1
|
Kim MS, Khan U, Boren SA, Narindrarangkura P, Ye Q, Simoes EJ. Transforming AADE7 for Use in an Evaluation Framework for Health Information Technology in Diabetes Mellitus. J Diabetes Sci Technol 2022; 16:764-770. [PMID: 33435720 PMCID: PMC9294563 DOI: 10.1177/1932296820985842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There is no validated framework to evaluate health information technology (HIT) for diabetes self-management education and support (DSMES). AADE7 Self-Care Behaviors is a patient-centered DSMES designed by the American Association of Diabetes Educators (AADE). We developed a codebook based on the AADE7 Self-Care Behaviors principles as an evaluation framework. In this commentary, we demonstrate the real-life applications of this codebook through three diabetes research studies. The first study analyzed features of mobile diabetes applications. The second study evaluated provider documentation patterns in electronic health records (EHRs) to deliver ongoing patient-centered DSMES. The third study analyzed feedback messages from diabetes apps. We found that this codebook, based on AADE7, can be instrumental as a framework for research, as well as real-life use in HIT for DSMES principles.
Collapse
Affiliation(s)
- Min Soon Kim
- Department of Health Management and
Informatics, University of Missouri Institute for Data Science and Informatics,
University of Missouri, Columbia, MO, USA
- Min Soon Kim, PhD, Department of Health
Management and Informatics, University of Missouri Institute for Data Science
and Informatics, University of Missouri, 5 Hospital Drive, Columbia, MO 65212,
USA.
| | - Uzma Khan
- Department of Medicine, Cosmopolitan
International Diabetes and Endocrinology Center, University of Missouri, Columbia,
USA
| | - Suzanne A. Boren
- Department of Health Management and
Informatics, University of Missouri Institute for Data Science and Informatics,
University of Missouri, Columbia, MO, USA
| | - Ploypun Narindrarangkura
- Department of Health Management and
Informatics, University of Missouri Institute for Data Science and Informatics,
University of Missouri, Columbia, MO, USA
| | - Qing Ye
- Department of Health Management and
Informatics, University of Missouri Institute for Data Science and Informatics,
University of Missouri, Columbia, MO, USA
| | - Eduardo J. Simoes
- Department of Health Management and
Informatics, University of Missouri Institute for Data Science and Informatics,
University of Missouri, Columbia, MO, USA
| |
Collapse
|
2
|
Alsuliman M, Zhang Q, Mishoe S, Durgampudi P. The risk factors for self-monitoring of blood glucose among individuals diagnosed with type 2 diabetes in Saudi Arabia. SAUDI JOURNAL FOR HEALTH SCIENCES 2022. [DOI: 10.4103/sjhs.sjhs_95_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
|
3
|
Marschalko EE, Kotta I, Kalcza-Janosi K, Szabo K, Jancso-Farcas S. Psychological Predictors of COVID-19 Prevention Behavior in Hungarian Women Across Different Generations. Front Psychol 2021; 12:596543. [PMID: 33574787 PMCID: PMC7870484 DOI: 10.3389/fpsyg.2021.596543] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 01/04/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Age related differences were found in prevention behavior, showing that older individuals tend to be the most proactive. The aim of the study was the identification of psychological predictors on COVID-19 prevention behavior in women, across four generations. In addition, the predictive role of the psychological variables was explored through the lens of negative and positive information processing perspective on total and domain-specific COVID-19 prevention behavior. METHODS A cross-sectional research was conducted. The sample included 834 Hungarian speaking women. The assessed variables were: COVID-19 knowledge, risk perception, COVID-19 health anxiety, negative automatic thoughts, psychological flexibility, and four domains of COVID-19 prevention behavior (social distancing, general hygiene, information seeking, health behavior). A three-level hierarchical linear regression analysis was conducted to investigate the predictors of preventive behavior in each generation. RESULTS A diversity across generations was found. In case of baby boomer generation, the final model explained 32.4% of the variance for total prevention behavior [F(14,215) = 8.847, p < 0.001], and only perceived risk made a significant contribution. For Gen X the final model accounted for 21.1% of variance of total prevention behavior [F(14,341) = 7.788, p < 0.001], marital status, perceived risk, COVID-19 health anxiety, and negative automatic thoughts made significant contributions. In case of Gen Y the final model accounted for 6.2% of variance on total prevention behavior [F(14,147) = 1.761, p = 0.05], only perceived risk had a contribution to the final model. For Gen Z the final model accounted for 23.4% of variance on total preventive behavior [F(13,71) = 2.979, p = 0.002], and only psychological flexibility made a contribution to the model. The results on the distinct domains of COVID-19 prevention behavior emphasized details in the dissimilarity among generations. CONCLUSION The role of generational identity on COVID-19 prevention behavior is relevant. The coexistence of negative and positive information processing may have its beneficial role in certain areas of prevention.
