A quasi-experimental study provides evidence that registered dietitian nutritionist care is aligned with the Academy of Nutrition and Dietetics evidence-based nutrition practice guidelines for type 1 and 2 diabetes
BackgroundOne previous study examined implementation of evidence-based nutrition practice guidelines (EBNPG).ObjectivesTo describe alignment of registered dietitian nutritionists' (RDNs) documented nutrition care with the Academy of Nutrition and Dietetics' EBNPG for Type 1 and Type 2 diab...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-09-01
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| Series: | Frontiers in Nutrition |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnut.2022.969360/full |
| _version_ | 1811209702042763264 |
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| author | Erin Lamers-Johnson Kathryn Kelley Kerri Lynn Knippen Kimberly Feddersen Damien M. Sánchez J. Scott Parrott Casey Colin Constantina Papoutsakis Elizabeth Yakes Jimenez Elizabeth Yakes Jimenez |
| author_facet | Erin Lamers-Johnson Kathryn Kelley Kerri Lynn Knippen Kimberly Feddersen Damien M. Sánchez J. Scott Parrott Casey Colin Constantina Papoutsakis Elizabeth Yakes Jimenez Elizabeth Yakes Jimenez |
| author_sort | Erin Lamers-Johnson |
| collection | DOAJ |
| description | BackgroundOne previous study examined implementation of evidence-based nutrition practice guidelines (EBNPG).ObjectivesTo describe alignment of registered dietitian nutritionists' (RDNs) documented nutrition care with the Academy of Nutrition and Dietetics' EBNPG for Type 1 and Type 2 diabetes and examine impact of a midpoint training on care alignment with the guideline.MethodsIn this 2-year, quasi-experimental study, 19 RDNs providing outpatient medical nutrition therapy to adults with diabetes (n = 562) documented 787 initial and follow-up encounters. At study midpoint, RDNs received a guideline content training. A validated, automated tool was used to match standardized nutrition care process terminology (NCPT) in the documentation to NCPT expected to represent guideline implementation. A congruence score ranging from 0 (recommendation not identified) to 4 (recommendation fully implemented) was generated based on matching. Multilevel linear regression was used to examine pre-to-post training changes in congruence scores.ResultsMost patients (~75%) had only one documented RDN encounter. At least one guideline recommendation was fully implemented in 67% of encounters. The recommendations “individualize macronutrient composition” and “education on glucose monitoring” (partially or fully implemented in 85 and 79% of encounters, respectively) were most frequently implemented. The mean encounter congruence scores were not different from pre-to-post guideline training (n = 19 RDNs, 519 encounters pre-training; n = 14 RDNs, 204 encounters post-training; β = −0.06, SE = 0.04; 95% CI: −0.14, 0.03).ConclusionsMost RDN encounters had documented evidence that at least one recommendation from the EBNPG was implemented. The most frequently implemented recommendations were related to improving glycemic control. A midpoint guideline training had no impact on alignment of care with the guideline. |
| first_indexed | 2024-04-12T04:43:55Z |
| format | Article |
| id | doaj.art-c2b3d95789324f31b5d8c4daa7521ae5 |
| institution | Directory Open Access Journal |
| issn | 2296-861X |
| language | English |
| last_indexed | 2024-04-12T04:43:55Z |
| publishDate | 2022-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Nutrition |
| spelling | doaj.art-c2b3d95789324f31b5d8c4daa7521ae52022-12-22T03:47:33ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2022-09-01910.3389/fnut.2022.969360969360A quasi-experimental study provides evidence that registered dietitian nutritionist care is aligned with the Academy of Nutrition and Dietetics evidence-based nutrition practice guidelines for type 1 and 2 diabetesErin Lamers-Johnson0Kathryn Kelley1Kerri Lynn Knippen2Kimberly Feddersen3Damien M. Sánchez4J. Scott Parrott5Casey Colin6Constantina Papoutsakis7Elizabeth Yakes Jimenez8Elizabeth Yakes Jimenez9Academy of Nutrition and Dietetics, Chicago, IL, United StatesAcademy of Nutrition and Dietetics, Chicago, IL, United StatesDepartment of Public and Allied Health, Bowling Green State University, Bowling Green, OH, United StatesFederal Bureau of Prisons, Rochester, MN, United StatesOrganization, Information, and Learning Sciences, University of New Mexico, Albuquerque, NM, United StatesDepartment of Interdisciplinary Studies, Rutgers University, Blackwood, NJ, United StatesNutrition and