scholarly journals Reductions in Positive Clostridioides difficile Events Reportable to NHSN With Adoption of Reflex EIA Testing in 13 Atlanta Hospitals

2020 ◽  
Vol 41 (S1) ◽  
pp. s47-s48
Author(s):  
Dana Goodenough ◽  
Samantha Sefton ◽  
Elizabeth Smith ◽  
Colleen Kraft ◽  
Jay Varkey ◽  
...  
Keyword(s):  
Population Based ◽  
Performance Measure ◽  
Test Method ◽  
Nucleic Acid Amplification ◽  
Test Results ◽  
Emerging Infections ◽  
Percent Reduction ◽  
Clostridioides Difficile ◽  
Reflex Testing ◽  
The Impact

Background: US hospitals are required to report C. difficile infections (CDIs) to the NHSN as a performance measure tied to payment penalties for poor scores. Currently, only the charted CDI test results performed last in reflex testing scenarios are reported to the NHSN (CDI events). We describe the reduction in NHSN CDI events from the addition of a reflex toxin enzyme immunoassay (EIA) after a positive nucleic acid amplification test (NAAT) in teaching and nonteaching hospitals, and we estimate the impact on standardized infection ratios (SIR). Methods: Reporting of all CDI test results, by test method, occurred during April 2018–July 2019 to the Georgia Emerging Infections program (funded by the Centers for Disease Control and Prevention), which conducts active population-based surveillance in an 8-county Atlanta area (population, 4 million). Among facilities starting reflex EIA testing, results were aggregated by test method during months of reflex testing to calculate facility-specific reduction in NHSN CDI events (% reduction; 1-[no. EIA+/no. NAAT+]). Differences in percent reduction between facilities by characteristic were compared using the Kruskal-Wallis test. We simulated expected changes in the SIR for a range of reductions, assuming equal effect on both community-onset (CO) and hospital-onset (HO) tests. Each facility’s historical NHSN CDI events prior to reflex testing were used to estimate changes to facility-specific SIRs by reducing values by the corresponding facility’s percent reduction. Results: Overall, 13 acute-care hospitals (bed size, 52–633; ICU bed size, 6–105) started reflex testing during the study period (mean, 7 months, 15,800 admissions, 66,400 patient days), resulting in 550 +NAAT tests reflexing to 180 +EIA tests (pooled mean 58% reduction). Percent reduction varied (mean, 67%; range, 42%–81%) but did not differ between larger (≥217 beds) and smaller hospitals (61 vs 50% reduction; P > .05) or by outsourced versus inhouse testing (65% vs 54% reduction; P > .05). Simulations identified a threshold reduction at which point effect on HO counteract the effects on CO events enough to reduce the SIR; thresholds for nonteaching and teaching were 26% and 32% reduction, respectively (Fig. 1). The estimated reductions in facility-specific SIRs using measured percent reductions on historic NHSN CDI events closely paralleled the simulation, and the mean estimated change in SIR was −46% (range, −12% to −71%) (Fig. 1). Conclusions: Although the magnitude of the effect varied, all 13 facilities experienced dramatic reductions in CDI events reportable to NHSN due to reflex testing; applying these reductions to historical NHSN data illustrates anticipated reductions in their facility-specific SIRs due to this testing change.Funding: NoneDisclosures: Scott Fridkin, consulting fee, vaccine industry (various) (spouse)

scholarly journals 754. A Two-step Testing Algorithm for Hospital-onset Clostridioides difficile Infection (CDI) Reduces Prescribing of C. difficile (CD) Therapy but Its Ability to Guide Treatment Decisions Remains Unclear

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S474-S474
Author(s):  
Mackenzie Dolan ◽  
Heather Cox ◽  
Cirle A Warren ◽  
Costi Sifri ◽  
Melinda Poulter ◽  
...  
Keyword(s):  
Decision Support Tool ◽  
Treatment Decisions ◽  
Adverse Outcomes ◽  
Nucleic Acid Amplification ◽  
Test Results ◽  
Patient Death ◽  
Support Tool ◽  
Clostridioides Difficile ◽  
Days Of Therapy ◽  
Testing Algorithm

