scholarly journals A Narrative Review of Diabetes Intervention Studies to Explore Diabetes Care Opportunities for Pharmacists

2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
Shamala Ayadurai ◽  
H. Laetitia Hattingh ◽  
Lisa B. G. Tee ◽  
Siti Norlina Md Said
Keyword(s):  
Diabetes Care ◽  
Intervention Studies ◽  
Diabetes Management ◽  
Intervention Strategy ◽  
Pressure Control ◽  
Evidence Based ◽  
Diabetes Intervention ◽  
Randomised Controlled ◽  
Evidence Based Care

Background. We conducted a review of current diabetes intervention studies in type 2 diabetes and identified opportunities for pharmacists to deliver quality diabetes care.Methods. A search on randomised controlled trials (RCT) on diabetes management by healthcare professionals including pharmacists published between 2010 and 2015 was conducted.Results and Discussion. Diabetes management includes multifactorial intervention which includes seven factors as outlined in diabetes guidelines, namely, glycaemic, cholesterol and blood pressure control, medication, lifestyle, education, and cardiovascular risk factors. Most studies do not provide evidence that the intervention methods used included all seven factors with exception of three RCT which indicated HbA1c (glycated hemoglobin) reduction range of 0.5% to 1.8%. The varied HbA1C reduction suggests a lack of standardised and consistent approach to diabetes care. Furthermore, the duration of most studies was from one month to two years; therefore long term outcomes could not be established.Conclusion. Although pharmacists’ contribution towards improving clinical outcomes of diabetes patients was well documented, the methods used to deliver structured, consistent evidence-based care were not clearly stipulated. Therefore, approaches to achieving long term continuity of care are uncertain. An intervention strategy that encompass all seven evidence-based factors will be useful.

scholarly journals Type 2 diabetes in women of reproductive age

2021 ◽  
Vol 9 (2) ◽  
Author(s):  
Donna M. Williams ◽  
Kathryn Evans Kreider
Keyword(s):  
Type 2 Diabetes ◽  
Nurse Practitioners ◽  
Diabetes Management ◽  
Reproductive Age ◽  
Current Evidence ◽  
Evidence Based ◽  
Women Of Reproductive Age

The prevalence of type 2 diabetes in women of reproductive age ranges from 3% to 7%. Due to the common nature of this condition, it is imperative for nurse practitioners who care for women to understand evidence-based methods of diabetes management. The aim of this article is to describe current screening and diagnostic criteria for type 2 diabetes, discuss current evidence-based management and patient education necessary to prevent long-term complications, and provide the tools for a healthy reproductive plan in women with type 2 diabetes from puberty until menopause. Diabetes management extends well beyond glucose control, and nurse practitioners should be attuned to all factors that can impact cardiovascular risk and quality of life.

The State of Evidence-Based Care in Long-Term Care Institutions: A Provincial Survey

2001 ◽  
Vol 20 (3) ◽  
pp. 357-372 ◽  
Author(s):  
Julie Richardson ◽  
Julie Moreland ◽  
Pat Fox
Keyword(s):  
Long Term Care ◽  
The State ◽  
Evidence Based ◽  
Term Care ◽  
Maladies Chroniques ◽  
Longue Duree ◽  
Pour Cent ◽  
Evidence Based Care ◽  
Pratique Clinique

RÉSUMÉEn Ontario (Canada), on a mené une enquête sur l'importance du recours aux directives cliniques dans les établissements de maladies chroniques et de soins de longue durée et de la prise en compte de l'opinion du personnel en matière de conditions cliniques ou de problèmes reliés au développement des directives de pratique clinique et sur les facteurs qui initient les changements de la pratique clinique. Cinq cent cinquante questionnaires ont été envoyés en deux étapes et 306 d'entre eux ont été retournés. Quarante pour cent des établissements connaissaient les directives fondées sur les résultats mais seulement 21,6 pour cent les utilisaient. Elles sont surtout utilisées par les organismes financés par le gouvernement, plus par les établissements de soins aigus qui disposent de lits pour les malades chroniques et par les centres d'accueil et moins par les organismes qui ne sont pas financés par le gouvernement. Les problèmes cliniques que les organismes jugent les plus importants pour l'élaboration des directives sont les problèmes de comportement, l'incontinence, les problèmes d'alimentation et les problèmes de soins de la peau. Les conclusions du sondage pourront servir à fixer le financement des établissements et à déterminer les cas où il faudra fonder les soins sur les résultats et ceux où l'on dispose de résultats sur lesquels constituer les soins sans toutefois s'y fier et pour comprendre les raisons de cette approche.

scholarly journals Effects of discontinuation of chronic medication in primary care: a systematic review of deprescribing trials

2018 ◽  
Vol 68 (675) ◽  
pp. e663-e672 ◽  
Author(s):  
Sioe Lie Thio ◽  
Joana Nam ◽  
Mieke L van Driel ◽  
Thomas Dirven ◽  
Jeanet W Blom
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Care Physician ◽  
Evidence Based ◽  
Chronic Medication ◽  
Primary Care Settings ◽  
Number Of Patients ◽  
The Mean ◽  
Randomised Controlled

