A1C Reduction in Patients Who Declined Pharmacist-Led Diabetes Management Services

2021 ◽  
pp. 089719002199339
Author(s):  
Fahamina Ahmed ◽  
Samah A. Hammad ◽  
Jonathan F. Lin ◽  
Teresa L. Gennaro ◽  
Alexis L. Gaspard ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Diabetes Management ◽  
Management Program ◽  
Phone Call ◽  
Patient Specific ◽  
P Value ◽  
The Mean ◽  
Diabetes Management Program ◽  
Management Services

Introduction: The purpose of this research is to assess the mean change in A1C associated with patients who declined a pharmacy-led diabetes management program and to evaluate effects of predictor variables on the odds of achieving improved A1C in these patients. Study design: Retrospective, single-center, single-group, cohort study. Methods: Patients 18 years or older with uncontrolled type 2 diabetes (defined as A1C ≥ 9%) who declined pharmacy-led diabetes management services were included in the study. The primary outcome of the study was to assess the mean change in A1C from time of phone call offering pharmacy management services (initial) to last observed A1C (final recorded A1C). Results: A total of 91 patients were included, 46 males and 45 females. The significant reduction in the mean change from baseline A1C to the final measured A1C was −0.59 (95% CI, −0.9327% to −0.2447%, P-value = 0.0010). This resulted in 8.79% of patients’ final A1C falling into the range of < 7%. Conclusion: Our study found a paradoxical reduction in A1C among patients who declined pharmacy-led diabetes management services, however, our study is limited by having no comparison group. Further research needs to be conducted to identify correlations between characteristics of patients declining diabetes management services in order to assist with identifying patient-specific methods for improving patient outcomes.

Comprehensive Diabetes Management Program for Poorly Controlled Hispanic Type 2 Patients at a Community Health Center

2011 ◽  
Vol 37 (5) ◽  
pp. 680-688 ◽  
Author(s):  
Garry Welch ◽  
Nancy A. Allen ◽  
Sofija E. Zagarins ◽  
Kelly D. Stamp ◽  
Sven-Erik Bursell ◽  
...  
Keyword(s):  
Community Health ◽  
Health Center ◽  
Diabetes Management ◽  
Community Health Center ◽  
Management Program ◽  
Diabetes Management Program

Pharmacist Impact on Clinical Outcomes in a Diabetes Disease Management Program via Collaborative Practice

2005 ◽  
Vol 39 (11) ◽  
pp. 1828-1832 ◽  
Author(s):  
Patrick J Kiel ◽  
Amie D McCord
Keyword(s):  
Disease Management ◽  
Clinical Outcomes ◽  
Diabetes Management ◽  
Management Program ◽  
Collaborative Practice ◽  
Diabetes Disease Management Program ◽  
Daily Aspirin ◽  
The Mean ◽  
Diabetes Management Program

BACKGROUND Clinical outcomes resulting from pharmaceutical care have been incompletely addressed in the diabetes population. We conducted a retrospective study evaluating clinical outcomes in a diabetes disease management program in which clinical pharmacists possessed collaborative practice agreements. OBJECTIVE To evaluate changes in clinical outcomes for patients enrolled in a pharmacist-coordinated diabetes management program. METHODS Medical records of 157 patients enrolled in the diabetes management program between June 2003 and April 2004 were retrospectively reviewed. Data collection included baseline and follow-up values for hemoglobin A1C (A1C) and lipids as well as frequency of adherence to preventive care, including annual foot and eye examinations and daily aspirin therapy. RESULTS For patients with both baseline and follow-up data, the mean A1C reduction was 1.6% (n = 109; p < 0.001). For patients with an initial A1C of ≥8.5%, the mean reduction was 2.7% (n = 57; p < 0.001). The percentage of patients with A1C ≤7% increased from 19% at baseline to 50% at follow-up (p < 0.001). The mean low-density lipoprotein (LDL) reduction observed was 16 mg/dL (n = 73; NS) and the percentage of patients with LDL values ≤100 mg/dL increased from 30% at baseline to 56% at follow-up (p < 0.001). The frequency of microalbumin screening increased by 27% (p < 0.001), and the number of patients with annual eye and foot examinations increased by 27% (p < 0.05) and 15% (p < 0.05), respectively. The percentage of patients who had a positive microalbumin test and were taking a renal protective agent rose 19% from baseline to follow-up (NS). The percentage of patients taking daily aspirin increased from 42% at baseline to 80% at follow-up (p < 0.01). CONCLUSIONS The pharmacist-coordinated diabetes management program was effective in improving clinical markers for enrolled patients. Significant improvements were observed in A1C and LDL values as well as the frequency of adherence to preventive care.

