The ABCs of Diabetes Diabetes Self-management Education Program for African Americans Affects A1C, Lipid-Lowering Agent Prescriptions, and Emergency Department Visits
The ABCs of Diabetes Diabetes Self-management Education Program for African Americans Affects A1C, Lipid-Lowering Agent Prescriptions, and Emergency Department Visits
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DOI：
10.1177/0145721710392246
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发表时间：
2011-01-01
影响因子：
3.9
通讯作者：
Youssef, Gretchen
中科院分区：
文献类型：
--
作者：
Magee, Michelle;Bowling, Andrea;Youssef, Gretchen
PurposeThe的目的是研究的可行性和影响，一个简洁的社区为基础的计划，糖尿病自我管理教育（DSME），根据急诊科的访问和知识的频率，处方，并控制A1 C，血压，和低密度脂蛋白（LDL）cholestero.MethodsA免费的社区为基础的DSME程序被放置在一个公共图书馆。成人糖尿病患者（N，360）同意参加这项前瞻性非随机队列研究，采用干预前-干预后设计。小组互动DSME（两个2.5小时的课程）的重点是改善心血管疾病的危险因素和促进沟通与初级保健physician.ResultsAn增加的知识，美国糖尿病协会推荐的A1 C，血压和低密度脂蛋白胆固醇从基线干预后的目标被视为参与者。显著的临床结局包括自我报告的急诊就诊减少和平均A1 C降低。然而，尽管降脂药物的处方增加，血压和LDL胆固醇并没有改变。参与者谁开始对胰岛素更有可能达到或维持A1 C < 7%相比，那些谁没有采取或停止服用胰岛素在study.ConclusionsOffering非裔美国人在公共图书馆DSME类是可行的，并显着影响6个月的临床结果，包括降低A1 C，如果在研究期间开始使用胰岛素，则达到A1 C < 7%的目标的可能性增加，并且因未控制的糖尿病而急诊的就诊次数减少了三分之二。观察到的结果表明，与社区为基础的组织，如公共图书馆合作提供了一个方便和良好的位置提供DSME计划。
PurposeThe purpose of the study was to examine the feasibility and impact of a concise community-based program on diabetes self-management education (DSME), according to frequency of emergency department visits and knowledge of, prescriptions for, and control of A1C, blood pressure, and low-density lipoprotein (LDL) cholesterol.MethodsA free community-based DSME program was placed in a public library. Adults with diabetes (N, 360) consented to participate in this prospective nonrandomized cohort study with preintervention-postintervention design. The small-group interactive DSME (two 2.5-hour classes) focused on improving cardiovascular disease risk factors and facilitating communication with the primary care physician.ResultsAn increase in knowledge of American Diabetes Association-recommended targets for A1C, blood pressure, and LDL cholesterol from baseline to postintervention was seen among participants. Significant clinical outcomes included reduction in self-reported emergency department visits and reduction in mean A1C. However, despite an increase in prescriptions written for lipid-lowering drugs, blood pressure and LDL cholesterol did not change. Participants who started on insulin were more likely to achieve or maintain A1C < 7% compared to those who either did not take or stopped taking insulin during the study.ConclusionsOffering DSME classes for African Americans at a public library was feasible and significantly affected 6-month clinical outcomes, including a reduction in A1C, an increased likelihood of attaining a target A1C of < 7% if insulin was started during the study period, and a two-thirds reduction in emergency department visits for uncontrolled diabetes. Observed results suggest that partnering with community-based organizations such as public libraries offers an accessible and well-received location for offering DSME programs.