scholarly journals An ethnographic study of factors associated with poorly controlled Type-2 diabetes and its management among patients accessing primary care services in Jordan

2019 ◽  
Author(s):  
Amer M. Al-Sahouri
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Ethnographic Study ◽  
Factors Associated ◽  
Care Services ◽  
Primary Care Services

scholarly journals Analysis of primary care prescription trends in England during the COVID-19 pandemic compared against a predictive model

2021 ◽  
Vol 9 (3) ◽  
pp. e001143
Author(s):  
John Scott Frazer ◽  
Glenn Ross Frazer
Keyword(s):  
Mental Health ◽  
Type 2 Diabetes ◽  
Primary Care ◽  
Predictive Model ◽  
End Of Life ◽  
Symptom Control ◽  
Face To Face ◽  
Care Services ◽  
Primary Care Services

ObjectivesThe COVID-19 pandemic has had an unprecedented impact across primary care. Primary care services have seen an upheaval, and more and more patients are engaging in telephone consultations in order to maintain social distancing. In the present study, we seek to quantify the effect of the pandemic on primary care prescribing.DesignWe conducted a retrospective analysis of the English Prescribing Dataset from January 2014 to November 2020, totalling 7 542 293 921 prescriptions. Data were separated into prepandemic and pandemic sets. A Holt-Winters predictive model was used to forecast individual drug prescribing based on historic trends. Observed data were compared with the forecast quantitatively and qualitatively.SettingAll prescriptions signed in England and dispensed during the years 2014–2020.ParticipantsAll residents of England who received a prescription from primary care facilities during 2014–2020.ResultsPrescribing of numerous health-critical medications was above predicted in March 2020, including salbutamol (53.0% (99% CI (41.2% to 66.9%))), insulin aspart (26.9% (99% CI (18.5% to 36.6%))) and tacrolimus (18.6% (99% CI (8.3% to 31.1%))). Medications for end-of-life symptom control increased in April, including levomepromazine hydrochloride (94.7% (99% CI (54.6% to 163.0%))). Medications requiring face-to-face visits decreased, including the local anaesthetic bupivacaine hydrochloride (86.6% (99% CI (89.3% to 82.0%))). There was no observed change in medications relating to type 2 diabetes, hypertension or mental health conditions.ConclusionsSignificantly increased prescribing of several medications was observed, especially among those critical for health. A dramatic spike in end-of-life prescribing highlights the adversity faced by community practitioners during 2020. Medications involving face-to-face consultations declined, as did contraceptives, travel-related vaccines and drugs used in dementia and Parkinson’s disease. Drugs relating to type 2 diabetes, hypertension and mental health were unchanged.

scholarly journals Readiness for enhanced self-health management among people with diabetes mellitus

2012 ◽  
Vol 25 (1) ◽  
pp. 133-139
Author(s):  
Márcio Flávio Moura de Araújo ◽  
Ana Maria Parente Garcia Alencar ◽  
Thiago Moura de Araújo ◽  
Marta Maria Coelho Damasceno ◽  
Joselany Áfio Caetano ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Pharmacological Treatment ◽  
Health Management ◽  
Oral Antidiabetic Agents ◽  
Inappropriate Behaviors ◽  
Care Services ◽  
Oral Antidiabetic ◽  
Nursing Diagnosis ◽  
Primary Care Services

OBJECTIVE: To identify the nursing diagnosis, readiness for enhanced self-health management, among people with type 2 diabetes who are adherent to pharmacological treatment. METHODS: The sample consisted of 579 subjects from 12 primary care services who received home visits. To determine adherence to the pharmacological treatment, the pill count test was conducted. Those classified as adherent were given a checklist with the defining characteristics of the nursing diagnosis, readiness for enhanced self-health management. RESULTS: Subjects with type 2 diabetes who presented with the nursing diagnosis were not alcoholics (p = 0.003), did not miss their diabetes consultations (p = 0.000), and had no difficulties / inappropriate behaviors with regard to taking their oral antidiabetic agents (p = 0.000). CONCLUSION: The identification of human responses to the clinical treatment of type 2 diabetes should be continuous, so that nurses can understand the factors involved in the readiness to enhance therapeutic control.