Collapse
|
4
|
Du Y, Dennis B, Rhodes SL, Sia M, Ko J, Jiwani R, Wang J. Technology-Assisted Self-Monitoring of Lifestyle Behaviors and Health Indicators in Diabetes: Qualitative Study. JMIR Diabetes 2020; 5:e21183. [PMID: 32857056 PMCID: PMC7486673 DOI: 10.2196/21183] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 07/02/2020] [Accepted: 07/27/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Self-monitoring is key to successful behavior change in diabetes and obesity, and the use of traditional paper-based methods of self-monitoring may be time-consuming and burdensome. OBJECTIVE This study aimed to explore participant experiences while using technology-assisted self-monitoring of lifestyle behaviors and health indicators among overweight or obese adults with type 2 diabetes. METHODS Qualitative data collected from the intervention group of a 6-month, three-arm (control, paper diary, and technology-assisted self-monitoring groups) randomized clinical trial were analyzed. Study participants in the intervention group monitored their diet, exercise, and weight using the LoseIt! app, and their blood glucose levels using a glucometer and the Diabetes Connect app. Semistructured group discussions were conducted at 6 weeks (n=10) from the initiation of the behavioral lifestyle intervention and again at 6 months (n=9). All group interviews were audiotaped and transcribed verbatim. Using a combination of thematic and comparative analysis approaches, two trained professionals coded the transcriptions independently and then discussed and concluded common themes for the 6-week and 6-month discussions separately. RESULTS The sample (n=10), which primarily involved African American participants (n=7) and female participants (n=8), had a mean age of 59.4 years. The following eight themes emerged: (1) perceived benefits of technology-assisted self-monitoring; (2) perceived ease of use (eg, barriers: technical difficulties and lack of self-discipline; facilitators: help from family, friends, and the program); (3) use of technology-assisted self-monitoring; (4) facilitators of engaging in healthy lifestyle behaviors (eg, visualization and awareness of calorie input/expenditure); (5) positive lifestyle change; (6) barriers of engaging in healthy lifestyle behaviors (eg, event influence); (7) learning curve; and (8) monitored data sharing. The first six of these themes were shared between the 6-week and 6-month timepoints, but the codes within these themes were not all the same and differed slightly between the two timepoints. These differences provide insights into the evolution of participant thoughts and perceptions on using technology for self-monitoring and subsequent behavioral lifestyle changes while participating in lifestyle interventions. The findings from the 6-week and 6-month data helped to paint a picture of participant comfort and the integration of technology and knowledge overtime, and clarified participant attitudes, difficulties, behavioral processes, and modifications, as well as health indicators that were experienced throughout the study. CONCLUSIONS Although there were some barriers, participants were able to identify various individual and external facilitators to adjust to and engage in technology-assisted self-monitoring, and it was concluded that the technology-assisted self-monitoring approach was beneficial, safe, and feasible to use for positive lifestyle change. These patient perspectives need to be considered in future research studies when investigating the effectiveness of using technology-assisted self-monitoring, as well as in clinical practice when recommending technology-assisted self-monitoring of lifestyle behaviors and health indicators to improve health outcomes.
