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跨学科速配约会增强了糖尿病自我管理教育和支持,以改善健康结果。

Interdisciplinary speed dating augments diabetes self-management education and support to improve health outcomes.

机构信息

Department of Pharmacy Practice, Auburn University Harrison School of Pharmacy, Auburn, USA; Montgomery Family Medicine Residency Program, Baptist Health System, 4371 Narrow Lane Rd, Suite #100 / Montgomery, Alabama, 36116, USA.

Department of Drug Discovery and Development, Auburn University Harrison School of Pharmacy, Auburn, USA.

出版信息

Patient Educ Couns. 2020 Nov;103(11):2305-2311. doi: 10.1016/j.pec.2020.05.015. Epub 2020 May 15.

DOI:10.1016/j.pec.2020.05.015
PMID:32475712
Abstract

OBJECTIVE

To determine if a novel interdisciplinary "speed-dating" clinic augments Diabetes Self-Management Education and Support (DSMES).

METHODS

Adult patients with diabetes attended a DSMES class. Two weeks later patients attended an interdisciplinary clinic utilizing a "speed-dating" format during which they progressed through 5 stations hosted by different healthcare disciplines at 30-minute increments: physician, pharmacist, nurse/dietitian, case manager, and psychologist. Shared decision-making was utilized to identify mutually agreeable recommendations. Change in clinical outcomes were compared for DSMES-only attenders versus Dual-attendees; utilization of emergency department and hospital services were measured 12 months before and after attending the Speed Dating clinic. This analysis represents patients attending the program during 2016.

RESULTS

Sixty-nine attended the DSMES class, 40 of whom followed-up in the "speed-dating" clinic (58% return rate). Attending the Speed Dating clinic improved A1C (p = 0.003) and LDL-C (p = 0.003) compared to the DSMES class alone. Comparatively, after attending the speed-dating clinic, patients had fewer emergency department (p = 0.366) and hospital admissions (p = 0.036), and shorter lengths of hospital stay (p = 0.030).

CONCLUSIONS

The interdisciplinary "speed-dating" approach improved diabetes outcomes beyond DSMES alone and reduced utilization of hospital services.

PRACTICE IMPLICATIONS

Patients should attend DSMES but also participate in an Interdisciplinary Speed Dating follow-up to further improve outcomes.

摘要

目的

确定一种新颖的跨学科“速配”诊所是否可以增强糖尿病自我管理教育和支持(DSMES)。

方法

成年糖尿病患者参加 DSMES 课程。两周后,患者参加了一个利用“速配”格式的跨学科诊所,在该诊所中,他们在 30 分钟的增量内通过 5 个由不同医疗保健学科主持的站点进行:医生、药剂师、护士/营养师、个案经理和心理学家。利用共同决策来确定双方都同意的建议。将仅参加 DSMES 的患者与双重参加者的临床结果变化进行比较;在参加“速配”诊所之前和之后的 12 个月,测量了急诊室和医院服务的使用情况。此分析代表在 2016 年参加该计划的患者。

结果

69 人参加了 DSMES 课程,其中 40 人在“速配”诊所跟进(参与率为 58%)。与仅参加 DSMES 课程相比,参加“速配”诊所可改善 A1C(p=0.003)和 LDL-C(p=0.003)。相比之下,参加“速配”诊所后,患者的急诊室就诊次数(p=0.366)和住院次数(p=0.036)减少,住院时间缩短(p=0.030)。

结论

跨学科的“速配”方法改善了 DSMES 单独治疗以外的糖尿病结果,并减少了医院服务的使用。

实践意义

患者应参加 DSMES,但也应参加跨学科的“速配”随访,以进一步改善结果。

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