scholarly journals Estimated impact of COVID-19 on preventive care service delivery: an observational cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Scott Laing ◽  
Sharon Johnston
Keyword(s):  
Colorectal Cancer ◽  
Type 2 Diabetes ◽  
Primary Care ◽  
Cervical Cancer ◽  
Preventive Care ◽  
Census Data ◽  
Care Service ◽  
Care Services ◽  
Preventive Care Services

Abstract Background COVID-19 has caused significant healthcare service disruptions. Surgical backlogs have been estimated but not for other healthcare services. This study aims to estimate the backlog of preventive care services caused by COVID-19. Methods This observational study assessed preventive care screening rates at three primary care clinics in Ottawa, Ontario from March to November 2020 using data from 22,685 electronic medical records. The change in cervical cancer, colorectal cancer, and type 2 diabetes screening rates were crudely estimated using 2016 census data, estimating the volume of key services delayed by COVID-19 across Ontario and Canada. Results The mean percentage of patients appropriately screened for cervical cancer decreased by 7.5% (− 0.3% to − 14.7%; 95% CI), colorectal cancer decreased by 8.1% (− 0.3% to − 15.8%; 95% CI), and type 2 diabetes decreased by 4.5% (− 0.2% to − 8.7%; 95% CI). Crude estimates imply 288,000 cervical cancer (11,000 to 565,000; 95% CI), 326,000 colorectal cancer (13,000 to 638,000; 95% CI), and 274,000 type 2 diabetes screenings (13,000 to 535,000; 95% CI) may be overdue in Ontario. Nationally the deficits may be tripled these numbers. Re-opening measures have not reversed these trends. Interpretation COVID-19 decreased the delivery of preventive care services, which may cause delayed diagnoses, increased mortality, and increased health care costs. Virtual care and reopening measures have not restored the provision of preventive care services. Electronic medical record data could be leveraged to improve screening via panel management. Additional, system-wide primary care and laboratory capacity will be needed to restore pre-COVID-19 screening rates.

scholarly journals Factors for Supporting Primary Care Physician Engagement With Patient Apps for Type 2 Diabetes Self-Management That Link to Primary Care: Interview Study (Preprint)

2018 ◽  
Author(s):  
Julie Ayre ◽  
Carissa Bonner ◽  
Sian Bramwell ◽  
Sharon McClelland ◽  
Rajini Jayaballa ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Care Physician ◽  
Self Management ◽  
Clinical Tool ◽  
Face To Face ◽  
Care Services ◽  
Primary Care Services ◽  
Potential Benefits

BACKGROUND The health burden of type 2 diabetes can be mitigated by engaging patients in two key aspects of diabetes care: self-management and regular contact with health professionals. There is a clear benefit to integrating these aspects of care into a single clinical tool, and as mobile phone ownership increases, apps become a more feasible platform. However, the effectiveness of online health interventions is contingent on uptake by health care providers, which is typically low. There has been little research that focuses specifically on barriers and facilitators to health care provider uptake for interventions that link self-management apps to the user’s primary care physician (PCP). OBJECTIVE This study aimed to explore PCP perspectives on proposed features for a self-management app for patients with diabetes that would link to primary care services. METHODS Researchers conducted 25 semistructured interviews. The interviewer discussed potential features that would link in with the patient’s primary care services. Interviews were audio-recorded, transcribed, and coded. Framework analysis and the Consolidated Criteria for Reporting Qualitative Research checklist were employed to ensure rigor. RESULTS Our analysis indicated that PCP attitudes toward proposed features for an app were underpinned by perceived roles of (1) diabetes self-management, (2) face-to-face care, and (3) the anticipated burden of new technologies on their practice. Theme 1 explored PCP perceptions about how an app could foster patient independence for self-management behaviors but could also increase responsibility and liability for the PCP. Theme 2 identified beliefs underpinning a commonly expressed preference for face-to-face care. PCPs perceived information was more motivating, better understood, and presented with greater empathy when delivered face to face rather than online. Theme 3 described how most PCPs anticipated an initial increase in workload while they learned to use a new clinical tool. Some PCPs accepted this burden on the basis that the change was inevitable as health care became more integrated. Others reported potential benefits were outweighed by effort to implement an app. This study also identified how app features can be positively framed, highlighting potential benefits for PCPs to maximize PCP engagement, buy-in, and uptake. For example, PCPs were more positive when they perceived that an app could facilitate communication and motivation between consultations, focus on building capacity for patient independence, and reinforce rather than replace in-person care. They were also more positive about app features that were automated, integrated with existing software, flexible for different patients, and included secondary benefits such as improved documentation. CONCLUSIONS This study provided insight into PCP perspectives on a diabetes app integrated with primary care services. This was observed as more than a technological change; PCPs were concerned about changes in workload, their role in self-management, and the nature of consultations. Our research highlighted potential facilitators and barriers to engaging PCPs in the implementation process.