Abstract Background Determining true CDI versus CD colonization through CD testing is a continuing challenge. A previously introduced decision support tool at UVA Health significantly reduced inappropriate testing without adverse outcomes. More recently, our methodology changed from nucleic acid amplification test (NAAT) alone to an initial NAAT followed by ELISA for toxin to improve specificity. The purpose of this analysis was to assess provider interpretation of test results, using targeted CD therapy as a surrogate. Methods This single-center, retrospective study evaluated all patients with a positive NAAT (Cepheid Xpert® C. difficile) on day 4 or later of hospitalization following 2-step algorithm implementation from Feb 2020 through Feb 2021. Toxin negative (TOX-) test results (C. DIFF QUIK CHEK COMPLETE®) were accompanied by a comment that discordance may represent colonization or CDI and to consider ID consult. The proportion of toxin positive (TOX+) versus TOX- patients receiving ≥ 1 dose of CD therapy served as the primary outcome with partial courses considered < 10 days. Clinical outcomes were also compared. Results Ninety patients with NAAT+ results were included, of whom 58 (64%) were TOX-. Thirty-two (100%) TOX+ (median days of therapy [IQR] = 14 [11-17]) versus 51 (88%) TOX- patients (median days of therapy [IQR] = 11 [7-14]) received CD therapy (p=0.04). Treatment decisions were guided by ID physicians for 32 (63%) TOX- patients; ID recommendations to discontinue CD therapy were followed in 2 out of 9 (22%) cases. TOX- patients received partial therapy due to patient death (n=5), presumptive colonization (n=3), and provider error (n=1). Of TOX- patients receiving partial or no treatment, there were no CDI-related adverse outcomes during the admission. CDI-related colectomy occurred in 2 (6%) and 1 (2%) TOX+ and TOX- patients, respectively. Five in-hospital deaths with CDI as a contributing factor occurred in the TOX+ group. Conclusion Adoption of a 2-step NAAT plus toxin testing algorithm for hospital-onset CDI reduced the frequency with which TOX- patients received CD therapy but the vast majority were still treated. Most providers considered a positive NAAT indicative of CDI, regardless of TOX status. Disclosures All Authors: No reported disclosures

scholarly journals Evaluation of Connecticut medical providers’ concordance with 2017 IDSA/SHEA Clostridioides difficile treatment guidelines in New Haven County, 2018–2019

2020 ◽  
pp. 1-8
Author(s):  
Casey Morgan Luc ◽  
Danyel Olson ◽  
David B. Banach ◽  
Paula Clogher ◽  
James Hadler
Keyword(s):  
Treatment Guidelines ◽  
Severe Disease ◽  
Recurrence Risk ◽  
Population Based ◽  
New Haven ◽  
Emerging Infections ◽  
Medical Providers ◽  
First Line ◽  
Clostridioides Difficile ◽  
Increased Risk

Abstract Objectives: To assess Connecticut medical providers’ concordance (2018–2019) with the 2017 Clostridioides difficile infection (CDI) treatment update by the Infectious Disease Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA). The effect of guideline concordance on CDI recurrence risk was also assessed. Design: Prospective, population-based study. Setting: New Haven County, Connecticut, from January 1, 2017, to December 31, 2019. Patients: CDI incident case (no positive tests in the prior 8 weeks), not limited by care setting. Methods: Using data from the Emerging Infections Program’s CDI surveillance, severity and concordance were defined. Presence of megacolon and/or ileus defined fulminant disease; absence defined nonsevere/severe disease. Using 2017 treatment as baseline, 2018–2019 concordance was defined as receiving the recommended first-line antibiotic (ie, vancomycin or fidaxomicin for adult patients, vancomycin or metronidazole for pediatric patients) for exactly 10 days. For all analyses, significance was P < .05. Results: Among 990 cases, concordance increased from 24.8% in 2018 to 37.0% in 2019. First-line antibiotic concordance increased from 61.2% in 2018 to 79.9% in 2019. Recurrence risk was significantly associated with patients aged ≥65 years and was highest for those aged 75–84 years, but this factor was not significantly associated with concordance. Conclusions: From 2018 through 2019, CDI treatment in New Haven County increasingly was concordant with the 2017 treatment update but remained low in 2019. Although concordance with treatment guidelines did not affect recurrence risk, close attention should be paid by medical providers to patients aged ≥65 years, specifically those aged 75–84 years because they are at an increased risk for recurrence.

scholarly journals Are Patients Preferentially Receiving Oral Vancomycin for Clostridioides difficile Infection in 2018? A Population Perspective

