Abstract
People with diabetes have a marked increase in morbidity and mortality. The American Diabetes Association has recommended evidence-based process and outcome measures to improve diabetes care. However, these are not met in the majority of patients under our current medical care system. There have been many (mostly unsuccessful) approaches to improving these outcomes including reminding patients about appointments, feeding back information on the patient to the physician, even when specific treatment recommendations for the individual patient were included, case management (when the case manager could not make treatment decisions), education of physicians and multifaceted quality improvement interventions in the practice setting. One approach has consistently been successful; case management when a nurse or pharmacist had the authority to make independent treatment decisions. In randomized clinical trials, Hb A1c levels were lowered approximately three times as much by nurses or pharmacists following approved detailed treatment algorithms (under the supervision of a physician) compared to usual care. Given the approaching epidemic of diabetes, our medical care system should strongly consider this approach to improving diabetes care to forestall the devastation of diabetic complications and the overwhelming costs of caring for these patients.
Keywords: Diabetes disease management, Nurse- and pharmacist-directed diabetes care, Quality of diabetes care
Current Diabetes Reviews
Title: The Effectiveness of Nurse- and Pharmacist-Directed Care in Diabetes Disease Management:A Narrative Review
Volume: 3 Issue: 4
Author(s): Mayer B. Davidson
Affiliation:
Keywords: Diabetes disease management, Nurse- and pharmacist-directed diabetes care, Quality of diabetes care
Abstract: People with diabetes have a marked increase in morbidity and mortality. The American Diabetes Association has recommended evidence-based process and outcome measures to improve diabetes care. However, these are not met in the majority of patients under our current medical care system. There have been many (mostly unsuccessful) approaches to improving these outcomes including reminding patients about appointments, feeding back information on the patient to the physician, even when specific treatment recommendations for the individual patient were included, case management (when the case manager could not make treatment decisions), education of physicians and multifaceted quality improvement interventions in the practice setting. One approach has consistently been successful; case management when a nurse or pharmacist had the authority to make independent treatment decisions. In randomized clinical trials, Hb A1c levels were lowered approximately three times as much by nurses or pharmacists following approved detailed treatment algorithms (under the supervision of a physician) compared to usual care. Given the approaching epidemic of diabetes, our medical care system should strongly consider this approach to improving diabetes care to forestall the devastation of diabetic complications and the overwhelming costs of caring for these patients.
Export Options
About this article
Cite this article as:
Davidson B. Mayer, The Effectiveness of Nurse- and Pharmacist-Directed Care in Diabetes Disease Management:A Narrative Review, Current Diabetes Reviews 2007; 3 (4) . https://dx.doi.org/10.2174/157339907782330058
DOI https://dx.doi.org/10.2174/157339907782330058 |
Print ISSN 1573-3998 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6417 |
Call for Papers in Thematic Issues
Advancing Diabetic Wound Healing: Mechanisms and Interventions
In recent years, diabetic wounds have become a global health concern with the increase in the incidence of diabetes. Diabetic wounds are a kind of chronic and refractory ulcer. It is generally due to the microcirculatory disturbances and the reduced levels of endogenous growth factors. Delayed cutaneous wound healing is ...read more
Oxidative and inflammatory responses in the development of secondary diabetic complications
Diabetes, along with its associated secondary complications, represents a significant global health challenge, contributing significantly to morbidity and mortality. Unhealthy lifestyle habits, reduced physical activity, environmental pollutants, and stress are pivotal factors in the onset of diabetes, particularly type-2 diabetes. Poorly managed hyperglycemia can lead to various complications, including neuropathy, ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Parkinson's Disease: A Role for the Immune System
Current Molecular Pharmacology The Role of Alpha-lipoic Acid Supplementation in the Prevention of Diabetes Complications: A Comprehensive Review of Clinical Trials
Current Diabetes Reviews Reactivity-Based Drug Discovery Using Vitamin B6-Derived Pharmacophores
Mini-Reviews in Medicinal Chemistry Neuroregeneration in Parkinson’s Disease: From Proteins to Small Molecules
Current Neuropharmacology Anti-Inflammatory Agents from Plants: Progress and Potential
Current Medicinal Chemistry Animal Models of Obesity and Metabolic Syndrome: Potential Tools for Alzheimers Disease Research
Current Alzheimer Research Antioxidant Components of Brassica Vegetables Including Turnip and the Influence of Processing and Storage on their Anti-oxidative Properties
Current Medicinal Chemistry Oxidative/Nitrosative Stress and Immuno-inflammatory Pathways in Depression: Treatment Implications
Current Pharmaceutical Design Recent Advances in Neuroinflammation Therapeutics: PPARs/LXR as Neuroinflammatory Modulators
Current Pharmaceutical Design Curcuminoids in Neurodegenerative Diseases
Recent Patents on CNS Drug Discovery (Discontinued) An Overview of Published Papers and Important Developments in the Past Three Years
Anti-Inflammatory & Anti-Allergy Agents in Medicinal Chemistry Modifiers of Hearing Impairment in Humans and Mice
Current Genomics Editorial (Thematic Issue: Combination Therapy of Vascular Diseases and Fangjiomics: When West Meets East in the Era of Phenomics)
Current Vascular Pharmacology Agave (Agave spp.) and its Traditional Products as a Source of Bioactive Compounds
Current Bioactive Compounds Diagnostic Tools for Diabetic Sensorimotor Polyneuropathy
Current Diabetes Reviews Micro RNA: An Epigenetic Regulator of Type 2 Diabetes
MicroRNA Pharmacologic Intervention in Axonal Excitability: In Vivo Assessment of Nodal Persistent Sodium Currents in Human Neuropathies
Current Molecular Pharmacology A Systematic Review of Overweight, Obesity, and Type 2 Diabetes Among Asian American Subgroups
Current Diabetes Reviews Potential Role of TRAIL in the Management of Autoimmune Diabetes Mellitus
Current Pharmaceutical Design Gene Expression Studies in Multiple Sclerosis
Current Genomics