An exploratory retrospective assessment of a quantitative measure of diabetes risk: medical management and patient impact in a primary care setting

Maureen R Courtney,1 Edward J Moler,2 John A Osborne,3 Geoff Whitney,4 Scott E Conard5 1College of Nursing, University of Texas Arlington, Arlington, 2Clarient Diagnostics, Aliso Viejo, CA, 3State of the Heart Cardiology, Grapevine, 4WaveTwo, Inc., Irving, 5ACAP Health, Dallas, TX, USA Background:...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Courtney MR, Moler EJ, Osborne JA, Whitney G, Conard SE
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2015
Materias:	Specialties of internal medicine RC581-951
Acceso en línea:	https://doaj.org/article/cca750cb673d4bfca7c692f8e90547d0
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:cca750cb673d4bfca7c692f8e90547d0
record_format	dspace
spelling	oai:doaj.org-article:cca750cb673d4bfca7c692f8e90547d02021-12-02T05:30:24ZAn exploratory retrospective assessment of a quantitative measure of diabetes risk: medical management and patient impact in a primary care setting1178-7007https://doaj.org/article/cca750cb673d4bfca7c692f8e90547d02015-09-01T00:00:00Zhttps://www.dovepress.com/an-exploratory-retrospective-assessment-of-a-quantitative-measure-of-d-peer-reviewed-article-DMSOhttps://doaj.org/toc/1178-7007Maureen R Courtney,1 Edward J Moler,2 John A Osborne,3 Geoff Whitney,4 Scott E Conard5 1College of Nursing, University of Texas Arlington, Arlington, 2Clarient Diagnostics, Aliso Viejo, CA, 3State of the Heart Cardiology, Grapevine, 4WaveTwo, Inc., Irving, 5ACAP Health, Dallas, TX, USA Background: Primary care providers with limited time and resources bear a heavy responsibility for chronic disease prevention or progression. Reliable clinical tools are needed to risk stratify patients for more targeted care. This exploratory study examined the care of patients who had been risk stratified regarding their likelihood of clinically progressing to type 2 diabetes. Methods: This was a retrospective chart review pilot study conducted to assess a primary care provider's use of a risk screening test. In this quality improvement project, the result of the risk screening was examined in relation to its influence on medical management and clinical impact on patients at risk for diabetes. All providers were board certified in family medicine and had more than 10 years clinical experience in managing diabetes and prediabetes. No specific clinical practice guidelines were mandated for patient care in this pilot study. Physicians in the practice group received an orientation to the diabetes risk measure and its availability for use in a pilot study to be conducted over a 6-month period. We identified the 696 nondiabetic adults in family practices who received a risk screening test (PreDx®, a multi-marker blood test that estimates the 5-year likelihood of conversion to type 2 diabetes) between June and November 2011 for a 6-month sample. A comparison group of 2,002 patients from a total database of 3.2 million patients who did not receive the risk test was randomly selected from the same clinical database after matching for age, sex, selected diagnoses, and metabolic risk factors. Patient groups were compared for intensity of care provided and clinical impact. Results: Compared to patients with a similar demographic and diagnostic profile, patients who had the risk test received more intensive primary care and had better clinical outcome than comparison patients. Risk-tested patients were more likely to return for follow-up visits, be monitored for relevant cardio-metabolic risk factors, and receive prescription medications with P<0.001. Further, intensity of care was associated with the level of risk test result: patients with moderate or high scores were more likely to return for follow-up visits and receive prescription medications than patients with low scores. All P-values for comparison patients between the low and moderate groups, low and high groups, and moderate and high groups resulted in P<0.001. Risk-tested patients were more likely than their comparison group counterparts to achieve weight reduction, lowered blood pressure, and improved blood glucose and cholesterol as demonstrated by P-values of <0.001. Conclusion: Use of a risk stratification test in primary care may help providers to more effectively identify high risk patients, manage diabetes risk, increase patient involvement in diabetes risk management, and improve clinical outcomes. A randomized controlled study is the next step to investigate the impact of diabetes risk stratification in primary care. Keywords: patient outcomes, diabetes, diabetes preventionCourtney MRMoler EJOsborne JAWhitney GConard SEDove Medical PressarticleSpecialties of internal medicineRC581-951ENDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol 2015, Iss default, Pp 447-453 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	Specialties of internal medicine RC581-951
spellingShingle	Specialties of internal medicine RC581-951 Courtney MR Moler EJ Osborne JA Whitney G Conard SE An exploratory retrospective assessment of a quantitative measure of diabetes risk: medical management and patient impact in a primary care setting