scholarly journals Factors associated with choice of intensification treatment for type 2 diabetes after metformin monotherapy: a cohort study in UK primary care

2018 ◽  
Vol Volume 10 ◽  
pp. 1639-1648 ◽  
Author(s):  
Samantha Wilkinson ◽  
Ian J Douglas ◽  
Elizabeth Williamson ◽  
Heide Stirnadel-Farrant ◽  
Damian Fogarty ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Cohort Study ◽  
Factors Associated ◽  
Metformin Monotherapy

scholarly journals Estimated Impact of COVID-19 on Preventive Care Service Delivery: An Observational Cohort Study

2021 ◽  
Author(s):  
Scott Laing ◽  
Sharon Johnston
Keyword(s):  
Colorectal Cancer ◽  
Type 2 Diabetes ◽  
Primary Care ◽  
Cervical Cancer ◽  
Preventive Care ◽  
Census Data ◽  
Care Service ◽  
Care Services ◽  
Preventive Care Services

Abstract Background: COVID-19 has caused significant healthcare service disruptions. Surgical procedure backlogs have been calculated but not those for other healthcare services. This study aims to estimate the backlog of key primary preventive care services caused by COVID-19. Methods: This observational study assessed preventive care screening rates at three primary care clinics in Ottawa, Ontario from March to November 2020 using data from 22,685 electronic medical records. The change in cervical cancer, colorectal cancer, and type 2 diabetes screening rates were extrapolated using 2016 census data, estimating the volume of key services delayed by COVID-19 across Ontario and Canada.Results: The mean percentage of patients appropriately screened for cervical cancer decreased by 7.5% (-0.3% to -14.7%; 95% CI), colorectal cancer decreased by 8.1% (-0.3% to -15.8%; 95% CI), and type 2 diabetes decreased by 4.5% (-0.2% to -8.7%; 95% CI). Extrapolation estimated that Ontarians delayed 288,000 cervical cancer (11,000 to 565,000; 95% CI), 326,000 colorectal cancer (13,000 to 638,000; 95% CI), and 274,000 type 2 diabetes screenings (13,000 to 535,000; 95% CI). Extrapolation to the Canadian population nearly triples these numbers. Re-opening measures have not reversed these trends.Interpretation: COVID-19 decreased the delivery of preventive care services, which may cause delayed diagnoses, increased mortality, and increased health care costs. Virtual care and reopening measures have not restored the provision of preventive care services. Electronic medical record data could be leveraged to improve screening via panel management. Additional, system-wide primary care and laboratory capacity will be needed to restore pre-COVID-19 screening rates.

scholarly journals The prevalence and factors associated with sarcopenia among community living elderly with type 2 diabetes mellitus in primary care clinics in Malaysia

PLoS ONE ◽  
2020 ◽  
Vol 15 (5) ◽  
pp. e0233299 ◽  
Author(s):  
Shariff-Ghazali Sazlina ◽  
Ping Yein Lee ◽  
Yoke Mun Chan ◽  
Mohamad Shariff A. Hamid ◽  
Ngiap Chuan Tan
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Primary Care ◽  
Type 2 Diabetes Mellitus ◽  
Community Living ◽  
Primary Care Clinics ◽  
Factors Associated
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