Diabetes education of patients and their entourage: out-of-hospital national study (EDUCATED 2)

Lapostolle, Frédéric; Hamdi, Nadia; Barghout, Majed; Soulat, Louis; Faucher, Anna; Lambert, Yves; Peschanski, Nicolas; Ricard-Hibon, A.; Chassery, Carine; Roti, Maryline; Bounes, Vincent; Debaty, Guillaume; Mokni, Tarak; Egmann, Gérald; Fort, Pierre-Arnaud; Boudenia, Karim; Alayrac, Laurent; Galinski, Michel; Adnet, Frédéric

doi:10.1007/s00592-016-0950-1

Cited by 9 publications

(6 citation statements)

References 31 publications

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“…In contrast, a study conducted in France on people with diabetes showed that the main contributing factor to the education of patients about diabetes was follow-up and counseling by a diabetologist compared to nurse-only counseling. 16 However, the later study examined general community nurses who only assisted patients with insulin injection and glucose monitoring and not a nurse specialist or an RN with specific training in diabetes.…”

Section: Discussionmentioning

confidence: 99%

Diabetes Control in the Community, Under the Management of a Diabetes-Clinic Nurse Specialist, and the Effect of a Parallel Diabetologist Advice

Gadot¹,

Azuri

2023

J Prim Care Community Health

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Introduction: Nurses play a key role in managing care and educating people with diabetes in various healthcare systems worldwide, while physicians play this role in others. In addition, some healthcare systems authorize specialist nurses to change patient dose regimens. Therefore, we examined diabetes outcomes in the community by the management of a diabetes-clinic nurse only versus parallel management with a diabetologist. Methods: Retrospective data were collected for 100 consecutive people with diabetes registered in a community clinic with a diabetes-clinic nurse specialist as a case manager from 1/2018. About half of the patients selected received parallel advice from a diabetologist. Inclusion criteria included poor control of type 2 diabetes (HbA1c above 9%). Patients using an insulin pump, glucose sensor technologies, or multiple injection insulin programs were excluded. Results: One hundred people with diabetes who met the study criteria were included in the study, 64 males and a mean age of 60.03 ± 11.11. In a follow-up of 161.31 ± 68.65 days, HbA1c levels decreased by 3.17% ± 1.95% and did not change in a further follow-up of 162.36 ± 72.75 days. Significant improvement was also observed in controlling the other risk factors examined. Parallel consultation with a diabetologist and the nurse’s use of her authority for dose modifications showed no differences in all parameters. Logistic regression for analyzing the effect of the variables related to the patient showed only a moderate effect. Conclusions: Access to professional services remains a significant challenge for healthcare systems in long-term diabetes control. Monitoring poorly controlled people with diabetes with the help of a diabetes-clinic nurse specialist in the community clinic significantly improved diabetes and risk factors control and persisted long after the intervention. Healthcare systems should consider expanding the service of the diabetes-clinic nurse specialist in the community. Further studies will be required to examine the results in different patient subgroups.

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Section: Discussionmentioning

confidence: 99%

Diabetes Control in the Community, Under the Management of a Diabetes-Clinic Nurse Specialist, and the Effect of a Parallel Diabetologist Advice

Gadot¹,

Azuri

2023

J Prim Care Community Health

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“…24 The Standards for Quality Improvement Reporting Excellence checklist was used for preparing this article. 18 Minitab software V.17 was used for data analysis.…”

Section: Contextmentioning

confidence: 99%

“…Health education provided by prehospital medical staff to patients with diabetes needed to be enhanced. 18 Diabetes education is essential for self-management and positive health-related outcomes. 19 Therefore, training HMCAS paramedics to provide appropriate diabetes education could reduce the patients’ 999 callback rates, thereby reducing the demand on HMCAS resources.…”

