Organization of Diabetes Care

Clement, Maureen; Filteau, Pierre; Harvey, Betty; Jin, Susie; Laubscher, Tessa; Mukerji, Geetha; Sherifali, Diana

doi:10.1016/j.jcjd.2017.10.005

Cited by 44 publications

(71 citation statements)

References 102 publications

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“…135,139 In recognition of this, the current Diabetes Canada guidelines have assigned telehealth a grade A recommendation, as a technology that may help facilitate many of the quality improvement strategies derived from the Chronic Care Model. 140 Thus, while the evidence for DHI and telehealth is heterogeneous in CV risk factor management, a key determinant of success appears to be clinician review of patient-generated data linked to actual changes in medical management and the involvement of a broader healthcare team than just a single physician. 114 The very best examples of telehealth in the literature improved patient satisfaction, knowledge, and self-efficacy, in addition to CV risk factors like BP levels and HbA1c.…”

Section: Telehealth For Diabetes Carementioning

confidence: 99%

Implications of the COVID-19 Pandemic for Cardiovascular Disease and Risk-Factor Management

Lau

McAlister

2021

Canadian Journal of Cardiology

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COVID-19 and our public health responses to the pandemic may have far-reaching implications for cardiovascular risk affecting the general population and not just survivors of COVID-19. In this narrative review, we discuss how the pandemic may impact general cardiovascular risk for years to come, and explore the mitigating potential of telehealth interventions. From a health care perspective, the shift away from in-person office visits may have led many to defer routine risk factor management and may have had unforeseen effects on continuity of care and adherence. Fear of COVID-19 has led some patients to forego care for acute cardiovascular events. Curtailment of routine outpatient laboratory testing has likely delayed intensification of risk-factor modifying medical therapy, and drug shortages and mis-information may have negatively impacted adherence to antihypertensive, glucose-lowering, and lipid-lowering agents. From a societal perspective, the unprecedented curtailment of social and economic activities has led to income loss, unemployment, social isolation, decreased physical activity, and increased frequency of depression and anxiety, all of which are known to be associated with worse cardiovascular risk-factor control and outcomes. We must embrace and evaluate measures to mitigate these potential harms to avoid an epidemic of cardiovascular morbidity and mortality in the coming years that could dwarf the initial health impacts of COVID-19.

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Section: Telehealth For Diabetes Carementioning

confidence: 99%

Implications of the COVID-19 Pandemic for Cardiovascular Disease and Risk-Factor Management

Lau

McAlister

2021

Canadian Journal of Cardiology

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“…Furthermore, 22% of the population is estimated to be prediabetic ( 2 ). Given that almost 80% of diabetes care occurs at the primary care level, adequate diabetes management in the primary care setting is essential ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

“…In Canada, medical care for people with diabetes generally comprises individual physician visits, with referral to specialists and allied professionals as needed. In accordance with current initiatives to foster evidence-based and patient-centered medicine, Diabetes Canada recommends a multidisciplinary approach that includes physicians, nurse practitioners, nurses, pharmacists, dieticians, and psychological health workers to support individuals managing their diabetes ( 3 ). Evidence also suggests that diabetes management is improved when patients are empowered and engaged in self-care ( 4 , 5 ).…”

Section: Introductionmentioning

confidence: 99%

The Quebec Diabetes Empowerment Group Program: Program Description and Considerations Regarding Feasibility and Acceptability of Implementation in Primary Health Care Settings

Hersson-Edery

Reoch²,

Gagnon

2021

Front. Nutr.

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Introduction: Diabetes is a highly prevalent chronic disease that frequently coexists with other medical conditions and implies a high burden for patients and the healthcare system. Clinicians currently are challenged to provide effective interventions that are both multidisciplinary and empower patient self-care. The Diabetes Empowerment Group Program (DEGP) was developed with the aims of fostering patient engagement in diabetes self-care through the lens of empowerment and to support the empowerment of patients with diabetes by providing multidisciplinary group-based care. This research's objectives were to: (1) develop a comprehensive description of the DEGP for potential adopters, and (2) explore the factors influencing the feasibility and acceptability of implementing it in other healthcare settings in Montreal.Methods: A qualitative descriptive study was conducted, following a participatory approach. Data were obtained from: (1) semi-structured interviews with 14 patients who participated in the pilot program; (2) from semi-structured group interviews with patient partners, healthcare professionals, and other stakeholders from 4 Montreal family medicine groups, and (3) discussions among the participatory research team during various knowledge translation activities. Inductive content analysis of the data was performed.Results: The DEGP identified seven key elements: medical visit, continuity of care, group-based dynamics, multi-disciplinarity, clinician facilitation, patient-centered agenda, and a theoretical framework of empowerment. The content and organization of the group visits were conceived to address each of these four domains. The empowerment framework comprises four domains of self-care: emotional (attitude), cognitive (knowledge), behavioral (skills), and relational (relatedness). Factors impacting the feasibility and acceptability of implementing the DEGP in other primary care settings were identified.Discussion: The DEGP fits within the discourse around the need for more patient-centered programs for people living with diabetes, following a more comprehensive empowerment model. This research could facilitate the development or adaptation of similar programs in other settings.

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“…The findings are organized under the six elements of the Chronic Care Model created by Wagner et al (1999): self-management, delivery system design, decision support, clinical information systems, community resources and health system organization. This model is an evidence-based framework designed to support quality improvement efforts to optimize chronic disease management (Clement et al, 2018;Wagner et al, 2001). The Chronic Care Model is one of the most widely adopted integrated care models to improve outcomes for individuals with chronic disease (World Health Organization, 2016b).…”

Section: Introductionmentioning

confidence: 99%

“…The methods include: 1) A narrative literature review consisting of a database search, and 2) A gap analysis consisting of local data and an environmental scan. The Chronic Care Model is an evidence-based integrated care framework used to organize the findings of the narrative literature review and the gap analysis and to frame the recommendations (Clement et al, 2018). Based on the findings, evidence-based recommendations were created specific to the context of diabetes care in Squamish, BC creating the opportunity for meaningful future quality improvement work.iii…”

mentioning

confidence: 99%

Narrative literature review and gap analysis of diabetes services in a community setting

Shaw¹

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The goal of this project was to outline best practices regarding the organization of diabetes care and services in the community in relation to the local context of services in Squamish, BC, Canada to create a foundation for future quality improvement work. The theoretical framework of personcentered care is essential to chronic disease management and underpins this work. The methods include: 1) A narrative literature review consisting of a database search, and 2) A gap analysis consisting of local data and an environmental scan. The Chronic Care Model is an evidence-based integrated care framework used to organize the findings of the narrative literature review and the gap analysis and to frame the recommendations (Clement et al., 2018). Based on the findings, evidence-based recommendations were created specific to the context of diabetes care in Squamish, BC creating the opportunity for meaningful future quality improvement work.

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Organization of Diabetes Care

Cited by 44 publications

References 102 publications

Implications of the COVID-19 Pandemic for Cardiovascular Disease and Risk-Factor Management

Implications of the COVID-19 Pandemic for Cardiovascular Disease and Risk-Factor Management

The Quebec Diabetes Empowerment Group Program: Program Description and Considerations Regarding Feasibility and Acceptability of Implementation in Primary Health Care Settings

Narrative literature review and gap analysis of diabetes services in a community setting

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