5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes:Standards of Care in Diabetes—2023

Diabetes Care, Год журнала: 2022, Номер 46(Supplement_1), С. S68 - S96

Опубликована: Дек. 12, 2022

The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide components diabetes care, general treatment goals guidelines, tools evaluate quality care. Members ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating Standards annually, or more frequently as warranted. For detailed description standards, statements, reports, well evidence-grading system full list Committee members, please refer Introduction Methodology. Readers who wish comment on invited do so at professional.diabetes.org/SOC.

Язык: Английский

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5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes—2024

Diabetes Care, Год журнала: 2023, Номер 47(Supplement_1), С. S77 - S110

Опубликована: Дек. 11, 2023

The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide components diabetes care, general treatment goals guidelines, tools evaluate quality care. Members ADA Professional Practice Committee, an interprofessional expert committee, are responsible for updating Standards annually, or more frequently as warranted. For a detailed description standards, statements, reports, well evidence-grading system full list Committee members, please refer Introduction Methodology. Readers who wish comment on invited do so at professional.diabetes.org/SOC.

Язык: Английский

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5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes—2025

Diabetes Care, Год журнала: 2024, Номер 48(Supplement_1), С. S86 - S127

Опубликована: Дек. 9, 2024

The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide components diabetes care, general treatment goals guidelines, tools evaluate quality care. Members ADA Professional Practice Committee, an interprofessional expert committee, are responsible for updating Standards annually, or more frequently as warranted. For a detailed description standards, statements, reports, well evidence-grading system full list Committee members, please refer Introduction Methodology. Readers who wish comment on invited do so at professional.diabetes.org/SOC.

Язык: Английский

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Use telehealth as needed: telehealth substitutes in-person primary care and associates with the changes in unplanned events and follow-up visits

BMC Health Services Research, Год журнала: 2023, Номер 23(1)

Опубликована: Май 3, 2023

Telehealth rapidly expanded since the outbreak of COVID-19 pandemic. This study aims to understand how telehealth can substitute in-person services by 1) estimating changes in non-COVID emergency department (ED) visits, hospitalizations, and care costs among US Medicare beneficiaries visit modality (telehealth vs. in-person) during pandemic relative previous year; 2) comparing follow-up time patterns between care.A retrospective longitudinal design using patients 65 years or older from an Accountable Care Organization (ACO). The period was April-December 2020, baseline March 2019 - February 2020. sample included 16,222 patients, 338,872 patient-month records 134,375 outpatient encounters. Patients were categorized as non-users, only, only users both types. Outcomes number unplanned events per month at patient level; days until next whether happened within 3-, 7-, 14- 30-days encounter level. All analyses adjusted for characteristics seasonal trends.Beneficiaries who used had comparable health conditions but healthier than those types services. During period, group significantly fewer ED visits/hospitalizations lower payments (ED 13.2, 95% CI [11.6, 14.7] 24.6 1,000 hospitalization 8.1 [6.7, 9.4] 12.7); visits (21.9 [20.3, 23.5] 26.1) payments, not hospitalizations; both-types more hospitalizations (23.0 [21.4, 24.6] 17.8). different encounters (33.4 31.2 days) probabilities 3- 7-day (9.2 9.3% 21.8 vs.23.5%).Patients providers treated substitutes either depending on medical needs availability. did lead sooner

Язык: Английский

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Technology and health inequities in diabetes care: How do we widen access to underserved populations and utilize technology to improve outcomes for all?

Diabetes Obesity and Metabolism, Год журнала: 2024, Номер 26(S1), С. 3 - 13

Опубликована: Янв. 31, 2024

Abstract Digital health technologies are being utilized increasingly in the modern management of diabetes. These include tools such as continuous glucose monitoring systems, connected blood devices, hybrid closed‐loop smart insulin pens, telehealth, and smartphone applications (apps). Although many these have a solid evidence base, from perspective person living with diabetes, there remain multiple barriers preventing their optimal use, creating digital divide. In this article, we describe origins offer recommendations on widening access to for underserved populations diabetes improve outcomes.

Язык: Английский

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Mental Health Utilization Among Transgender Veterans

JAMA Network Open, Год журнала: 2025, Номер 8(1), С. e2454694 - e2454694

Опубликована: Янв. 13, 2025

Compared with cisgender (CG) individuals, transgender and gender-diverse (TGD) individuals experience substantial social economic disparities that can result in adverse mental health consequences. It is critical to understand potential barriers care address the causes of future. To characterize utilization among TGD veterans depression. This cohort study used electronic record data from US Department Veterans Affairs (VA) create a 1:3 age group-matched VA facility-matched nationwide CG documentation depression during 2018 2020. Data analysis was performed January November 2023. identity ascertained by diagnosis gender disorder. The primary outcome utilization, including counts outpatient (in specialty settings), telehealth, emergency department, inpatient visits this cohort. Descriptive statistics were statistically significant differences between tested using χ2 Fisher exact tests. Wilcoxon rank-sum tests test for 2 groups. Adjusted logistic regression, controlling group, administrative sex, race, Charlson Comorbidity Index, number medications (eg, antidepressant, antipsychotic, anxiolytic medications), also compare veterans. Among 10 564 (mean [SD] age, 46.4 [15.2] years; 8050 male [76.2%]), 2643 matched 7921 had 6 more per year than [SD], 13.93 [20.08] vs 8.46 [14.96] year; median [range], 7.14 [0.00-246.30] 3.76 [0.00-202.38] year). In adjusted models, compared veterans, 2.6 times likely have an mental-health visit (odds ratio, 2.60; 95% CI, 2.16-3.15). depression, significantly higher services even after adjusting several relevant factors. Different system resources may be required meet needs population. Further studies are needed determinants these subsequently how them.