2020 ◽  
Vol 41 (S1) ◽  
pp. s461-s462
Author(s):  
Dana Goodenough ◽  
Carolyn Mackey ◽  
Michael Woodworth ◽  
Max Adelman ◽  
Scott Fridkin
Keyword(s):  
Recurrent Infection ◽  
Population Based ◽  
Outpatient Setting ◽  
Definitive Treatment ◽  
Emerging Infections ◽  
Oral Vancomycin ◽  
Active Population ◽  
First Line Therapy ◽  
Clostridioides Difficile ◽  
Incident Cases

Background: Historically, metronidazole was first-line therapy for Clostridioides difficile infection (CDI). In February 2018, the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA) updated clinical practice guidelines for CDI. The new guidelines recommend oral vancomycin or fidaxomicin for treatment of initial episode of CDI in adults. We examined the changes in treatment of CDI during 2018 across all types of healthcare settings in metropolitan Atlanta. Methods: Cases were identified through the Georgia Emerging Infections program (funded by the Centers for Disease Control and Prevention), which conducts active population-based surveillance in an 8-county area including Atlanta, Georgia (population, 4,126,399). An incident case was a resident of the catchment area with a positive C. difficile toxin test and no additional positive test in the previous 8 weeks. Recurrent CDI was defined as >1 incident CDI episode in 1 year. Clinical and treatment data were abstracted on a random 33% sample of adult (>17 years) cases. Definitive treatment categories were defined as the single antibiotic agent, metronidazole or vancomycin, used to complete a course. We examined the effect of time of infection, location of treatment, and number of CDI episodes on the use of metronidazole only. Results: We analyzed treatment information for 831 adult sampled cases. Overall, cases were treated at 29 hospitals (568 cases), 4 nursing homes (6 cases), and 101 outpatient providers (257 cases). The mean age was 60 (IQR, 34–86), and 111 (13.4%) had recurrent infection. Moreover, ∼28% of first-incident CDI episodes, 8% of second episodes, and 6% of third episodes were treated with metronidazole only. Compared to facility-based providers, outpatient providers were more likely to treat initial CDI episodes with metronidazole only (44% vs 21%; relative risk [RR], 2.1; 95% CI, 1.7–2.7). Treatment changed over time from 56% metronidazole only in January to 10% in December (Fig. 1). First-incident cases in the first quarter of 2018 were more likely to be treated with metronidazole only compared to those in the fourth quarter (RR, 2.76; 95% CI, 1.91–3.97). Conclusions: Preferential use of vancomycin for initial CDI episodes increased throughout 2018 but remained <100%. CDI episodes treated in the outpatient setting and nonrecurrent episodes were more likely to be treated with metronidazole only. Additional studies on persistent barriers to prescribing oral vancomycin, such as cost, are warranted.Funding: NoneDisclosures: Scott Fridkin reports that his spouse receives a consulting fee from the vaccine industry.

Effects of Chemical Composition on the Impact Properties of A533B Steels

2010 ◽  
Vol 654-656 ◽  
pp. 2895-2898
Author(s):  
Byung Jun Kim ◽  
Ryuta Kasada ◽  
Akihiko Kimura
Keyword(s):  
Chemical Composition ◽  
Energy Use ◽  
Test Method ◽  
Test Results ◽  
Shelf Energy ◽  
Intergranular Cracking ◽  
Test Technique ◽  
Physical Mechanisms ◽  
Specimen Test ◽  
The Impact

In order to estimate the long life integrity of vessel steels with considering various material compositions and irradiation conditions, it is necessary to understand physical mechanisms of the degradation of mechanical properties. In this research, chemical composition effects were investigated for Reactor Pressure Vessel Steels (RPVS) to apply small specimen test technique to surveillance test method. All specimens used in this study were machined from the A533B plate material, which are standard, low Mn, high Cu, high P, and high Cu and high P steels. Tensile strength is increased by phosphorous and copper additions. Charpy tests were carried out at temperature from 73 K to 473 K. The ductile to brittle transition temperature (DBTT) is shifted to higher temperatures with phosphorus additions accompanied by the reduction of the upper shelf energy (USE). The fracture mode of P-added A533B steels at temperatures in the lower shelf energy (LSE) region is intergranular cracking. Test results were discussed in view of the differences on elements of Cu, Mn and P.

scholarly journals A Bundled Approach to Reduce Delayed Testing and Hospital-Acquired Cases of Clostridioides difficile Infection

