Novel Interventions to Increase Uptake of Diabetes Self-Management Support Training within Primary Care

摘要 糖尿病患者的生活可能具有挑战性，但糖尿病自我管理教育和支持（DSMES） 众所周知，它可以帮助糖尿病患者（PWDM）学会科普糖尿病患者生活的不确定性。 不幸的是，DSMES在当前的医疗保健环境中未得到充分利用。这是一个多因素的问题， 两个最大的问题是供应商不转介病人和病人不参加DSMES计划。 这些项目和支持它们的卫生保健工作者有可能改变这种疾病 包括可能改变长期发病率和死亡率。我们建议 可行性研究，以测试向医疗保健提供者提供的最佳实践指南（BPA）的影响， 糖尿病护理和教育专家通过电子健康记录，当PWDM被识别为 有资格参加DSMES。我们将确定BPA是否影响DSMES的转诊时间以及 预测患者是否被转诊至DSMES的因素。我们还建议评估同行的影响 支持推动PWDM参加DSMES并选择更健康的生活方式。我们假设如果 PWDM能够与同样患有糖尿病的同龄人联系，他们可能更有可能参加 DSMES。最后，我们将定性评估医疗保健提供者对使用BPA的感受 提醒，探讨PWDM如何看待同伴支持者的效用，以及 他们接受的糖尿病教育。从这些经验教训中，我们将与利益相关者合作， 一项大型、实用的随机试验，旨在增加DSMES（糖尿病的重要组成部分）的摄入 谜题

Abstract Living with diabetes can be challenging, however Diabetes Self-Management Education and Support (DSMES) is well known to help persons with diabetes (PWDM) learn to cope with the uncertainties of life with diabetes. Unfortunately, DSMES is underutilized in the current health care setting. This is a multifactorial problem with the two largest issues being providers not referring patients and patients not attending the DSMES programs. These programs and the health care workers who support them have the potential to modify the disease course for many PWDM, including potentially modifying long term morbidity and mortality. We are proposing a feasibility study to test the impact of best practice advisories (BPAs) delivered to the health care provider and the diabetes care and education specialists via the electronic health record when a PWDM is identified as qualifying for DSMES. We will determine if the BPAs influence the time to referral for DSMES as well as the factors that predict whether a patient is referred to DSMES. We also propose to assess the impact of a peer support on motivating PWDM to attend DSMES and make healthier lifestyle choices. We hypothesize that if PWDM are able to connect with a peer who is also living with diabetes, they may be more likely to attend DSMES. Finally, we will assess qualitatively how the health care providers felt about the use of the BPA reminders, explore how the PWDM felt about the utility of the peer supporters, and the overall relevance of the diabetes education they received. From these lessons learned we will work with our stakeholders to design a large, pragmatic randomized trial designed to increase the uptake of DSMES, a vital piece of the diabetes puzzle.