Registry-Managed Care Coordination and Education for Patients With Co-occurring Diabetes and Serious Mental Illness.
Registry-Managed Care Coordination and Education for Patients With Co-occurring Diabetes and Serious Mental Illness.
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DOI：
10.1176/appi.ps.202000096
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发表时间：
2021-08-01
影响因子：
3.8
通讯作者：
Santos, Charles J.
中科院分区：
文献类型：
--
作者：
Cook, Judith A.;Jonikas, Jessica A.;Steigman, Pamela J.;Glover, Crystal M.;Burke-Miller, Jane K.;Weidenaar, Joni;O'Neill, Sheila;Pavick, Debbie;Jami, Asma;Santos, Charles J.
在引入涉及电子疾病管理、护理协调和个性化患者教育的干预措施后，对患有严重精神疾病和合并糖尿病的患者的健康结局的纵向变化进行了检查。这项观察性队列研究纳入了芝加哥一家行为健康之家的179名严重精神疾病和2型糖尿病患者。该干预措施雇用了一名护理协调员，他使用糖尿病登记处将服务与个性化患者教育沿着整合。结局包括血糖、血脂和血压（通过电子病历中的A1 C、LDL、甘油三酯和收缩/舒张值评估），以及完成眼科医生和足科医生确认的专业访视。中断时间序列分段随机回归模型测试了干预实施后8个研究乳区与8个实施前研究乳区的水平变化，控制了临床试验机构和干预前长期趋势。实施后血糖、血脂、血压指标均明显下降。此外，完成验光转诊增加了44%，完成足病转诊增加了60%。在引入多组分护理协调干预措施后，发现行为健康之家患有糖尿病和精神疾病的患者的医疗结果有显着改善，无论他们参加了哪个诊所。
Longitudinal changes in health outcomes of patients with serious mental illness and co-occurring diabetes were examined following introduction of an intervention involving electronic disease management, care coordination, and personalized patient education. This observational cohort study included 179 patients with serious mental illness and diabetes mellitus type 2 at a behavioral health home in Chicago. The intervention employed a care coordinator who used a diabetes registry to integrate services along with personalized patient education. Outcomes included glucose, lipid, and blood pressure as assessed by A1C, LDL, triglycerides, and systolic/diastolic values from electronic medical records, and completion of specialty visits confirmed with ophthalmologists and podiatrists. Interrupted time series segmented random regression models tested for level changes in the 8 study quarters following intervention implementation compared to 8 pre-implementation study quarters, controlling for clinic site and pre-intervention secular trends. There were significant level declines in glucose, lipid, and blood pressure indicators post-implementation. In addition, completed optometry referrals increased by 44% and completed podiatry referrals increased by 60%. Significant improvement in medical outcomes was found among behavioral health home patients with co-morbid diabetes and mental illness after introduction of a multicomponent care coordination intervention, regardless of which clinic they attended.
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影响因子：
16.2
作者：
American Diabetes Association
通讯作者：
American Diabetes Association
影响因子：
7.9
作者：
Clark, M;Hampson, SE;Simpson, R
通讯作者：
Simpson, R
影响因子：
2.7
作者：
Clausen, Whitney;Watanabe-Galloway, Shinobu;Britigan, Denise H.
通讯作者：
Britigan, Denise H.
影响因子：
2.7
作者：
Banerjea, Ranjana;Sambamoorthi, Usha;Pogach, Leonard M.
通讯作者：
Pogach, Leonard M.
影响因子：
1.9
作者：
Davis, Kristin E.;Brigell, Emily;Wilkniss, Sandra M.
通讯作者：
Wilkniss, Sandra M.