Evaluating the effectiveness of a multi-faceted inpatient diabetes management program among hospitalised patients with diabetes mellitus
| Autor: | E. Shyong Tai, Shih Ling Kao, Yilin Ning, Ying Chen, Mark Kevin Salloway, Eric Yin Hao Khoo, Chuen Seng Tan, Maudrene L. S. Tan |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
030209 endocrinology & metabolism Healthcare quality improvement Hypoglycemia Tertiary care lcsh:Diseases of the endocrine glands. Clinical endocrinology 03 medical and health sciences 0302 clinical medicine Diabetes mellitus Diabetes management Intervention (counseling) medicine 030212 general & internal medicine Inpatient hyperglycemia Intervention program lcsh:RC648-665 business.industry Confounding General Medicine medicine.disease Work force Emergency medicine Inpatient hypoglycemia business Research Article |
| Zdroj: | Clinical Diabetes and Endocrinology, Vol 6, Iss 1, Pp 1-13 (2020) Clinical Diabetes and Endocrinology |
| ISSN: | 2055-8260 |
| DOI: | 10.1186/s40842-020-00107-2 |
| Popis: | Background Diabetes mellitus (DM) is one of the most common chronic diseases. Individuals with DM are more likely to be hospitalised and stay longer than those without DM. Inpatient hypoglycemia and hyperglycemia, which are associated with adverse outcomes, are common, but can be prevented through hospital quality improvement programs. Methods We designed a multi-faceted intervention program with the aim of reducing inpatient hypoglycemia and hyperglycemia. This was implemented over seven phases between September 2013 to January 2016, and covered all the non-critical care wards in a tertiary hospital. The program represented a pragmatic approach that leveraged on existing resources and infrastructure within the hospital. We calculated glucometric outcomes in June to August 2016 and compared them with those in June to August 2013 to assess the overall effectiveness of the program. We used regression models with generalised estimating equations to adjust for potential confounders and account for correlations of repeated outcomes within patients and admissions. Results We observed significant reductions in patient-days affected by hypoglycemia (any glucose reading p 14 mmol/L: OR = 0.84, 95% CI: 0.71 to 0.99, p = 0.041). Similar findings were observed for admission-level hypoglycemia and hyperglycemia. Further analyses suggested that these reductions started to occur four to 6 months post-implementation. Conclusions Our program was associated with sustained improvements in clinically relevant outcomes. Our described intervention could be feasibly implemented by other secondary and tertiary care hospitals by leveraging on existing infrastructure and work force. |
| Databáze: | OpenAIRE |
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