Digging deep into diabetes: achieving better glycemic control in diabetic patients in a resident-run clinic
Background: Diabetes mellitus (DM) affects over 30 million Americans with an estimated annual cost of $327 billion in 2017. Patients with diabetes, especially with financial and/or social hardships, pose challenges in achieving target hemoglobin A1c (HbA1c) values. Understanding patient-specific bar...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Greater Baltimore Medical Center
2019-07-01
|
| Series: | Journal of Community Hospital Internal Medicine Perspectives |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/20009666.2019.1650594 |
| _version_ | 1797966458281525248 |
|---|---|
| author | Sara Hawatmeh Maggie Meier Erika Leung Ramza Haque Harinderjeet Kaur Muhammad F. Asghar Amirsoheil Talebian Osman Qaiyum Rajat Shailly Omar Al-Abboud Keerthi Patlolla Akm Towfique Aziz Hameem I. Kawsar |
| author_facet | Sara Hawatmeh Maggie Meier Erika Leung Ramza Haque Harinderjeet Kaur Muhammad F. Asghar Amirsoheil Talebian Osman Qaiyum Rajat Shailly Omar Al-Abboud Keerthi Patlolla Akm Towfique Aziz Hameem I. Kawsar |
| author_sort | Sara Hawatmeh |
| collection | DOAJ |
| description | Background: Diabetes mellitus (DM) affects over 30 million Americans with an estimated annual cost of $327 billion in 2017. Patients with diabetes, especially with financial and/or social hardships, pose challenges in achieving target hemoglobin A1c (HbA1c) values. Understanding patient-specific barriers offer opportunities to improve outcomes in patient care. Objective: We aimed to improve a patient’s glycemic control by reducing barriers to care. Furthermore, we evaluated the impact that a resident quality improvement effort had on providing high value diabetic care. Methods: We performed a retrospective cohort study of patients with HbA1c >9.0% in an underserved, resident-run clinic. Patients were surveyed on their knowledge of diabetes and reported obstacles to achieve diabetic control. We then implemented a 12 -month customized, patient-directed, multi-modal, multidisciplinary intervention. Results: Ninety-four patients with HbA1c >9.0% were identified, 65 surveyed, and 51 included in the intervention phase. After the intervention phase, re-evaluation of HbA1c in a paired sample comparison showed that the average HbA1c had decreased by 1.41% (11.28% vs. 9.87%, p < 0.01). Among the patients included in the intervention group, approximately 8% had their HbA1c reduced by ≥50% from their baseline, 23% had their HbA1c reduced by ≥25% from their baseline and 49% had their HbA1c reduced by ≥10% from their baseline. Conclusions: A strategically designed, a patient-centered customized intervention can have a positive impact on a patient’s diabetic control. |
| first_indexed | 2024-04-11T02:14:48Z |
| format | Article |
| id | doaj.art-32621f5bcd1540cf9a31f06b384e3836 |
| institution | Directory Open Access Journal |
| issn | 2000-9666 |
| language | English |
| last_indexed | 2024-04-11T02:14:48Z |
| publishDate | 2019-07-01 |
| publisher | Greater Baltimore Medical Center |
| record_format | Article |
| series | Journal of Community Hospital Internal Medicine Perspectives |
| spelling | doaj.art-32621f5bcd1540cf9a31f06b384e38362023-01-03T01:12:39ZengGreater Baltimore Medical CenterJournal of Community Hospital Internal Medicine Perspectives2000-96662019-07-019429029510.1080/20009666.2019.16505941650594Digging deep into diabetes: achieving better glycemic control in diabetic patients in a resident-run clinicSara Hawatmeh0Maggie Meier1Erika Leung2Ramza Haque3Harinderjeet Kaur4Muhammad F. Asghar5Amirsoheil Talebian6Osman Qaiyum7Rajat Shailly8Omar Al-Abboud9Keerthi Patlolla10Akm Towfique Aziz11Hameem I. Kawsar12St. Luke’s HospitalSt. Luke’s HospitalSt. Luke’s HospitalSt. Luke’s HospitalSt. Luke’s HospitalSt. Luke’s HospitalSt. Luke’s HospitalSt. Luke’s HospitalSt. Luke’s HospitalSt. Luke’s HospitalSt. Luke’s HospitalM&E Specialist at TANGO InternationalSt. Luke’s HospitalBackground: Diabetes mellitus (DM) affects over 30 million Americans with an estimated annual cost of $327 billion in 2017. Patients with diabetes, especially with financial and/or social hardships, pose challenges in achieving