scholarly journals Exploration of Fatalism and Religiosity by Gender and Varying Levels of Engagement Among Mexican-American Adults of a Type 2 Diabetes Management Program

2021 ◽  
Vol 9 ◽  
Author(s):  
Cindy Lynn Salazar-Collier ◽  
Belinda M. Reininger ◽  
Anna V. Wilkinson ◽  
Steven H. Kelder
Keyword(s):  
Type 2 Diabetes ◽  
Mexican American ◽  
Diabetes Management ◽  
Healthcare Setting ◽  
Structured Interview ◽  
Management Program ◽  
Care Management Program ◽  
Diabetes Management Program

Objectives: Purpose of study is to explore the roles religiosity and fatalistic beliefs play in diabetes management among newly, currently, and long-term enrolled Mexican-American participants in a Type 2 diabetes mellitus (T2DM) chronic care management program.Methods: In 2017, study participants (n = 15) completed a semi-structured interview in their preferred language (English or Spanish). Sample was stratified by amount of time individual had been enrolled as a participant of the Salud y Vida program: newly, currently, or long-term. Interviews assessed religious beliefs, beliefs concerning the cause(s) of diabetes, perceived relationship between religiosity and fatalistic beliefs with T2DM management, and the appropriateness of discussing such topics with a health professional. Interview responses were analyzed using ATLAS.ti 8.Results: Themes identified included: perceived autonomy over diabetes prognosis, motivators for self-care, discussions of personal beliefs in the healthcare setting, and the church's role in diabetes management.Conclusions: Among this sample, religiosity and religious fatalism played a complex role in coping with and managing diabetes. Long-term enrolled and male participants expressed beliefs of divine control over health, and a connection between religiosity and health behavior. Long-term enrolled participants felt religious and fatalistic beliefs may be suitable and beneficial to discuss in the healthcare setting.

scholarly journals Lysulin and Testing HbA1c in the Pharmacy or at Home-How the Pharmacist can help their Customers with Diabetes to Better Health

2019 ◽  
pp. 30-32
Author(s):  
John F Burd
Keyword(s):  
Type 2 Diabetes ◽  
Diabetes Management ◽  
Nutritional Supplement ◽  
Management Program ◽  
Lifestyle Changes ◽  
Healthcare Team ◽  
Double Blind ◽  
Diabetes Management Program ◽  
At Home

Pharmacists can be part of the healthcare team to help people with diabetes and prediabetes to better health. Obesity and type 2 diabetes are a worldwide epidemic and a problem that can be helped dramatically with lifestyle changes (diet and exercise) combined with treatment with drugs and supplements. Lysulin is a patent-pending nutritional supplement that contains lysine, zinc and vitamin C and has been shown in double blind placebo controlled studies to help people with prediabetes and type 2 diabetes to better glycemic control and lower their HbA1c. The pharmacist needs to be aware of this breakthrough and inform his customers of the availability of this new product for improving their health. In addition, HbA1c testing at the pharmacy or at home can be very useful in helping people with diabetes know how well their diabetes management program is working.

875-P: Breathe Diabetes Management Program: A Personalized App to Assist Type 2 Diabetics in India to Achieve Healthy Outcomes

Diabetes ◽  
2021 ◽  
Vol 70 (Supplement 1) ◽  
pp. 875-P
Author(s):  
PAWAN K. GOYAL ◽  
ROHAN VERMA ◽  
ADITYA KAICKER ◽  
SAURAV DEKA ◽  
SRIVANI PALUKURI ◽  
...  
Keyword(s):  
Diabetes Management ◽  
Management Program ◽  
Type 2 Diabetics ◽  
Diabetes Management Program

scholarly journals Prevalence of comorbidities associated with type 2 diabetes in patients attending a disease management program, Medellín, Colombia 2014 - 2019: a descriptive study.

