Effective, patient-centred, and multi-professional diabetes care delivered in a community diabetes clinic in a regional centre
Kennedy, R. Lee, Hird, K., Corkhill, L., Malabu, U.H., Joseph, A., and Lawlor, J. (2010) Effective, patient-centred, and multi-professional diabetes care delivered in a community diabetes clinic in a regional centre. Annals of the Australasian College of Tropical Medicine, 11 (2). pp. 68-69.
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Diabetes is generally managed in Primary Care or by specialist hospitalbased teams. There are few published examples of effective community based specialist care. Our approach is protocol driven, managed according to the Educators' caseload, and makes extensive use made of telephone and Email. Mean age for 299 patients was 53.2 years, and 48 (16.1%) lived >50 km from the clinic. Mean HbA1c was 9.1%. 141 (47.2%) had nephropathy. Good control was defined as HbA1c < 7.0%, moderate 7.0-8.9%, and poor >9.0%. After 6 months HbA1c improved for those with good control (6.33% vs. 6.16%, p=0.02), moderate control (7.92% vs. 7.05%, p<0.001), and poor control (11.05% vs. 8.33%, p<0.001). In a comparable hospital group (n=204), there was no improvement in good (6.34 vs. 6.82, p = 0.07) or moderate control (8.09% vs. 8.10%, p=0.47), while poor control improved (10.76% vs. 9.45%, p<0.001). After 6 months, weight decreased (95.8 vs. 94.3 kg, p<0.001), as did waist circumference (112.6 vs. 110.0 cm, p<0.001). Mean total cholesterol, HDL cholesterol and triglycerides were respectively 4.57, 1.01, and 2.46 mmol/L. Mean systolic and diastolic BP were 122.5 and 71.8, 91.9% having systolic <140 and 93.4% having diastolic <80. In this clinic with documented high levels of patient satisfaction, cardiovascular risk profile improved markedly over 6 months. Increasing prevalence of diabetes and need for tighter therapeutic targets are driving the demand for novel models of care.
|Item Type:||Article (Abstract)|
|Date Deposited:||10 Oct 2011 02:51|
|FoR Codes:||11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110306 Endocrinology @ 100%|
|SEO Codes:||92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920104 Diabetes @ 100%|
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