The New Zealand medical journal · 2023
A diabetes registrar assisted workflow intervention in general practice for systematic initiation of cardiorenal medications for patients with type 2 diabetes and albuminuria in Aotearoa New Zealand.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Niyagama Anjana, Moffitt Allan, Patel Mahesh, Strickland Minnie, Aprea Sara, Chepulis Lynne, Paul Ryan, Schmiedel Ole, Murphy Rinki
Аннотация
AIMS: To evaluate whether a weekly diabetes registrar clinic and case discussions conducted over 12 weeks in primary care improves guideline management of type 2 diabetes (T2D).
METHODS: A registrar-led diabetes clinic was incorporated into two primary care practices in Tāmaki Makaurau Auckland for 3 months. Patients with T2D and albuminuria appearing on practice dashboards as not prescribed angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (ACEi/ARB), or sodium-glucose cotransporter-2 inhibitor/glucagon-like peptide-1 receptor agonist (SGLT2i/GLP1RA) were booked into these clinics. Opportunistic education sessions were provided by the diabetes registrar and prescribers were surveyed to understand the challenges in management of T2D.
RESULTS: Of 125 patients booked, 80 attended the registrar clinic. Of these, 68% were clinically suitable for SGLT2i/GLP1RA and 8% for ACEi/ARB. SGLT2i/GLP1RA were initiated in 92% and ACEi/ARB in 89% of eligible patients. Two patients had contraindications for SGLT2i/GLP1RA, and one patient declined both. Additional cardiorenal medications were initiated in 16% of patients. Survey responses of 12 prescribers indicated acute illness takes priority over diabetes management, and lack of time and knowledge are main barriers to optimising diabetes care.
CONCLUSIONS: A visiting diabetes registrar intervention was successful in initiating guideline medications for T2D in primary care. It remains to be evaluated whether this leads to practice-wide improvements in prescribing gaps in the short or longer term.
METHODS: A registrar-led diabetes clinic was incorporated into two primary care practices in Tāmaki Makaurau Auckland for 3 months. Patients with T2D and albuminuria appearing on practice dashboards as not prescribed angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (ACEi/ARB), or sodium-glucose cotransporter-2 inhibitor/glucagon-like peptide-1 receptor agonist (SGLT2i/GLP1RA) were booked into these clinics. Opportunistic education sessions were provided by the diabetes registrar and prescribers were surveyed to understand the challenges in management of T2D.
RESULTS: Of 125 patients booked, 80 attended the registrar clinic. Of these, 68% were clinically suitable for SGLT2i/GLP1RA and 8% for ACEi/ARB. SGLT2i/GLP1RA were initiated in 92% and ACEi/ARB in 89% of eligible patients. Two patients had contraindications for SGLT2i/GLP1RA, and one patient declined both. Additional cardiorenal medications were initiated in 16% of patients. Survey responses of 12 prescribers indicated acute illness takes priority over diabetes management, and lack of time and knowledge are main barriers to optimising diabetes care.
CONCLUSIONS: A visiting diabetes registrar intervention was successful in initiating guideline medications for T2D in primary care. It remains to be evaluated whether this leads to practice-wide improvements in prescribing gaps in the short or longer term.