Impact of Diabetes Prevention Guideline Adoption on Health Outcomes: A Pragmatic Implementation Trial.

Autor: Murphy WJ; Academy of Nutrition and Dietetics, Chicago, IL; Lumere Inc, a GHX Company, Chicago, IL., Hand RK; Department of Nutrition, Case Western Reserve University, Cleveland, OH; Dietetics Practice Based Research Network, Research International and Scientific Affairs with the Academy of Nutrition and Dietetics, Chicago, IL., Abram JK; Nutrition Research Network (former Dietetics Practice Based Research Network), Research International and Scientific Affairs with the Academy of Nutrition and Dietetics, Chicago, IL., Papoutsakis C; Nutrition and Dietetics Data Science Center, Research International and Scientific Affairs with the Academy of Nutrition and Dietetics, Chicago, IL. Electronic address: cpapoutsakis@eatright.org.
Jazyk: angličtina
Zdroj: Journal of the Academy of Nutrition and Dietetics [J Acad Nutr Diet] 2021 Oct; Vol. 121 (10), pp. 2090-2100.e1. Date of Electronic Publication: 2020 Dec 03.
DOI: 10.1016/j.jand.2020.11.001
Abstrakt: Limited research exists to evaluate nutrition guideline impact on clinical practice and patient health outcomes. In this study we investigate (1) the impact of guideline training on the implementation of the diabetes prevention Evidence-Based Nutrition Practice Guideline (EBNPG), and (2) the relationship between EBNPG congruence and resulting health outcomes in patients with prediabetes. We conducted an implementation study in which registered dietitian nutritionists (RDNs) provided nutrition care with 3-month follow-up to 102 pre-diabetes patients before and after a professional training on the implementation of the Diabetes Prevention EBNPG. Using the RDNs' Nutrition Care Process (NCP) documentation, we measured percent guideline congruence and health outcomes (body weight, waist circumference, fasting glucose, glycosylated hemoglobin), and modeled health outcomes. Guideline congruence improved after training by 4.3% (P < 0.05). However, no significant associations were observed between guideline training, or guideline congruence and health outcomes. Our model showed a reduction in waist circumference (2.1 ± 0.92 cm; P = 0.023), and body weight (-1.78 ± 0.55 kg; P = 0.001) throughout the course of the study. Training of nutrition professionals improved congruence to EBNPG for Diabetes Prevention. Nevertheless, improved guideline congruence did not impact related health outcomes. Standard care including nutrition intervention resulted in body weight and waist circumference reductions. Future research needs to further address the impact of evidence-based guidelines on outcomes in all areas of practice.
(Copyright © 2021 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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