Patient Care Teams
In patient care management, Patient Care Teams are defined as "Care of patients by a multidisciplinary team usually organized under the leadership of a physician; each member of the team has specific responsibilities and the whole team contributes to the care of the patient."[1]
Rational for patient care teams
The need for multidisciplinary teams in diabetes is demonstrated by the diversity of markers of quality care for diabetics, which at a minimum, include glycemic control, blood pressure control, and lipid control[2][3][4].
Additional markers of quality of care include cessation of tobacco use, serial eye and dental examinations, foot examination, and vaccinations[3], as well as renal monitoring for albuminuria[4].
Achieving these goals is difficult with typical rates of success:
- 21.2% of American adults in 2015-2018 achieved all three goals per NHANES data (individualized HbA1c targets ["less than 6.5% for young adults aged 18 to 44 years without complications, less than 7.0% for both young adults with complications and middle-aged adults aged 45 to 64 years without complications, less than 8.0% for both middle-aged adults and older adults aged 65 years or older with complications, and less than 7.5% for older adults without complications."], blood pressure less than 130/80 mm Hg, and low-density lipoprotein cholesterol level less than 100 mg/dL)[4]
- 22.2% of American adults in 2015-2018 achieved all three goals per NHANES data in a second study (HbA1c <7%, non-high-density lipoprotein cholesterol level, <130 mg per deciliter, blood-pressure control <140/90 mm Hg)[3]
Implementations of patient care teams
18.2% (vs. 8.1%% in usual care) of patients achieved control of glycemic, blood pressure ("HbA1c level less than 7% plus BP less than 130/80 mm Hg and/or LDLc level less than 100 mg/dL"), and LDL goals in a randomized controlled trial of patient care teams in an international study of patients with "poor cardiometabolic profiles (glycated hemoglobin [HbA1c] level ≥8% plus systolic blood pressure [BP] ≥140 mm Hg and/or low-density lipoprotein cholesterol [LDLc] level ≥130 mg/dL)."[5]. These rates were lower than in a prior study of Kaiser[6].
The impact of patient care team and many other quality improvement efforts to improve the care of diabetes patients have been systematically reviewed[7].
See also
External links
References
- ↑ Anonymous (2022), Patient Care Teams (English). Medical Subject Headings. U.S. National Library of Medicine. https://meshb.nlm.nih.gov/record/ui?ui=D010348
- ↑ Ali MK, Bullard KM, Saaddine JB, Cowie CC, Imperatore G, Gregg EW (2013). "Achievement of goals in U.S. diabetes care, 1999-2010". N Engl J Med. 368 (17): 1613–24. doi:10.1056/NEJMsa1213829. PMID 23614587.
- ↑ 3.0 3.1 3.2 Fang M, Wang D, Coresh J, Selvin E (2021). "Trends in Diabetes Treatment and Control in U.S. Adults, 1999-2018". N Engl J Med. 384 (23): 2219–2228. doi:10.1056/NEJMsa2032271. PMC 8385648 Check
|pmc=value (help). PMID 34107181 Check|pmid=value (help). - ↑ 4.0 4.1 4.2 Wang L, Li X, Wang Z, Bancks MP, Carnethon MR, Greenland P; et al. (2021). "Trends in Prevalence of Diabetes and Control of Risk Factors in Diabetes Among US Adults, 1999-2018". JAMA. doi:10.1001/jama.2021.9883. PMC 8233946 Check
|pmc=value (help). PMID 34170288 Check|pmid=value (help). - ↑ "Correction: Effectiveness of a Multicomponent Quality Improvement Strategy to Improve Achievement of Diabetes Care Goals". Ann Intern Med. 167 (4): 292. 2017. doi:10.7326/L17-0327. PMID 28806811.
- ↑ Schroeder EB, Hanratty R, Beaty BL, Bayliss EA, Havranek EP, Steiner JF (2012). "Simultaneous control of diabetes mellitus, hypertension, and hyperlipidemia in 2 health systems". Circ Cardiovasc Qual Outcomes. 5 (5): 645–53. doi:10.1161/CIRCOUTCOMES.111.963553. PMC 3590111. PMID 22851534.
- ↑ Yogasingam S, Konnyu KJ, Lépine J, Sullivan K, Alabousi M, Edwards A; et al. (2023). "Quality improvement strategies for diabetes care: Effects on outcomes for adults living with diabetes". Cochrane Database Syst Rev. 5 (5): CD014513. doi:10.1002/14651858.CD014513. PMC 10233616 Check
|pmc=value (help). PMID 37254718 Check|pmid=value (help).