Collapse
Affiliation(s)
- Yan Du
- Center on Smart and Connected Health Technologies, School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Brittany Dennis
- Center on Smart and Connected Health Technologies, School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Shanae Lakel Rhodes
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Michelle Sia
- Center on Smart and Connected Health Technologies, School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Jisook Ko
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Rozmin Jiwani
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Jing Wang
- Center on Smart and Connected Health Technologies, School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| |
Collapse
|
5
|
Mitchell S, Malanda B, Damasceno A, Eckel RH, Gaita D, Kotseva K, Januzzi JL, Mensah G, Plutzky J, Prystupiuk M, Ryden L, Thierer J, Virani SS, Sperling L. A Roadmap on the Prevention of Cardiovascular Disease Among People Living With Diabetes. Glob Heart 2020; 14:215-240. [PMID: 31451236 DOI: 10.1016/j.gheart.2019.07.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 07/22/2019] [Indexed: 12/19/2022] Open
Affiliation(s)
| | - Belma Malanda
- International Diabetes Federation, Brussels, Belgium
| | | | - Robert H Eckel
- Division of Endocrinology, Metabolism and Diabetes, and Cardiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Dan Gaita
- Universitatea de Medicina si Farmacie Victor Babes, Institutul de Boli Cardiovasculare, Clinica de Recuperare Cardiovasculara, Timisoara, Romania
| | - Kornelia Kotseva
- Imperial College Healthcare NHS Trust, London, United Kingdom; National Institute for Prevention and Cardiovascular Health, National University of Ireland, Galway, Ireland
| | - James L Januzzi
- Cardiology Division, Massachusetts General Hospital, Boston, MA, USA
| | - George Mensah
- Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Jorge Plutzky
- Preventive Cardiology, Cardiovascular Medicine, Brigham and Women's Hospital, Shapiro Cardiovascular Centre, Boston, MA, USA
| | - Maksym Prystupiuk
- Department of Surgery №2, Bogomolets National Medical University, Kyiv, Ukraine
| | - Lars Ryden
- Department of Medicine K2, Karolinska Institute, Stockholm, Sweden
| | - Jorge Thierer
- Unidad de Insuficiencia Cardíaca, Centro de Educación Médica e Investigación Clínica CEMIC, Buenos Aires, Argentina
| | - Salim S Virani
- Cardiology and Cardiovascular Research Sections, Baylor College of Medicine, Houston, TX, USA; Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX
| | - Laurence Sperling
- Emory Heart Disease Prevention Center, Department of Global Health Rollins School of Public Health at Emory University, Atlanta, GA, USA.
| |
Collapse
|
6
|
Chevinsky JD, Wadden TA, Chao AM. Binge Eating Disorder in Patients with Type 2 Diabetes: Diagnostic and Management Challenges. Diabetes Metab Syndr Obes 2020; 13:1117-1131. [PMID: 32341661 PMCID: PMC7166070 DOI: 10.2147/dmso.s213379] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 03/26/2020] [Indexed: 12/21/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) is associated with an increased risk of disordered eating behaviors including binge eating disorder (BED). Comorbid BED in patients with T2DM has been associated with adverse clinical outcomes such as higher body mass index (BMI) and depressive symptoms. Identifying and addressing this disorder in patients with T2DM is a significant challenge for health-care providers. The purpose of this narrative review is to discuss current perspectives on BED in the context of T2DM with implications for screening and management of these highly comorbid conditions. BED continues to be underrecognized and underdiagnosed. However, there are established tools that providers can use to screen for BED such as the SCOFF Questionnaire and Questionnaire on Eating and Weight Patterns-5. There are several effective treatments for BED including cognitive behavioral therapy, interpersonal therapy, and lisdexamfetamine dimesylate. However, few studies have examined the effects of these treatments in patients with co-morbid T2DM and BED.