Section: Introductionmentioning

confidence: 99%

Quality improvement tools to manage emergency callbacks from patients with diabetes in a prehospital setting

et al. 2023

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Diabetes is rising at an alarming rate, as 1 in 10 adults worldwide now lives with the disease. In Qatar, a middle eastern Arab country, diabetes prevalence is equally concerning and is predicted to increase from 17% to 24% among individuals aged 45 and 54 years by 2050. While most healthcare strategies focus on preventative and improvement of in-hospital care of patients with diabetes, a notable paucity exists concerning diabetes in the prehospital setting should ideally be provided. This quality improvement study was conducted in a middle eastern ambulance service and aimed to reduce ambulance callbacks of patients with diabetes-related emergencies after refusing transport to the hospital at the first time. We used iterative four-stage problem-solving models. It focused on the education and training of both paramedics and patients. The study showed that while it was possible to reduce the rate of ambulance callbacks of patients with diabetes, this was short-lived and numbers increased again. The study demonstrated that improvements could be effective. Hence, changes that impacted policy, systems of care and ambulance protocols directed at managing and caring for patients with diabetes-related prehospital emergencies may be required to reify them.

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“…10–12 Some self-care skills may be difficult to acquire during TPE, including managing uncontrolled and severe hypoglycaemia. 13 …”

Section: Introductionmentioning

confidence: 99%

“…Most TPE programmes only offer instruction but neglect skills necessary for everyday life 10–12. Some self-care skills may be difficult to acquire during TPE, including managing uncontrolled and severe hypoglycaemia 13…”

Section: Introductionmentioning

confidence: 99%

First use of Simulation in Therapeutic Patient Education (S-TPE) in adults with diabetes: a pilot study

Penneçot

Luu²,

Gagnayre

et al. 2022

BMJ Open

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ObjectiveTo pilot test the feasibility and acceptability of Simulation in Therapeutic Patient Education (S-TPE), in both adult patients with diabetes and educators.ConceptionAdult patients with insulin-dependent diabetes and who participated in a full TPE programme for the implementation of a FreeStyle were included in this monocentric pilot study. S-TPE intervention was based on a consensus conference determining the conditions and objectives of S-TPE. Main outcomes were the patients’ and educators’ perception of the usefulness of S-TPE and the patient’s satisfaction level at the conclusion of the simulation sequence, measured on validated scales. Secondary outcomes were organisational, human, material and temporal, facilitating and limiting factors for patients and educators, patient self-efficacy and anxiety scores.InterventionsThe final session of TPE used the simulation. For each group, one patient volunteered to be the simulated patient. Intervention was divided into three steps: (1) a pre-briefing, (2) a simulation of hypoglycaemia and (3) a debriefing with the group of patients and educators. The whole intervention lasted about 2 hours.ResultsWe included 23 patients (mean age ±SD 63±15 years, 14 men) and 3 educators. After S-TPE intervention, patients’ and educators’ perceived usefulness score were 20.6/25 and 37.5/40, respectively. Patient’s satisfaction score was 51.9/60. Qualitative analysis revealed no limiting factors to implementing S-TPE. Self-efficacy was stable. Decrease in anxiety score after S-TPE reached statistical significance in women (from 35.1±4.5 to 32.7±5.5, p=0.04) but not in men.ConclusionNo limiting factors that could prevent the conduct of clinical trials to assess S-TPE efficacy in patients with diabetes were identified. S-TPE appears as a promising technique to improve diabetes management.Trial registration numberRegistration N°: 2019-A00773-54 and NTC: 03956927.

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Diabetes education of patients and their entourage: out-of-hospital national study (EDUCATED 2)

Abstract: In France, diabetic patients and their entourage are inadequately educated. Their education benefits most from care by a diabetologist.

Cited by 9 publications

References 31 publications

Diabetes Control in the Community, Under the Management of a Diabetes-Clinic Nurse Specialist, and the Effect of a Parallel Diabetologist Advice

Diabetes Control in the Community, Under the Management of a Diabetes-Clinic Nurse Specialist, and the Effect of a Parallel Diabetologist Advice

Quality improvement tools to manage emergency callbacks from patients with diabetes in a prehospital setting

First use of Simulation in Therapeutic Patient Education (S-TPE) in adults with diabetes: a pilot study

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