BackgroundPolypharmacy is becoming more prevalent and evaluation of appropriateness of medication use is increasingly important. The primary care physician often conducts the deprescribing process; however, there are several barriers to implementing this.AimTo examine the feasibility and safety of discontinuation of medication, with a focus on studies that have been conducted in the community, that is, primary care (or general practice) and nursing homes.Design and settingThis systematic review included randomised controlled trials published in 2005–2017, which studied withdrawal of long-term drugs prescribed in primary care settings and compared continuing medication with discontinuing.MethodPubMed and EMBASE searches were conducted and the extracted data included the number of patients who successfully stopped medication and the number of patients who experienced relapse of symptoms or restarted medication.ResultsA total of 27 studies reported in 26 papers were included in this review. The number of participants in the studies varied from 20 to 2471 and the mean age of participants ranged from 50.3 years to 89.2 years. The proportion of patients who successfully stopped their medication varied from 20% to 100%, and the range of reported relapse varied from 1.9% to 80%.ConclusionOnly a few studies have examined the success rate and safety of discontinuing medication in primary care, and these studies are very heterogeneous. Most studies show that deprescribing and cessation of long-term use seem safe; however, there is a risk of relapse of symptoms. More research is needed to advise physicians in making evidence-based decisions about deprescribing in primary care settings.

scholarly journals Self-harm in older people: a clear need for specialist assessment and care

2012 ◽  
Vol 200 (5) ◽  
pp. 356-358 ◽  
Author(s):  
Michael S. Dennis ◽  
David W. Owens
Keyword(s):  
Older Adults ◽  
Older People ◽  
Evidence Based ◽  
Short Term ◽  
Younger Adults ◽  
Suicide Rates ◽  
Self Harm ◽  
Evidence Based Care

SummarySuicide rates are generally elevated after episodes of non-fatal self-harm, especially among older adults. Evidence suggests that non-fatal and fatal self-harm are more closely related in older than in younger adults. Older people who have self-harmed need specialist assessment followed by good short-term and long-term evidence-based care.

scholarly journals DPARD: rationale, design and initial results from the Dutch national diabetes registry

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jessica C. G. Bak ◽  
Dick Mul ◽  
Erik H. Serné ◽  
Harold W. de Valk ◽  
Theo C. J. Sas ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetes Care ◽  
Diabetes Management ◽  
Management Strategies ◽  
Clinical Information ◽  
Past Century ◽  
Hospital Data ◽  
Diabetes Registry ◽  
Quality Of Diabetes Care

Abstract Background Treatment of diabetes mellitus has majorly improved over the past century, however, the disease burden is high and its prevalence still expanding. Further insight in the diabetes population is imperative to improve the quality of diabetes care by enhancement of knowledge-based diabetes management strategies. To this end, in 2017 a Dutch nationwide consortium of diabetologists, paediatric endocrinologists, and diabetes patients has founded a national outpatient diabetes care registry named Dutch Pediatric and Adult Registry of Diabetes (DPARD). We aim to describe the implementation of DPARD and to provide an overview of the characteristics of patients included during the first 2 years. Methods For the DPARD cohort with long-term follow-up of observational nature, hospital data are gathered directly from electronic health records and securely transferred and stored. DPARD provides weekly updated clinical information on the diabetes population care on a hospital-level benchmarked against the national average. Results Between November 2017 and January 2020, 20,857 patients were included from 8 (11%) Dutch hospitals with a level of care distribution representative of all diabetic outpatients in the Netherlands. Among patients with known diabetes type, 41% had type 1 diabetes, 51% type 2 diabetes, and 8% had diabetes due to other causes. Characteristics of the total patient population were similar to patients with unknown diabetes classification. HbA1c levels decreased over the years, while BMI levels showed an increase over time. Conclusions The national DPARD registry aims to facilitate investigation of prevalence and long-term outcomes of Dutch outpatients with diabetes mellitus and their treatment, thus allowing for quality improvement of diabetes care as well as allowing for comparison of diabetes care on an international level.

scholarly journals Metabolic Vipaka

2019 ◽  
Vol 07 (01) ◽  
pp. 028-030
Author(s):  
Dayakshi D. K. Abeyaratne ◽  
Gagan Priya ◽  
Sanjay Kalra ◽  
Than Than Aye ◽  
Moe Wint Aung ◽  
...  
Keyword(s):  
Stress Reduction ◽  
Psychological Health ◽  
Diabetes Care ◽  
Mindfulness Meditation ◽  
Diabetes Management ◽  
Legacy Effect ◽  
Reduction Strategies ◽  
Short And Long Term ◽  
The Individual

AbstractDiabetes management should focus on biopsychosocial aspects and comprehensive care. The philosophical tenets of Buddhism can be a source of inspiration for both the individual with diabetes and health care provider. Buddhism preaches the immutable relationship between action and outcomes. This has a corollary in diabetes care; optimized metabolic control in diabetes is associated with improved short- and long-term outcomes and a legacy effect. Buddhism emphasizes on maintaining a “middle path.” When applied to diabetes care, this would mean avoiding both extremes of hyperglycemia and hypoglycemia and optimization of metabolic health while minimizing treatment-emergent adverse events. Mindfulness meditation-based stress reduction strategies may further improve not only psychological health but also biophysical outcomes in diabetes and merit further research.

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