Dietetics Department, University of North Florida, Jacksonville, FL, United StatesAcademy of Nutrition and Dietetics, Chicago, IL, United StatesAcademy of Nutrition and Dietetics, Chicago, IL, United StatesDepartments of Pediatrics and Internal Medicine and College of Population Health, University of New Mexico, Albuquerque, NM, United StatesBackgroundOne previous study examined implementation of evidence-based nutrition practice guidelines (EBNPG).ObjectivesTo describe alignment of registered dietitian nutritionists' (RDNs) documented nutrition care with the Academy of Nutrition and Dietetics' EBNPG for Type 1 and Type 2 diabetes and examine impact of a midpoint training on care alignment with the guideline.MethodsIn this 2-year, quasi-experimental study, 19 RDNs providing outpatient medical nutrition therapy to adults with diabetes (n = 562) documented 787 initial and follow-up encounters. At study midpoint, RDNs received a guideline content training. A validated, automated tool was used to match standardized nutrition care process terminology (NCPT) in the documentation to NCPT expected to represent guideline implementation. A congruence score ranging from 0 (recommendation not identified) to 4 (recommendation fully implemented) was generated based on matching. Multilevel linear regression was used to examine pre-to-post training changes in congruence scores.ResultsMost patients (~75%) had only one documented RDN encounter. At least one guideline recommendation was fully implemented in 67% of encounters. The recommendations “individualize macronutrient composition” and “education on glucose monitoring” (partially or fully implemented in 85 and 79% of encounters, respectively) were most frequently implemented. The mean encounter congruence scores were not different from pre-to-post guideline training (n = 19 RDNs, 519 encounters pre-training; n = 14 RDNs, 204 encounters post-training; β = −0.06, SE = 0.04; 95% CI: −0.14, 0.03).ConclusionsMost RDN encounters had documented evidence that at least one recommendation from the EBNPG was implemented. The most frequently implemented recommendations were related to improving glycemic control. A midpoint guideline training had no impact on alignment of care with the guideline.https://www.frontiersin.org/articles/10.3389/fnut.2022.969360/fullmedical nutrition therapy (MNT)type 2 diabetestype 1 diabetesnutrition care process (NCP)dietitians |
| spellingShingle | Erin Lamers-Johnson Kathryn Kelley Kerri Lynn Knippen Kimberly Feddersen Damien M. Sánchez J. Scott Parrott Casey Colin Constantina Papoutsakis Elizabeth Yakes Jimenez Elizabeth Yakes Jimenez A quasi-experimental study provides evidence that registered dietitian nutritionist care is aligned with the Academy of Nutrition and Dietetics evidence-based nutrition practice guidelines for type 1 and 2 diabetes Frontiers in Nutrition medical nutrition therapy (MNT) type 2 diabetes type 1 diabetes nutrition care process (NCP) dietitians |
| title | A quasi-experimental study provides evidence that registered dietitian nutritionist care is aligned with the Academy of Nutrition and Dietetics evidence-based nutrition practice guidelines for type 1 and 2 diabetes |
| title_full | A quasi-experimental study provides evidence that registered dietitian nutritionist care is aligned with the Academy of Nutrition and Dietetics evidence-based nutrition practice guidelines for type 1 and 2 diabetes |
| title_fullStr | A quasi-experimental study provides evidence that registered dietitian nutritionist care is aligned with the Academy of Nutrition and Dietetics evidence-based nutrition practice guidelines for type 1 and 2 diabetes |
| title_full_unstemmed | A quasi-experimental study provides evidence that registered dietitian nutritionist care is aligned with the Academy of Nutrition and Dietetics evidence-based nutrition practice guidelines for type 1 and 2 diabetes |
| title_short | A quasi-experimental study provides evidence that registered dietitian nutritionist care is aligned with the Academy of Nutrition and Dietetics evidence-based nutrition practice guidelines for type 1 and 2 diabetes |
| title_sort | quasi experimental study provides evidence that registered dietitian nutritionist care is aligned with the academy of nutrition and dietetics evidence based nutrition practice guidelines for type 1 and 2 diabetes |
| topic | medical nutrition therapy (MNT) type 2 diabetes type 1 diabetes nutrition care process (NCP) dietitians |
| url | https://www.frontiersin.org/articles/10.3389/fnut.2022.969360/full |
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