Collapse
Affiliation(s)
| | - Thomas A Wadden
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, USA
| | - Ariana M Chao
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, USA
- University of Pennsylvania School of Nursing, Department of Biobehavioral Health Sciences, Philadelphia, PA, USA
- Correspondence: Ariana M Chao University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA19104, USATel +1215-746-7183Fax +1215-898-2878 Email
| |
Collapse
|
7
|
Chen CM, Hung LC, Chen YL, Yeh MC. Perspectives of patients with non-insulin-treated type 2 diabetes on self-monitoring of blood glucose: A qualitative study. J Clin Nurs 2018; 27:1673-1683. [PMID: 29266453 DOI: 10.1111/jocn.14227] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2017] [Indexed: 12/18/2022]
Abstract
AIMS AND OBJECTIVES To explore experiences of self-monitoring of blood glucose among patients with non-insulin-treated type 2 diabetes. BACKGROUND Self-monitoring of blood glucose is essential to diabetes care and facilitates glycaemic control. Patients' perspectives of self-monitoring of blood glucose have seldom been discussed in the literature, and engagement in self-monitoring of blood glucose is consistently low. DESIGN The descriptive phenomenological method was used. METHODS Purposive sampling was conducted to recruit participants from the endocrinology departments of medical institutions in Taiwan based on the following criteria: (i) having a medical diagnosis of type 2 diabetes, (ii) not being treated with insulin, (iii) having engaged in self-monitoring of blood glucose at least once within the preceding 6 months, (iv) being at least 20 years old and (v) not having any major mental or cognitive disorders. Data were collected in outpatient consultation rooms, the participants' homes and other settings where the participants felt secure and comfortable. In-depth interviews were conducted to collect data from 16 patients with diabetes. RESULTS The participants perceived that lifestyle affected blood glucose levels and did not know how to handle high or low blood glucose levels. Their willingness to continue self-monitoring of blood glucose depended on whether healthcare professionals checked or discussed their blood glucose levels with them. CONCLUSIONS The patients' knowledge regarding blood glucose variation and healthcare professionals' attitudes affected the patients' self-monitoring of blood glucose behaviours. The empirical findings illustrated self-monitoring of blood glucose experiences and recommended that healthcare professionals' closely attend to patients' requirements and responses to diabetes and incorporate the self-monitoring of blood glucose into therapy plans. RELEVANCE TO CLINICAL PRACTICE Healthcare professionals should reinforce patients' knowledge on appropriate responses to high and low blood glucose levels, intervene appropriately, discuss self-monitoring of blood glucose results with patients and track these results.
Collapse
Affiliation(s)
- Chen-Mei Chen
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Li-Chen Hung
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan.,School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | | | - Mei Chang Yeh
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| |
Collapse
|
8
|
An Overview of Factors Associated with Adherence to Lifestyle Modification Programs for Weight Management in Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14080922. [PMID: 28813030 PMCID: PMC5580624 DOI: 10.3390/ijerph14080922] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 07/19/2017] [Accepted: 08/08/2017] [Indexed: 12/13/2022]
Abstract
This review aims to provide an overview of the factors associated with adherence reported in existing literature on lifestyle modification programs for weight management among the adult population. An electronic search was performed using PubMed, Medline, PsycINFO and PsycARTICLE to identify studies that examined the factors of adherence to lifestyle modification programs with explicit definition of adherence indicators. We identified 19 studies published between 2004 and 2016. The most commonly used indicator of adherence was attrition, followed by attendance, self-monitoring and dietary adherence. A broad array of factors has been studied but only few studies exploring each factor. Limited evidence suggested older age, higher education, healthier eating and physical activity behaviours, higher stage of change at baseline and higher initial weight loss may predict better adherence. On the other hand, having depression, stress, strong body shape concern, more previous weight loss attempts and being unemployed may predict poor adherence. Inconsistent findings were obtained for self-efficacy, motivation and male gender. This review highlights the need for more rigorous studies to enhance our knowledge on factors related to adherence. Identification of the factors of adherence could provide important implication for program improvement, ultimately improving the effectiveness and the cost-effectiveness of lifestyle modification program.
Collapse
|
9
|
Lemstra M, Bird Y, Nwankwo C, Rogers M, Moraros J. Weight loss intervention adherence and factors promoting adherence: a meta-analysis. Patient Prefer Adherence 2016; 10:1547-59. [PMID: 27574404 PMCID: PMC4990387 DOI: 10.2147/ppa.s103649] [Citation(s) in RCA: 191] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Adhering to weight loss interventions is difficult for many people. The majority of those who are overweight or obese and attempt to lose weight are simply not successful. The objectives of this study were 1) to quantify overall adherence rates for various weight loss interventions and 2) to provide pooled estimates for factors associated with improved adherence to weight loss interventions. METHODS We performed a systematic literature review and meta-analysis of all studies published between January 2004 and August 2015 that reviewed weight loss intervention adherence. RESULTS After applying inclusion and exclusion criteria and checking the methodological quality, 27 studies were included in the meta-analysis. The overall adherence rate was 60.5% (95% confidence interval [CI] 53.6-67.2). The following three main variables were found to impact adherence: 1) supervised attendance programs had higher adherence rates than those with no supervision (rate ratio [RR] 1.65; 95% CI 1.54-1.77); 2) interventions that offered social support had higher adherence than those without social support (RR 1.29; 95% CI 1.24-1.34); and 3) dietary intervention alone had higher adherence than exercise programs alone (RR 1.27; 95% CI 1.19-1.35). CONCLUSION A substantial proportion of people do not adhere to weight loss interventions. Programs supervising attendance, offering social support, and focusing on dietary modification have better adherence than interventions not supervising attendance, not offering social support, and focusing exclusively on exercise.