2020 ◽  
Vol 41 (S1) ◽  
pp. s92-s92
Author(s):  
Ioana Chirca ◽  
Alan Sun ◽  
Adrienne Wright Albrecht ◽  
Kelly Henry
Keyword(s):  
Developed Countries ◽  
Nucleic Acid Amplification ◽  
University Hospital ◽  
National Standard ◽  
Contact Precautions ◽  
The Third ◽  
Clostridioides Difficile ◽  
Clostridioides Difficile Infection ◽  
Healthcare Associated ◽  
The Impact

Background:Clostridioides difficile is a leading cause of nosocomial infectious diarrhea in developed countries, and it has a significant economic impact throughout the world. Early detection of the pathogen and its toxins is critical because early treatment significantly reduces infection-related morbidity, mortality, and medical cost. Surveillance of healthcare-associated infections (HAIs) is conducted using the NHSN standardized infection ratio (SIR). This metric allows comparison of a facility’s observed infection rate to a national benchmark. The SIR can be elevated due to both a lack of institutional criteria for stool submission and the use of highly sensitive but poorly specific testing as a standalone test for diagnosis. The SIR can be artificially elevated by inclusion of C difficile carriers rather than infected patients due to inappropriate testing and overly sensitive methods. We aimed to determine the impact of an institutional nursing-driven protocol for stool submission as well as 2-step testing on the SIR. Methods: Starting from the fourth quarter of 2018, we instituted a nursing protocol for initiation of C. difficile testing. If the patient had ≥3 soft, loose, or liquid stools in 24 hours within the first 3 days of admission, they were placed on contact precautions and an unformed stool sample was submitted for C. difficile nucleic acid amplification testing (NAAT). A positive result prompted further evaluation with a stool enzyme immunoassay toxin test for confirmation of active infection. From hospital day 4 onward, stricter criteria were implemented for testing for C. difficile infection. Data were extrapolated for calculation of a quarterly SIR. This value was then compared to retrospective SIR data from the first quarter of 2016 to the third quarter of 2018. Results: The quarterly total of hospital-onset C. difficile infections from the first quarter of 2016 to the third quarter of 2018 ranged from 24 to 39 incidents per quarter. After implementing the nursing-driven protocol and 2-step testing, the quarterly total of hospital onset C. difficile infections decreased to 5–6 per quarter. The SIR prior to initiation ranged from 0.66 to 1.37 and decreased to 0.306–0.386 after the nursing-driven protocol and 2-step testing were implemented. Conclusions: Implementation of both an institutional nursing-driven protocol for stool submission and a 2-step testing protocol reduced the number of quarterly hospital-onset C. difficile events as well as our facility’s quarterly SIR to below the national standard.Funding: NoneDisclosures: Ioana Chirca, University Hospital

What are NCI-designated cancer centers using for breast cancer HER2 testing?

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 626-626 ◽  
Author(s):  
Kalliopi P. Siziopikou ◽  
Christine B. Weldon ◽  
Julia R. Trosman ◽  
William John Gradishar ◽  
Julian C. Schink
Keyword(s):  
Breast Cancer ◽  
Test Method ◽  
Test Results ◽  
Testing Methods ◽  
Specific Test ◽  
Exact Test ◽  
Cancer Centers ◽  
Her2 Testing ◽  
Biomarker Testing ◽  
Reflex Testing

626 Background: After 15 years of HER2 testing in breast cancer, various testing methods are used in practice. Studies comparing methods are published but no consensus exists on which method is best. Our study provides a benchmark on the use of breast HER2 testing methods in leading U.S. cancer centers. Methods: We conducted an IRB-approved web survey of 58 NCI cancer centers (pathologists and oncologists) providing adult breast cancer care. The survey included 14 questions on breast HER2 testing methods, and reflex and retest practices. We analyzed results using simple frequencies and Fisher's exact test. Results: We achieved a response rate of 98% (57/58 sites). In this cohort, 42% (24/57) of sites conduct HER2 testing for breast cancer using an IHC method with reflex to FISH. Of these, all sites reflex IHC 2+ results and 54% (13/24) automatically reflex IHC results beyond 2+ (see table, results are not mutually exclusive). Concurrent primary FISH and IHC testing is conducted at 32% (18/57) of sites; FISH only testing at 18% (10/57); concurrent primary SISH and IHC testing at 5% (3/57); concurrent primary CISH and IHC testing at 2% (1/57), and CISH only testing at 2% (1/57) of sites. The choice of testing protocol had no correlation with the size of institution, metro vs rural location, NCCN membership, or whether the site acts as a reference lab. However, sites where oncologists always or often request a specific test method were more likely (75%, 21/28) to use FISH as a primary method vs as a reflex method (38%, 9/24), p=.0108. Repeat HER2 testing on surgical tumor samples, after the core biopsy, was reported by 47% of sites (27/57); retesting of relapsed patients by 63% (36/57); and retesting for progressive metastatic disease by 56% (32/57). Conclusions: For HER2 breast biomarker testing, concurrent FISH and IHC testing and expanded reflex testing, beyond IHC 2+ results, have become a common practice at the NCI designated cancer centers. [Table: see text]