target hemoglobin A1c (HbA1c) values. Understanding patient-specific barriers offer opportunities to improve outcomes in patient care. Objective: We aimed to improve a patient’s glycemic control by reducing barriers to care. Furthermore, we evaluated the impact that a resident quality improvement effort had on providing high value diabetic care. Methods: We performed a retrospective cohort study of patients with HbA1c >9.0% in an underserved, resident-run clinic. Patients were surveyed on their knowledge of diabetes and reported obstacles to achieve diabetic control. We then implemented a 12 -month customized, patient-directed, multi-modal, multidisciplinary intervention. Results: Ninety-four patients with HbA1c >9.0% were identified, 65 surveyed, and 51 included in the intervention phase. After the intervention phase, re-evaluation of HbA1c in a paired sample comparison showed that the average HbA1c had decreased by 1.41% (11.28% vs. 9.87%, p < 0.01). Among the patients included in the intervention group, approximately 8% had their HbA1c reduced by ≥50% from their baseline, 23% had their HbA1c reduced by ≥25% from their baseline and 49% had their HbA1c reduced by ≥10% from their baseline. Conclusions: A strategically designed, a patient-centered customized intervention can have a positive impact on a patient’s diabetic control.http://dx.doi.org/10.1080/20009666.2019.1650594Diabetesglycemic controlquality improvementresident-run clinic |
| spellingShingle | Sara Hawatmeh Maggie Meier Erika Leung Ramza Haque Harinderjeet Kaur Muhammad F. Asghar Amirsoheil Talebian Osman Qaiyum Rajat Shailly Omar Al-Abboud Keerthi Patlolla Akm Towfique Aziz Hameem I. Kawsar Digging deep into diabetes: achieving better glycemic control in diabetic patients in a resident-run clinic Journal of Community Hospital Internal Medicine Perspectives Diabetes glycemic control quality improvement resident-run clinic |
| title | Digging deep into diabetes: achieving better glycemic control in diabetic patients in a resident-run clinic |
| title_full | Digging deep into diabetes: achieving better glycemic control in diabetic patients in a resident-run clinic |
| title_fullStr | Digging deep into diabetes: achieving better glycemic control in diabetic patients in a resident-run clinic |
| title_full_unstemmed | Digging deep into diabetes: achieving better glycemic control in diabetic patients in a resident-run clinic |
| title_short | Digging deep into diabetes: achieving better glycemic control in diabetic patients in a resident-run clinic |
| title_sort | digging deep into diabetes achieving better glycemic control in diabetic patients in a resident run clinic |
| topic | Diabetes glycemic control quality improvement resident-run clinic |
| url | http://dx.doi.org/10.1080/20009666.2019.1650594 |
| work_keys_str_mv | AT sarahawatmeh diggingdeepintodiabetesachievingbetterglycemiccontrolindiabeticpatientsinaresidentrunclinic AT maggiemeier diggingdeepintodiabetesachievingbetterglycemiccontrolindiabeticpatientsinaresidentrunclinic AT erikaleung diggingdeepintodiabetesachievingbetterglycemiccontrolindiabeticpatientsinaresidentrunclinic AT ramzahaque diggingdeepintodiabetesachievingbetterglycemiccontrolindiabeticpatientsinaresidentrunclinic AT harinderjeetkaur diggingdeepintodiabetesachievingbetterglycemiccontrolindiabeticpatientsinaresidentrunclinic AT muhammadfasghar diggingdeepintodiabetesachievingbetterglycemiccontrolindiabeticpatientsinaresidentrunclinic AT amirsoheiltalebian diggingdeepintodiabetesachievingbetterglycemiccontrolindiabeticpatientsinaresidentrunclinic AT osmanqaiyum diggingdeepintodiabetesachievingbetterglycemiccontrolindiabeticpatientsinaresidentrunclinic AT rajatshailly diggingdeepintodiabetesachievingbetterglycemiccontrolindiabeticpatientsinaresidentrunclinic AT omaralabboud diggingdeepintodiabetesachievingbetterglycemiccontrolindiabeticpatientsinaresidentrunclinic AT keerthipatlolla diggingdeepintodiabetesachievingbetterglycemiccontrolindiabeticpatientsinaresidentrunclinic AT akmtowfiqueaziz diggingdeepintodiabetesachievingbetterglycemiccontrolindiabeticpatientsinaresidentrunclinic AT hameemikawsar diggingdeepintodiabetesachievingbetterglycemiccontrolindiabeticpatientsinaresidentrunclinic |