Collapse
Affiliation(s)
| | | | | | - Marla Rogers
- College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | | |
Collapse
|
10
|
Effectiveness of personalised support for self-management in primary care: a cluster randomised controlled trial. Br J Gen Pract 2016; 66:e354-61. [PMID: 27080318 DOI: 10.3399/bjgp16x684985] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 10/25/2015] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Self-management support is an important component of the clinical management of many chronic conditions. The validated Self-Management Screening questionnaire (SeMaS) assesses individual characteristics that influence a patient's ability to self-manage. AIM To assess the effect of providing personalised self-management support in clinical practice on patients' activation and health-related behaviours. DESIGN AND SETTING A cluster randomised controlled trial was conducted in 15 primary care group practices in the south of the Netherlands. METHOD After attending a dedicated self-management support training session, practice nurses in the intervention arm discussed the results of SeMaS with the patient at baseline, and tailored the self-management support. Participants completed a 13-item Patient Activation Measure (PAM-13) and validated lifestyle questionnaires at baseline and after 6 months. Data, including individual care plans, referrals to self-management interventions, self-monitoring, and healthcare use, were extracted from patients' medical records. Multilevel multiple regression was used to assess the effect on outcomes. RESULTS The PAM-13 score did not differ significantly between the control (n = 348) and intervention (n = 296) arms at 6 months. In the intervention arm, 29.4% of the patients performed self-monitoring, versus 15.2% in the control arm (effect size r = 0.9, P = 0.01). In the per protocol analysis (control n = 348; intervention n = 136), the effect of the intervention was significant on the number of individual care plans (effect size r = 1.3, P = 0.04) and on self-monitoring (effect size r = 1.0, P = 0.01). CONCLUSION This study showed that discussing SeMaS and offering tailored support did not affect patient activation or lifestyle, but did stimulate patients to self-monitor and use individual care plans.
Collapse
|
11
|
Gruson D, Ko G. Laboratory medicine and mobile health technologies at crossroads: Perspectives for the management of chronic diseases. Crit Rev Clin Lab Sci 2016; 53:352-7. [PMID: 26983900 DOI: 10.3109/10408363.2016.1167163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Management of chronic diseases represents a leading health and economic issue worldwide. Biomarkers are critical for the diagnosis and management of both communicable and non-communicable chronic diseases, and mobile health (mHealth) technologies are about to change the "game" with regard to the management of patients with such chronic diseases. The development of efficient, accurate and interactive solutions that integrate biomarkers and mHealth opens new perspectives for caregivers for the management of chronic illness.
Collapse
Affiliation(s)
- Damien Gruson
- a Pôle de recherche en Endocrinologie, Diabète et Nutrition, Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires St-Luc and Université Catholique de Louvain , Brussels , Belgium .,b Department of Laboratory Medicine , Cliniques Universitaires St-Luc and Université Catholique de Louvain , Brussels , Belgium , and
| | - Gabriel Ko
- c GKo and Co Consulting , Paris , France
| |
Collapse
|
12
|
Morello CM, Christopher MLD, Ortega L, Khoan J, Rotunno T, Edelman SV, Henry RR, Hirsch JD. Clinical Outcomes Associated With a Collaborative Pharmacist-Endocrinologist Diabetes Intense Medical Management "Tune Up" Clinic in Complex Patients. Ann Pharmacother 2015; 50:8-16. [PMID: 26546580 DOI: 10.1177/1060028015615586] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND No previous studies exist examining the impact of a short-term pharmacist-endocrinologist collaborative practice model on glycemic control in complex patients. OBJECTIVE Evaluate outcomes associated with a PharmD-Endocrinologist Diabetes Intense Medical Management (DIMM) "tune up" clinic for complex patients. METHODS A retrospective cohort study of 99 patients referred to DIMM clinic versus a comparator group of 56 primary care provider (PCP) patients meeting the same criteria (adult type 2 diabetes patients, glycosylated hemoglobin [A1C] ≥ 8%, follow-up visit within 6 months) in a Veterans Affairs Medical Center. DIMM clinic used a short-term model that coupled personalized clinical care with real-time, patient-specific diabetes education during two to four 60-minute visits over 6 months. PCP patients received usual care. Primary outcome was mean A1C change after 6 months. Secondary measures included fasting blood glucose, lipids, blood pressure, weight, body mass index, and percentage of patients meeting goals. RESULTS Patients in each group had an average of 8 and were taking 12 to 14 medications daily. Mean A1C (%) improvement in DIMM group was significantly greater at 6 months (-2.4 [SD = 2.1] vs -0.8 [SD = 1.7]; P < 0.001), than PCP group. Percentage meeting A1C goal levels (<7%, <8%, and <9%) was significantly greater at 3 and 6 months compared with baseline in the DIMM group (P < 0.001) versus (only <8%) at 3 and 6 months compared with baseline in PCP group. CONCLUSIONS The DIMM clinic "tune up" model demonstrates a successful collaborative practice which helped complex diabetes patients achieve glycemic control in a 6-month period.
