TORONTO--(EON: Enhanced Online News)--LMC Diabetes & Endocrinology, North America’s largest diabetes specialist care provider, has published a landmark study demonstrating the impact of its comprehensive, patient-centred care approach. The study, titled “DROP A1C”, was recently published in Diabetes Care, a peer-reviewed journal published by the American Diabetes Association. (http://care.diabetesjournals.org/content/early/2016/08/09/dc15-2666)
“Specialist-led diabetes registries and predictors of poor glycemic control in type 2 diabetes: Insights into the functionally refractory patient from the LMC Diabetes Registry database”
The objective of the study was to determine if functionally refractory patients with type 2 diabetes (persistent HbA1c ≥9.0%) could be identified, better understood and then better treated in order to finally improve their health outcomes. After a 12-month intervention, the mean reduction in HbA1C was 1.5% (17 mmol/mol) versus only 0.5% (5 mmol/mol) in the source cohort (n = 966) who continued with the standard of care (P < 0.01 vs. baseline).
The LMC group of clinician researchers used its patient registry, the largest globally, to identify active patients who had been unable to respond effectively to all prior efforts. The team of diabetes specialists, psychiatrists, nurses and dietitians developed a structured tool called the “Barriers to Care Index” to assess each patient’s particular needs and challenges. They then developed a unique set of care paths, designed to give each healthcare provider the strategies to tackle these unique patient barriers. Strategies ranged from telephone and home visits to providing care in a patient’s own language to coordinating mental health consultant access when needed.
Through the use of the LMC Diabetes Patient Registry, LMC specialists were able to identify 3,662 functionally refractory patients with 1,379 eligible for inclusion. 155 patients were ultimately enrolled in the study. The Barriers to Care Index was used to collect a detailed inventory of all the barriers a patient might experience in achieving optimal glycemic control. Barriers were grouped into five main categories: accessibility, cultural, co-morbidity, socioeconomic and psychological. Barrier-specific care paths were then designed by the multidisciplinary team and each patient was assigned an experienced case manager who implemented the care paths to help optimize the patient’s glycemic control.
The DROP A1c study continues to build on an internationally-recognized specialization in management of complex and challenging situations for patients with diabetes. Dr. Ronnie Aronson and other LMC researchers have previously published and presented their findings in a global review of the topic in the Journal of Diabetes in 2015 in a report titled, “Specialist-led diabetes registries and predictors of poor glycemic control in type 2 diabetes: Insights into the functionally refractory patient from the LMC Diabetes Registry database”.
“All specialists carry a proportion of patients who chronically struggle to achieve their optimal health targets in diabetes care,” explained Dr. Ronnie Aronson, founder and Chief Medical Officer of LMC Diabetes & Endocrinology. “That proportion can range from a fifth to a full half of the patients in a specialist’s practice and appears to be consistent in published practices globally. Specialists are generally seeing patients with more challenging issues in their diabetes care, but the problem is present in all of our practices, if we’re practising in diabetes.”
“It’s natural human nature for healthcare providers to recall our successes each day.” Dr. Aronson believes that only a detailed registry of patient health outcomes can provide detailed feedback to their physicians, a health quality report card, in a sense.
France Brilhante, one of the DROP A1c program participants explained, “I experienced challenges with my diabetes including balancing it with my other health issues, being motivated to make changes, needing more diabetes education and finding ways to financially manage my condition. Working with my diabetes educator and having her support helped me address these barriers and reduce my A1c level.”
About LMC Diabetes & Endocrinology
LMC is North America’s largest specialist care provider in diabetes and endocrinology, caring for nearly 30,000 patients with diabetes across Canada. LMC also provides Canada’s largest nationally accredited Diabetes Education Program. LMC researchers have conducted or contributed to over 300 clinical research studies in the field of diabetes. For more information visit https://www.lmc.ca and https://lmcresearch.com.
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