesFlex Trial

2022 ◽  
Author(s):  
Tinne Laurberg ◽  
Liv Marit Valen Schougaard ◽  
Niels Henrik Ingvar Hjollund ◽  
Kirsten Elisabeth Lomborg ◽  
Troels Krarup Hansen ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Randomized Controlled ◽  
The Impact

scholarly journals Motivational Interviewing and Self-care in Type 1 Diabetes:a randomized controlled clinical trial study protocol

2020 ◽  
Author(s):  
Dacil Alvarado-Martel ◽  
Mauro Boronat ◽  
María del Pino Alberiche ◽  
María Andrea Algara ◽  
Ana M Wägner
Keyword(s):  
Type 1 Diabetes ◽  
Motivational Interviewing ◽  
Intervention Group ◽  
Self Care ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Randomized Controlled Clinical Trial ◽  
Randomized Controlled

Abstract BackgroundType 1 diabetes is a chronic disease with complex therapeutic recommendations that require day-to-day lifestyle changes. People with type 1 diabetes need to be involved in their health care in order to achieve satisfactory control of the condition. Motivational Interviewing is a communication tool that has been shown to be effective in changing behaviors in people with addictions, obesity and type 2 diabetes.Our objective is to evaluate the impact of a Motivational Interviewing intervention in patients with type 1 diabetes, through a randomized controlled clinical trial.MethodsSixty-six patients with type 1 diabetes and hemoglobin A1c>= 8% have been included and randomly assigned (computer-generated sequence, sealed envelopes, ratio 1:1) either to the intervention group or to the control group. In the intervention group, appointments every four months with the endocrinologist include Motivational Interviewing; in the control group, the appointments proceed as usual. Patients will be followed for 16 months.The primary outcome will be self-care behaviors, assessed according to a validated questionnaire, the Diabetes Self-Care Inventory-Revised Version. Secondary outcomes include: HbA1c, motivation for self-care, self-efficacy, health-related quality of life, satisfaction with professional-patient relationship, fulfillment of patients' own objectives and other sociodemographic and clinical variables related to disease control.The practitioners will receive training in Motivational Interviewing in order to help them promote adherence to self-care, encourage patient motivation and improve the doctor-patient relationship. The Motivational Interviewing intervention will be evaluated through videorecordings of the sessions and the administration of a purpose-built questionnaire, the EVEM 2.0 scale, by two psychologists, blinded to the assigned treatment. DiscussionThere is evidence that MI can improve self-care in type 2 diabetes. In T1D, however, its application has focused on adolescents, but, at present, there are no published data on the effect of MI in adults with T1D. In this study, we aim to evaluate the effect of MI on self-care and HbA1c.

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