Author: Davidson, Mayer B.

Source: Current Diabetes Reviews, Volume 3, Number 4, November 2007 , pp. 280-286(7)

Publisher: Bentham Science Publishers

Abstract:

People with diabetes have a marked increase in morbidity and mortality. The American Diabetes Association has recommended evidence-based process and outcome measures to improve diabetes care. However, these are not met in the majority of patients under our current medical care system. There have been many (mostly unsuccessful) approaches to improving these outcomes including reminding patients about appointments, feeding back information on the patient to the physician, even when specific treatment recommendations for the individual patient were included, case management (when the case manager could not make treatment decisions), education of physicians and multifaceted quality improvement interventions in the practice setting. One approach has consistently been successful; case management when a nurse or pharmacist had the authority to make independent treatment decisions. In randomized clinical trials, Hb A1c levels were lowered approximately three times as much by nurses or pharmacists following approved detailed treatment algorithms (under the supervision of a physician) compared to usual care. Given the approaching epidemic of diabetes, our medical care system should strongly consider this approach to improving diabetes care to forestall the devastation of diabetic complications and the overwhelming costs of caring for these patients.

Keywords: Diabetes disease management; Nurse- and pharmacist-directed diabetes care; Quality of diabetes care

Document Type: Research article

Publication date: 2007-11-01

More about this publication?

• Current Diabetes Reviews publishes frontier reviews on all the latest advances on diabetes and its related areas e.g. pharmacology, pathogenesis, complications, epidemiology, clinical care, and therapy.
  
  The journal's aim is to publish the highest quality review articles dedicated to clinical research in the field. The journal is essential reading for all researchers and clinicians who are involved in the field of diabetes.

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