description	Maureen R Courtney,1 Edward J Moler,2 John A Osborne,3 Geoff Whitney,4 Scott E Conard5 1College of Nursing, University of Texas Arlington, Arlington, 2Clarient Diagnostics, Aliso Viejo, CA, 3State of the Heart Cardiology, Grapevine, 4WaveTwo, Inc., Irving, 5ACAP Health, Dallas, TX, USA Background: Primary care providers with limited time and resources bear a heavy responsibility for chronic disease prevention or progression. Reliable clinical tools are needed to risk stratify patients for more targeted care. This exploratory study examined the care of patients who had been risk stratified regarding their likelihood of clinically progressing to type 2 diabetes. Methods: This was a retrospective chart review pilot study conducted to assess a primary care provider's use of a risk screening test. In this quality improvement project, the result of the risk screening was examined in relation to its influence on medical management and clinical impact on patients at risk for diabetes. All providers were board certified in family medicine and had more than 10 years clinical experience in managing diabetes and prediabetes. No specific clinical practice guidelines were mandated for patient care in this pilot study. Physicians in the practice group received an orientation to the diabetes risk measure and its availability for use in a pilot study to be conducted over a 6-month period. We identified the 696 nondiabetic adults in family practices who received a risk screening test (PreDx®, a multi-marker blood test that estimates the 5-year likelihood of conversion to type 2 diabetes) between June and November 2011 for a 6-month sample. A comparison group of 2,002 patients from a total database of 3.2 million patients who did not receive the risk test was randomly selected from the same clinical database after matching for age, sex, selected diagnoses, and metabolic risk factors. Patient groups were compared for intensity of care provided and clinical impact. Results: Compared to patients with a similar demographic and diagnostic profile, patients who had the risk test received more intensive primary care and had better clinical outcome than comparison patients. Risk-tested patients were more likely to return for follow-up visits, be monitored for relevant cardio-metabolic risk factors, and receive prescription medications with P<0.001. Further, intensity of care was associated with the level of risk test result: patients with moderate or high scores were more likely to return for follow-up visits and receive prescription medications than patients with low scores. All P-values for comparison patients between the low and moderate groups, low and high groups, and moderate and high groups resulted in P<0.001. Risk-tested patients were more likely than their comparison group counterparts to achieve weight reduction, lowered blood pressure, and improved blood glucose and cholesterol as demonstrated by P-values of <0.001. Conclusion: Use of a risk stratification test in primary care may help providers to more effectively identify high risk patients, manage diabetes risk, increase patient involvement in diabetes risk management, and improve clinical outcomes. A randomized controlled study is the next step to investigate the impact of diabetes risk stratification in primary care. Keywords: patient outcomes, diabetes, diabetes prevention
format	article
author	Courtney MR Moler EJ Osborne JA Whitney G Conard SE
author_facet	Courtney MR Moler EJ Osborne JA Whitney G Conard SE
author_sort	Courtney MR
title	An exploratory retrospective assessment of a quantitative measure of diabetes risk: medical management and patient impact in a primary care setting
title_short	An exploratory retrospective assessment of a quantitative measure of diabetes risk: medical management and patient impact in a primary care setting
title_full	An exploratory retrospective assessment of a quantitative measure of diabetes risk: medical management and patient impact in a primary care setting
title_fullStr	An exploratory retrospective assessment of a quantitative measure of diabetes risk: medical management and patient impact in a primary care setting
title_full_unstemmed	An exploratory retrospective assessment of a quantitative measure of diabetes risk: medical management and patient impact in a primary care setting
title_sort	exploratory retrospective assessment of a quantitative measure of diabetes risk: medical management and patient impact in a primary care setting
publisher	Dove Medical Press
publishDate	2015
url	https://doaj.org/article/cca750cb673d4bfca7c692f8e90547d0
work_keys_str_mv	AT courtneymr anexploratoryretrospectiveassessmentofaquantitativemeasureofdiabetesriskmedicalmanagementandpatientimpactinaprimarycaresetting AT molerej anexploratoryretrospectiveassessmentofaquantitativemeasureofdiabetesriskmedicalmanagementandpatientimpactinaprimarycaresetting AT osborneja anexploratoryretrospectiveassessmentofaquantitativemeasureofdiabetesriskmedicalmanagementandpatientimpactinaprimarycaresetting AT whitneyg anexploratoryretrospectiveassessmentofaquantitativemeasureofdiabetesriskmedicalmanagementandpatientimpactinaprimarycaresetting AT conardse anexploratoryretrospectiveassessmentofaquantitativemeasureofdiabetesriskmedicalmanagementandpatientimpactinaprimarycaresetting AT courtneymr exploratoryretrospectiveassessmentofaquantitativemeasureofdiabetesriskmedicalmanagementandpatientimpactinaprimarycaresetting AT molerej exploratoryretrospectiveassessmentofaquantitativemeasureofdiabetesriskmedicalmanagementandpatientimpactinaprimarycaresetting AT osborneja exploratoryretrospectiveassessmentofaquantitativemeasureofdiabetesriskmedicalmanagementandpatientimpactinaprimarycaresetting AT whitneyg exploratoryretrospectiveassessmentofaquantitativemeasureofdiabetesriskmedicalmanagementandpatientimpactinaprimarycaresetting AT conardse exploratoryretrospectiveassessmentofaquantitativemeasureofdiabetesriskmedicalmanagementandpatientimpactinaprimarycaresetting
_version_	1718400376720326656

An exploratory retrospective assessment of a quantitative measure of diabetes risk: medical management and patient impact in a primary care setting

Ejemplares similares