Язык: Английский

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The Impact of Virtual Consultations on Quality of Care for Patients With Type 2 Diabetes: A Systematic Review and Meta-Analysis

Journal of Diabetes Science and Technology, Год журнала: 2025, Номер unknown

Опубликована: Фев. 17, 2025

Background Virtual consultations (VC) have transformed healthcare delivery, offering a convenient and effective way to manage chronic conditions such as Type 2 Diabetes (T2D). This systematic review meta-analysis evaluated the impact of VC on quality care provided patients with T2D, mapping it across six domains US National Academy Medicine (NAM) quality-of-care framework (ie, effectiveness, efficiency, patient-centeredness, timeliness, safety, equity). Methods A search was conducted in PubMed/MEDLINE, Cochrane, Embase, CINAHL, Web Science for period between January 2010 December 2024. Eligible studies involved adult T2D patients, synchronous VCs, reported outcomes relevant NAM domains. Two independent reviewers performed screening, were assessed using Mixed Appraisal Tool (MMAT). narrative synthesis each domain, HbA1c levels random-effects models. Results In total, 15 involving 821 014 participants included. VCs comparable face-to-face improvements accessibility patient satisfaction. results found safety due limitations physical assessments, equity, older adults those lower digital literacy facing more challenges. The showed no significant difference reduction (standardized mean [SMD] = -0.31, 95% confidence interval [CI]: -0.71 0.09, P 0.12). Conclusion offer promising alternative in-person care, but addressing disparities improving access are essential maximizing potential.

Язык: Английский

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Mobile Health Intervention in Patients With Type 2 Diabetes

JAMA Network Open, Год журнала: 2023, Номер 6(9), С. e2333629 - e2333629

Опубликована: Сен. 29, 2023

Clinical pharmacists and health coaches using mobile (mHealth) tools, such as telehealth text messaging, may improve blood glucose levels in African American Latinx populations with type 2 diabetes.To determine whether clinical mHealth tools can hemoglobin A1c (HbA1c) levels.This randomized trial included 221 or patients diabetes elevated HbA1c (≥8%) from an academic medical center Chicago. Adult aged 21 to 75 years were enrolled March 23, 2017, through January 8, 2020. Patients the intervention group received support for 1 year followed by monitored usual care during a second (follow-up duration, 24 months). Those waiting list control year.The remote (eg, review of medication intensification) via video platform. Health coach activities addressing barriers use assisting reconciliation telehealth) occurred person at participant homes phone calls messaging. Usual comprised routine patients' primary physicians, including adjustment.Outcomes (primary outcome), pressure, cholesterol, body mass index, health-related quality life, distress, self-efficacy, depressive symptoms, social support, medication-taking behavior, self-care measured every 6 months.Among participants (mean [SD] age, 55.2 [9.5] years; 154 women [69.7%], 148 adults [67.0%], 73 [33.0%]), baseline mean (SD) level was 9.23% (1.53%). Over initial 12 months, improved -0.79 percentage points compared -0.24 (treatment effect, -0.62; 95% CI, -1.04 -0.19; P = .005). subsequent significant change observed after they same change, -0.57 points; .002), while maintained benefit 0.17 .35). No between-group differences found adjusted models secondary outcomes.In this trial, among diabetes. These findings suggest that pharmacist coach-delivered help reduce racial ethnic disparities.ClinicalTrials.gov Identifier: NCT02990299.

Язык: Английский

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Barriers and Facilitators to Video Telehealth Use in Low-Income Hispanic Patients

Family & Community Health, Год журнала: 2025, Номер unknown

Опубликована: Янв. 14, 2025

Background and Objectives: As telehealth grows in ubiquity, it is important to understand the barriers facilitators utilization historically marginalized populations. This study utilizes Theory of Planned Behavior (TPB) assess correlates intention utilize video consultations among low-income Hispanic patients. Methods: cross-sectional observational included participants (N = 138) recruited from a federally qualified health center affiliated with large university system. Components TPB were assessed using an in-person survey. Participant survey responses analyzed multiple logistic regression identify participants’ consultations. Results: Multiple revealed subjective norms (adjusted odds ratio (aOR [95% CI]) 3.29 [1.66, 6.52], P .001) as only significant correlate Attitudes toward CI] 1.32 [0.60, 2.89], .49) perceived behavioral control (1.72 [0.89, 3.32], .11) did not independently intention. Conclusions: Ratings correlated low-income, predominantly Spanish-speaking adults. These results suggest potentially central role relational influences determining engagement this population.

Язык: Английский

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Enhancing access to primary care is critical to the future of an equitable health service: using process visualisation to understand the impact of national policy in the UK

Frontiers in Health Services, Год журнала: 2025, Номер 4

Опубликована: Янв. 27, 2025

Access to UK general practice is complicated by the need provide equitable and universal care within a system adapting workforce challenges, digital innovation, unprecedented demand. Despite importance of accessing primary in meeting overall aim delivering care, this first time direct indirect influence policies intended facilitate access have been systematically explored. Further consideration policymakers needed accommodate difference between what patients want when differences their ability utilise options. The designation was hindered long-standing issues reliable data variations interpretation local national protocols guidelines.

Язык: Английский

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