scholarly journals 2339. Clostridioides difficile: Impact of Active Screening of Asymptomatic Carriers and Testing Stewardship

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S803-S804
Author(s):  
Mary Beth Graham ◽  
Blake W Buchan ◽  
Siddhartha Singh ◽  
Sara Revolinski ◽  
Nathan A Ledeboer ◽  
...  
Keyword(s):  
Electronic Medical Records ◽  
Medical Records ◽  
Phase 1 ◽  
Nucleic Acid Amplification ◽  
Phase 3 ◽  
Active Screening ◽  
Asymptomatic Carriers ◽  
Clostridioides Difficile ◽  
Testing Algorithm ◽  
The Impact

Abstract Background We recently implemented a hospital-wide C. difficile testing algorithm and screening/isolation of C. difficile asymptomatic carriers primarily in heme-onc units. We aim to evaluate the impact of these interventions on the epidemiology of C. difficile + tests. Methods This retrospective cohort was performed in a 600-bed hospital in Milwaukee, WI, from January 1, 2016 to March 31, 2019. All clinical C. difficile tests included nucleic acid amplification (NAAT; Xpert C. difficile, Cepheid). On February 2017, all NAAT+ tests had toxin (tox) checked (Quick check complete, Alere). Testing algorithm (Figure 1) started mid 2016 until now. Screening phases included: Phase 1 (September 2016–May 2017): C. difficile screening cultures shared with units but not placed in electronic medical records (EMR). Patients + placed on enteric precautions (gown, gloves, hand hygiene). Phase 2 (May 2017–January 2018): C. difficile screening (NAAT) performed on admission and weekly thereafter, results placed in EMR, NAAT+ patients placed on enteric precautions. Phase 3 (January 2018–present): C. difficile screening (NAAT) on admission, results placed in EMR, NAAT+ patients placed on enteric precautions. Federal reporting changed to only reporting NAAT+tox+. Tests (NAAT+, NAAT+tox+, and NAAT+tox-) were analyzed using Poisson regression offsetting for log of patient-days using SAS, v9.4. Results Hospital-wide C. difficile tests decreased from 21 to 10.9 tests per 1,000 patient-days (P < 0.0001; Figure 2). This effect was seen in heme-onc units (41 to 15.7; P < 0.0001; Figure 3) and in all other units (18.9 to 9.9; P < 0.0001). All NAAT+ results decreased from 2.99 to 1.94 per 1,000 patient-days hospital wide (P < 0.0001) but remained unchanged in heme-onc units (4.6 to 3.7, P > 0.05). NAAT+tox+ results remained unchanged hospital wide and in heme-onc units (0.8 to 0.7 and 1.1 to 1.2, respectively; both P > 0.05); however, the frequency of NAAT+tox− tests decreased hospital wide (1.8 to 1.3; P = 0.0003) and in heme-onc units (3.8 to 2.4; P = 0.05). Conclusion A C. difficile testing algorithm was successful decreasing the number of C. difficile tests performed and had a hospital-wide reduction of NAAT+tox− tests. The rate of NAAT+tox+ cases in heme-onc units and hospital wide remained unchanged despite active screening and isolation in selected units. Disclosures All authors: No reported disclosures.

scholarly journals Influence of Diagnostic Method on Outcomes in Phase 3 Clinical Trials of Bezlotoxumab for the Prevention of Recurrent Clostridioides difficile Infection: A Post Hoc Analysis of MODIFY I/II

2019 ◽  
Vol 6 (8) ◽  
Author(s):  
Mark H Wilcox ◽  
Galia Rahav ◽  
Erik R Dubberke ◽  
Lori Gabryelski ◽  
Kerrie Davies ◽  
...  
Keyword(s):  
Relative Difference ◽  
Test Method ◽  
Absolute Difference ◽  
Phase 3 ◽  
Post Hoc Analysis ◽  
Clostridioides Difficile ◽  
Toxigenic Culture ◽  
Clostridioides Difficile Infection ◽  
Post Hoc ◽  
The Impact