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 389
Author(s):  
Uriel Palacios-Barahona ◽  
Jaime Ordoñez Molina ◽  
Nelson Alvis Guzmán ◽  
José Fernando Botero Arango
Keyword(s):  
Type 2 Diabetes ◽  
Disease Management ◽  
Disease Management Program ◽  
Prevalence Ratio ◽  
Descriptive Study ◽  
Management Program ◽  
P Value ◽  
The Mean ◽  
Clinical Records

Background: Type 2 diabetes is a significant cause of morbidity and mortality worldwide. The prevalence has increased due to population aging, obesity, and longer life expectancy. Likewise, the development of complications related to the disease has contributed to a more significant disease burden and is the leading cause of death in people with diabetes.  Methods: A descriptive study of patients in a disease management program in Medellín, Colombia, from June 10, 2014 to March 30, 2019 was carried out. Sociodemographic and clinical data were collected from clinical records. Descriptive analysis was performed using absolute and relative frequencies and the prevalences presented by sex. The Chi-square test was used to calculate the prevalence ratio with a 95 % confidence interval, with a p-value < 0.05 being considered statistically significant. Results: There were 1,018 patients with type 2 diabetes analyzed. The mean age was 66.0 years (SD: 12.93), the mean duration with diabetes was 12.9 years (SD:9.3), 55 % of patients were women, and 60.6 % of patients had no metabolic control. The main comorbidities were dyslipidemia in 67.9 %, obesity in 61.4 %, and hypertension in 59 % of patients. Differences were observed in the prevalence ratio (PR) of women versus men for dyslipidemia (PR 0.68 [CI: 0.52 - 0.89]), coronary artery disease (PR 0.41 [CI: 0.28 - 0,61]) and obesity (PR 0.23 [CI: 0.17 - 0.30]). Conclusions: Patients with type 2 diabetes have a high prevalence of comorbidities: dyslipidemia, obesity and arterial hypertension. A lower prevalence of comorbidities was observed in women than men for dyslipidemia, coronary heart disease, and obesity.

Improved Glycemic Control With a Digital Health Intervention in Adults With Type 2 Diabetes: Retrospective Study (Preprint)

2021 ◽  
Author(s):  
Gretchen Zimmermann ◽  
Aarathi Venkatesan ◽  
Kelly Rawlings ◽  
Michael Scahill
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Diabetes Management ◽  
Digital Health ◽  
Management Program ◽  
Health Intervention ◽  
Diabetes Management Program ◽  
Program Engagement

BACKGROUND Traditional lifestyle interventions have shown limited success in improving diabetes related outcomes. Digital interventions with continuously available support and personalized educational content may offer unique advantages for self-management and glycemic control. OBJECTIVE In the present study, we evaluate changes in glycemic control among participants with type 2 diabetes who enrolled in a digital diabetes management program. METHODS The study employed a single-arm, retrospective design. A total of 950 participants with a HbA1c baseline value of at least 7.0% enrolled in the Vida Health Diabetes Management Program. The intervention included one-to-one remote sessions with a Vida provider and structured lessons and tools related to diabetes management. Hemoglobin A1c (HbA1c) was the primary outcome measure. A total of 258 (27.2%) participants had a follow-up HbA1c completed at least 90 days from program start. Paired t-tests were utilized to evaluate changes in HbA1c between baseline and follow-up. Additionally, a cluster-robust multiple regression analysis was employed to evaluate the relationship between high and low program engagement and HbA1c change. A repeated measures ANOVA was used to evaluate difference in HbA1c as a function of measurement period (ie, pre-Vida enrollment, baseline, and post-enrollment follow-up). RESULTS We observed a significant reduction in HbA1c of -0.81 points between baseline (M = 8.68, SD = 1.7) and follow-up (M = 7.88, SD = 1.46), t(257) = 7.71, P = .00). Among participants considered high-risk (baseline HbA1c >= 8), there was an average reduction of -1.44 points between baseline (M = 9.73, SD = 1.68) and follow-up (M = 8.29, SD = 1.64), t(139) = 9.14, P = .00). Additionally, average follow-up HbA1c (M = 7.82, SD = 1.41) was significantly lower than pre-enrollment HbA1c (M = 8.12, SD = 1.46), F(2, 210) = 22.90, P = .00. There was also significant effect of engagement on HbA1c change, β = -.60, P = .00, such that high engagement was associated with a greater decrease in HbA1c (M = -1.02, SD = 1.60) compared to low-engagement, (M = -.61, SD = 1.72). CONCLUSIONS The present study revealed clinically meaningful improvements in glycemic control among participants enrolled in a digital diabetes management intervention. Higher program engagement was associated with greater improvements in HbA1c. The findings of the present study suggest that digital health intervention may represent an accessible, scalable, and effective solution to diabetes management and improved HbA1c. The study was limited by a non-randomized, observational design and limited post-enrollment follow-up data.

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