Collapse
Affiliation(s)
- Candis M Morello
- UC San Diego, La Jolla, CA, USA Veterans Affairs of San Diego Healthcare System, San Diego, CA, USA
| | - Melissa L D Christopher
- Veterans Affairs of San Diego Healthcare System, San Diego, CA, USA Academic Detailing for VACO Pharmacy Benefits Management, San Diego, CA, USA
| | - Linda Ortega
- UC San Diego, La Jolla, CA, USA Rite Aid in Ontario, CA, USA
| | | | | | - Steven V Edelman
- UC San Diego, La Jolla, CA, USA Veterans Affairs of San Diego Healthcare System, San Diego, CA, USA
| | - Robert R Henry
- UC San Diego, La Jolla, CA, USA Veterans Affairs of San Diego Healthcare System, San Diego, CA, USA
| | - Jan D Hirsch
- UC San Diego, La Jolla, CA, USA Veterans Affairs of San Diego Healthcare System, San Diego, CA, USA
| |
Collapse
|
13
|
Hood KK, Hilliard M, Piatt G, Ievers-Landis CE. Effective strategies for encouraging behavior change in people with diabetes. ACTA ACUST UNITED AC 2015. [DOI: 10.2217/dmt.15.43] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
14
|
Chen CM, Chang Yeh M. The experiences of diabetics on self-monitoring of blood glucose: a qualitative metasynthesis. J Clin Nurs 2014; 24:614-26. [DOI: 10.1111/jocn.12691] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Chen-Mei Chen
- Department of Nursing; Chang Gung University of Science and Technology; Taipei Taiwan
- Department of Nursing; College of Medicine; National Taiwan University; Taipei Taiwan
| | - Mei Chang Yeh
- Department of Nursing; College of Medicine; National Taiwan University; Taipei Taiwan
| |
Collapse
|
15
|
Mohammadzadeh N, Safdari R. Patient monitoring in mobile health: opportunities and challenges. Med Arch 2014; 68:57-60. [PMID: 24783916 PMCID: PMC4272470 DOI: 10.5455/medarh.2014.68.57-60] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2013] [Accepted: 12/25/2013] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND In most countries chronic diseases lead to high health care costs and reduced productivity of people in society. The best way to reduce costs of health sector and increase the empowerment of people is prevention of chronic diseases and appropriate health activities management through monitoring of patients. To enjoy the full benefits of E-health, making use of methods and modern technologies is very important. METHODS This literature review articles were searched with keywords like Patient monitoring, Mobile Health, and Chronic Disease in Science Direct, Google Scholar and Pub Med databases without regard to the year of publications. RESULTS Applying remote medical diagnosis and monitoring system based on mobile health systems can help significantly to reduce health care costs, correct performance management particularly in chronic disease management. Also some challenges are in patient monitoring in general and specific aspects like threats to confidentiality and privacy, technology acceptance in general and lack of system interoperability with electronic health records and other IT tools, decrease in face to face communication between doctor and patient, sudden interruptions of telecommunication networks, and device and sensor type in specific aspect. CONCLUSIONS It is obvious identifying the opportunities and challenges of mobile technology and reducing barriers, strengthening the positive points will have a significant role in the appropriate planning and promoting the achievements of the health care systems based on mobile and helps to design a roadmap for improvement of mobile health.