Abstract Background The optimum diagnostic test method for Clostridioides difficile infection (CDI) remains controversial due to variation in accuracy in identifying true CDI. This post hoc analysis examined the impact of CDI diagnostic testing methodology on efficacy outcomes in phase 3 MODIFY I/II trials. Methods In MODIFY I/II (NCT01241552/NCT01513239), participants received bezlotoxumab (10 mg/kg) or placebo during anti-CDI treatment for primary/recurrent CDI (rCDI). Using MODIFY I/II pooled data, initial clinical cure (ICC) and rCDI were assessed in participants diagnosed at baseline using direct detection methods (enzyme immunoassay [EIA]/cell cytotoxicity assay [CCA]) or indirect methods to determine toxin-producing ability (toxin gene polymerase chain reaction [tgPCR]/toxigenic culture). Results Of 1554 participants who received bezlotoxumab or placebo in MODIFY I/II, 781 (50.3%) and 773 (49.7%) were diagnosed by tgPCR/toxigenic culture and toxin EIA/CCA, respectively. Participants diagnosed by toxin EIA/CCA were more likely to be inpatients, older, and have severe CDI. In bezlotoxumab recipients, ICC rates were slightly higher in the toxin EIA/CCA subgroup (81.7%) vs tgPCR/toxigenic culture (78.4%). Bezlotoxumab significantly reduced the rCDI rate vs placebo in both subgroups; however, the magnitude of reduction was substantially larger in participants diagnosed by toxin EIA/CCA (relative difference, –46.6%) vs tgPCR/toxigenic culture (–29.1%). In bezlotoxumab recipients, the rCDI rate was lower in the toxin EIA/CCA subgroup (17.6%) vs tgPCR/toxigenic culture (23.6%; absolute difference, –6.0%; 95% confidence interval, –12.4 to 0.3; relative difference, –25.4%). Conclusions Diagnostic tests that detect fecal C. difficile toxins are of fundamental importance to accurately diagnosing CDI, including in clinical trial design, ensuring that therapeutic efficacy is not underestimated.

Model estimates of the results of diabetes patients using modern glucometers with tri-color technology for displaying test results

2019 ◽  
pp. 81-89
Author(s):  
Larisa Dmitrievna Popovich ◽  
Svetlana Valentinovna Svetlichnaya ◽  
Aleksandr Alekseevich Moiseev
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Economic Benefits ◽  
Test Results ◽  
Self Monitoring ◽  
Patients With Diabetes ◽  
The Impact

Diabetes – a disease in which the effect of the treatment substantially depends on the patient. Known a study showed that the use of glucometers with the technology of three-color display of test results facilitates self-monitoring of blood sugar and leads to a decrease in glycated hemoglobin (HbAlc). Purpose of the study: to modeling the impact of using of a glucometer with a color-coded display on the clinical outcomes of diabetes mellitus and calculating, the potential economic benefits of reducing the hospitalization rate of patients with diabetes. Material and methods. Based on data from two studies (O. Schnell et al. and M. Baxter et al.) simulation of the reduction in the number of complications with the use of a glucometer with a color indication. In a study by O. Schnell et al. a decrease of HbA1c by 0.69 percent is shown when using the considered type of glucometers, which was the basis of the model. Results. In the model, the use of a glucometer with a color-coded display for type 1 diabetes led to a decrease in the total number of complications by 9.2 thousand over 5 years per a cohort of 40 thousand patients with different initial levels of HbA1c. In a cohort of 40 thousand patients with type 2 diabetes, the simulated number of prevented complications was 1.7 thousand over 5 years. When extrapolating these data to all patients with diabetes included in the federal register of diabetes mellitus (FRD), the number of prevented complications was 55.4 thousand cases for type 1 diabetes and 67.1 thousand cases for type 2 diabetes. The possible economic effect from the use of the device by all patients with a diagnosis of diabetes, which are included in the FRD, estimated at 1.5 billion rubles for a cohort of patients with type 1 diabetes and 5.3 billion rubles for patients with type 2 diabetes. Conclusion. Improving the effectiveness of self-monitoring, which is the result of the use of glucometers with color indicators, can potentially significantly reduce the incidence of complications in diabetes and thereby provide significant economic benefits to society.

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