Asunto(s)
Enfermedad Crónica/terapia , Conductas Relacionadas con la Salud , Medicina Integrativa/organización & administración , Farmacéuticos/organización & administración , Rol Profesional , Enfermedad Crónica/epidemiología , Atención a la Salud/organización & administración , Epidemias , Humanos , Atención Dirigida al Paciente/organización & administración , Calidad de la Atención de Salud/organización & administración , Estados Unidos/epidemiologíaRESUMEN
Purpose The purpose of this study is to evaluate the impact of a collaborative diabetes shared medical appointment on patient outcomes in an urban family medicine practice. Methods Fifty-nine patients were enrolled to participate in multiple shared medical appointments (SMAs) over 12 months. Baseline data included hemoglobin (A1C), lipids, systolic blood pressure (SBP), weight, adherence to American Diabetes Association (ADA) guidelines, and surveys, including the Problem Areas in Diabetes (PAID-2) scale and the Spoken Knowledge in Low Literacy in Diabetes Scale (SKILLD). A1C and SBP were evaluated at each visit. Lipid control was assessed at baseline and at 6 and 12 months. Adherence to ADA guidelines, SKILLD and PAID-2 survey scores, and number of antihyperglycemic and antihypertensive medications were also evaluated at 12 months. Results Thirty-eight patients completed the study. Compared with baseline, A1C and low-density lipoprotein cholesterol (LDL-C) levels decreased significantly over 12 months ( P < .001 and P = .004, respectively). More patients became compliant with the ADA guidelines throughout the course of the study. Specifically, more patients achieved the LDL-C goal of ≤100 mg/dL (2.59 mmol/L; P < .001), were prescribed appropriate antihypertensive medications ( P < .001) and aspirin ( P < .001), and received the pneumonia vaccine ( P < .001). PAID-2 and SKILLD survey scores also significantly improved over the course of the study ( P ≤ .001 and P = .003, respectively). Conclusion Short-term interdisciplinary SMAs decreased A1C and LDL-C, improved patient adherence to ADA guidelines, improved emotional distress related to diabetes, and increased knowledge of diabetes.
Asunto(s)
Citas y Horarios , Diabetes Mellitus Tipo 2/terapia , Medicina Familiar y Comunitaria/métodos , Procesos de Grupo , Grupo de Atención al Paciente , Adulto , Anciano , Antihipertensivos/uso terapéutico , LDL-Colesterol/sangre , Diabetes Mellitus Tipo 2/sangre , Femenino , Hemoglobina Glucada/análisis , Adhesión a Directriz , Conocimientos, Actitudes y Práctica en Salud , Humanos , Hipoglucemiantes/uso terapéutico , Masculino , Persona de Mediana Edad , Cooperación del Paciente , Resultado del Tratamiento , Adulto JovenRESUMEN
Staying up to date with evolving pharmacotherapies is important to providing optimal therapies to patients. The authors present available evidence to support the role of novel and existing agents in treating type-2 diabetes.
RESUMEN
PURPOSE: The results of a survey to (1) assess the current status of preceptor development within pharmacy residency programs, (2) understand challenges to preceptor development, and (3) identify directions for future preceptor development opportunities are presented. METHODS: In June 2012, pharmacy residents and preceptors listed in the ASHP online residency directory were surveyed. The survey was developed from a review of the literature and underwent expert review. The final instrument included 19 preceptor-specific items and 12 resident-specific items. RESULTS: A total of 1437 preceptors and residents participated in the survey. Forty-nine percent of preceptor respondents reported having attended a formal Residency Learning System workshop. Most surveyed preceptors (88.1%) felt they were adequately trained as a preceptor to be effective in educating pharmacy residents, but only 51.5% of preceptors felt they had adequate time for precepting residents. Preceptors reported the lack of time as the primary barrier to their development as preceptors, with 60% indicating that "effectively precepting while meeting employment responsibilities" was their primary precepting challenge. CONCLUSION: Less than half of respondents to the preceptor survey reported that their institutions had a policy outlining specific requirements for preceptor development. Preceptor survey respondents reported the lack of time as the primary barrier to preceptor development. Many surveyed residents indicated that providing effective verbal feedback and providing effective written feedback were the greatest challenges for their preceptors.