Collapse
|
16
|
Breland JY, McAndrew LM, Burns E, Leventhal EA, Leventhal H. Using the Common Sense Model of Self-Regulation to Review the Effects of Self-Monitoring of Blood Glucose on Glycemic Control for Non–Insulin-Treated Adults With Type 2 Diabetes. DIABETES EDUCATOR 2013; 39:541-59. [DOI: 10.1177/0145721713490079] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose This systematic review examined the relationship between self-monitoring of blood glucose (SMBG) and glycemic control in patients with type 2 diabetes. The Common Sense Model of Self-Regulation (CSM) served as a theoretical framework for examining how, when (mediators), and for whom (moderators) SMBG improved glycemic control. Data Sources Five databases were searched: Medline, PsychInfo, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and Cumulative Index to Nursing & Allied Health Literature. Study Selection Included studies had cross-sectional, longitudinal, or randomized controlled trial designs; were published between 2007 and 2011; and included patients with type 2 diabetes at least some of whom were not taking insulin; 1318 studies were screened, 119 were reviewed in detail, and 26 were included. Data Extraction Data were collected on the relationship between SMBG and glycemic control, study design, mediators, moderators, participant characteristics, the CSM, and limitations. Data Synthesis Twenty-six studies met criteria for inclusion: 11 cross-sectional, 4 longitudinal, and 11 randomized controlled trials. The results of the cross-sectional studies were inconclusive. Results from the longitudinal studies and randomized control trials suggested that SMBG may improve glycemic control. The few studies investigating mediators or moderators reported mixed results. Few studies effectively measured the CSM. Conclusion Data suggested that SMBG may help improve glycemic control. Future trials must be designed to test hypotheses and improve our understanding of when, how, and for whom SMBG can enhance glycemic control. Rigorously controlled repetitions of current 2-arm trials will yield little new knowledge of theoretical or practical value.
Collapse
Affiliation(s)
- Jessica Y. Breland
- Department of Psychology and the Institute for Health, Healthcare Policy & Aging Research, Rutgers, the State University of New Jersey, New Brunswick, New Jersey (Ms Breland, Dr H. Leventhal)
- Department of Veterans Affairs, New Jersey Health Care System, East Orange, New Jersey (Dr McAndrew)
- New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, New Jersey (Dr McAndrew)
- Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin (Dr Burns)
- Department of Medicine, Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, New Brunswick, New Jersey (Dr EA Leventhal)
| | - Lisa M. McAndrew
- Department of Psychology and the Institute for Health, Healthcare Policy & Aging Research, Rutgers, the State University of New Jersey, New Brunswick, New Jersey (Ms Breland, Dr H. Leventhal)
- Department of Veterans Affairs, New Jersey Health Care System, East Orange, New Jersey (Dr McAndrew)
- New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, New Jersey (Dr McAndrew)
- Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin (Dr Burns)
- Department of Medicine, Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, New Brunswick, New Jersey (Dr EA Leventhal)
| | - Edith Burns
- Department of Psychology and the Institute for Health, Healthcare Policy & Aging Research, Rutgers, the State University of New Jersey, New Brunswick, New Jersey (Ms Breland, Dr H. Leventhal)
- Department of Veterans Affairs, New Jersey Health Care System, East Orange, New Jersey (Dr McAndrew)
- New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, New Jersey (Dr McAndrew)
- Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin (Dr Burns)
- Department of Medicine, Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, New Brunswick, New Jersey (Dr EA Leventhal)
| | - Elaine A. Leventhal
- Department of Psychology and the Institute for Health, Healthcare Policy & Aging Research, Rutgers, the State University of New Jersey, New Brunswick, New Jersey (Ms Breland, Dr H. Leventhal)
- Department of Veterans Affairs, New Jersey Health Care System, East Orange, New Jersey (Dr McAndrew)
- New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, New Jersey (Dr McAndrew)
- Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin (Dr Burns)
- Department of Medicine, Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, New Brunswick, New Jersey (Dr EA Leventhal)
| | - Howard Leventhal
- Department of Psychology and the Institute for Health, Healthcare Policy & Aging Research, Rutgers, the State University of New Jersey, New Brunswick, New Jersey (Ms Breland, Dr H. Leventhal)
- Department of Veterans Affairs, New Jersey Health Care System, East Orange, New Jersey (Dr McAndrew)
- New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, New Jersey (Dr McAndrew)
- Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin (Dr Burns)
- Department of Medicine, Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, New Brunswick, New Jersey (Dr EA Leventhal)
| |
Collapse
|