Digging deep into diabetes: achieving better glycemic control in diabetic patients in a resident-run clinic.

Autor: Hawatmeh, Sara, Meier, Maggie, Leung, Erika, Haque, Ramza, Kaur, Harinderjeet, Asghar, Muhammad F., Talebian, Amirsoheil, Qaiyum, Osman, Shailly, Rajat, Al-Abboud, Omar, Patlolla, Keerthi, Aziz, Akm Towfique, Kawsar, Hameem I.
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Zdroj: Journal of Community Hospital Internal Medicine Perspectives (JCHIMP); Jul/Aug2019, Vol. 9 Issue 4, p290-295, 6p
Abstrakt: Background: Diabetes mellitus (DM) affects over 30 million Americans with an estimated annual cost of $327 billion in 2017. Patients with diabetes, especially with financial and/or social hardships, pose challenges in achieving target hemoglobin A1c (HbA1c) values. Understanding patient-specific barriers offer opportunities to improve outcomes in patient care. Objective: We aimed to improve a patient's glycemic control by reducing barriers to care. Furthermore, we evaluated the impact that a resident quality improvement effort had on providing high value diabetic care. Methods: We performed a retrospective cohort study of patients with HbA1c >9.0% in an underserved, resident-run clinic. Patients were surveyed on their knowledge of diabetes and reported obstacles to achieve diabetic control. We then implemented a 12 -month customized, patient-directed, multi-modal, multidisciplinary intervention. Results: Ninety-four patients with HbA1c >9.0% were identified, 65 surveyed, and 51 included in the intervention phase. After the intervention phase, re-evaluation of HbA1c in a paired sample comparison showed that the average HbA1c had decreased by 1.41% (11.28% vs. 9.87%, p < 0.01). Among the patients included in the intervention group, approximately 8% had their HbA1c reduced by ≥50% from their baseline, 23% had their HbA1c reduced by ≥25% from their baseline and 49% had their HbA1c reduced by ≥10% from their baseline. Conclusions: A strategically designed, a patient-centered customized intervention can have a positive impact on a patient's diabetic control. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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