The Experts below are selected from a list of 267 Experts worldwide ranked by ideXlab platform
Linda M Siminerio - One of the best experts on this subject based on the ideXlab platform.
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Diabetes Educator impact in value based care models
Diabetes, 2018Co-Authors: Janice Koshinsky, Kristine Ruppert, Jodi Krall, Justin Kanter, X Francis J R Solano, Linda M SiminerioAbstract:Background: Health systems are implementing value-based care models focused on quality. Organized care teams set the foundation for successful models with processes that address patient outreach and engagement. The purpose of this study was to evaluate the impact of “Glucose to Goal (G2G),” a Diabetes Educator (DE) driven, population-based intervention on glycemic improvement in reaching quality metrics for Diabetes mellitus (DM) care. Methods: A large primary care (PC) network established pod-style patient-centered medical homes (PCMHs) clustered by grouping multiple PC practices together based on patient panel size, hospital affiliation, and geographic proximity, and incorporating expanded care teams (DE, behavioral health, social worker, wellness guide, nurse care manager). Specific to DM, PCMHs adopted the G2G intervention whereby DEs used population health reports to proactively identify patients with HbA1c levels above target (>7%). G2G was assessed in 5 pods by comparing HbA1c values for only those patients with DM with pre/post results who participated over a three-month period (n=284) to those who did not (n=265). Results: A total of 80% of patients receiving G2G improved their HbA1c levels with 46.8% reducing HbA1c by 1% and 24% reducing HbA1c by 2%. Comparatively, 31.3% of patients not receiving G2G improved their HbA1c with only 6.4% reducing HbA1c by 1% and only 1.5% reducing HbA1c by 2% or more. This translated into more than 1.5% difference in mean HbA1c change between groups, with patients receiving DE experiencing a mean reduction in HbA1c of 1.35% (8.61 to 7.26%) compared to increase of 0.35% (7.96 to 8.30%) for those not participating in DE (p Conclusions: Study findings demonstrate the relevance of DE services in value-based PC models. As healthcare systems shift focus from volume to value, effective approaches to manage Diabetes and improve patient outcomes take on new meaning. Disclosure J.L. Koshinsky: None.J. Krall: None.K. Ruppert: None.J. Kanter: None.F.X. Solano: None.L.M. Siminerio: None.
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an insurer based Diabetes Educator community partnership leveraging education and Diabetes support leads
Clinical Diabetes, 2015Co-Authors: Linda M Siminerio, Karen Depasquale, Patricia A Johnson, Margaret ThearleAbstract:By the end of this decade, Diabetes likely will affect 15% of Americans, or ∼39 million people (1). This is particularly alarming given the nature of the disease and its complications. In addition to the humanistic burden, the economic consequences are substantial. The cost of medical care for patients with Diabetes averages 2.3 times higher than for similar patients without Diabetes, which translates to additional medical expenses of $6,649 per person with Diabetes (2,3). Payers are particularly interested in exploring ways to reduce these costs. The annual cost of care for a person with Diabetes in the commercially insured population has been reported to be between $8,000 and $12,000, excluding the costs of prescription drugs. Cost data from 2009 in a sample of 10 million commercial insurance plan members showed an average cost of members with Diabetes to be ∼$11,700 compared to an average $4,400 for the remainder of the population. The average yearly costs of $20,700 for people with complications of Diabetes are almost three times higher than the average cost of $7,800 for those without complications (1). There is now a large evidence base about effective interventions that address the complexities of managing chronic disease. Health plans are expected to use these resources to provide services and preventive care and to explore new partnerships. Interventions shown to reduce the Diabetes burden, including practice redesign, coaching, telephone-based support, hospital transitional care, and community programs are being instituted (4–8). The University of Pittsburgh Medical Center (UPMC) Health Plan is the insurance division for UPMC, an integrated health system, including hospital, community, and physician divisions. UPMC Health Plan …
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telemedicine for reach education access and treatment treat linking telemedicine with Diabetes self management education to improve care in rural communities
The Diabetes Educator, 2014Co-Authors: Linda M Siminerio, Kristine Ruppert, Kimberly Huber, Fredrico G S ToledoAbstract:PurposeThe purpose of this study was to examine Diabetes-related behavioral and psychosocial outcomes as well as patient satisfaction with the Telemedicine for Reach, Education, Access, and Treatment (TREAT) model.MethodsTREAT employs telemedicine services provided by an endocrinologist at an urban area in partnership with a Diabetes Educator in a rural area, working together with patients and primary care providers (PCPs). Thirty-five patients with type 2 Diabetes were referred by PCPs and received glycemic management and education in the TREAT model. A Diabetes Educator operated the videoconferencing equipment, remained with the patient to receive and review plan communicated by the endocrinologist during the visit, coordinated services, administered surveys, and provided self-management education and support. Empowerment, self-care, Diabetes distress, adherence to monitoring, and patient satisfaction were assessed by survey at baseline and follow-up.ResultsThere was significant improvement in empowerme...
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is the Diabetes Educator our next endangered species lessons from the american bald eagle
Diabetes Spectrum, 2007Co-Authors: Linda M SiminerioAbstract:Several years ago, our national bird, the American bald eagle, was in jeopardy of becoming extinct. Imagine how it would be if our national symbol could no longer be spotted in our country's skies. Fortunately, the bald eagle was protected and continues to be proudly hailed as a meaningful symbol of the United States. As the number of people developing Diabetes in the United States increases, there is a paradoxical and growing concern that Diabetes Educators, who can help stem this tide, will become extinct. Educators in both the American Diabetes Association (ADA) and the American Association of Diabetes Educators (AADE) report program closings and express frustration with the implementation of Medicare benefits and the difficulties involved in obtaining appropriate reimbursement. The ADA and AADE collaborated to conduct a survey of Diabetes self-management education (DSME) programs.1 Their findings in 122 sites confirmed other studies indicating that Diabetes education is an underutilized service.1–4 Nearly half of the sites reported an average visit volume of < 50 visits per month, and 19% reported only 51–100 visits per month.1 This means that relatively few Diabetes patients have continuing contact with Educators. With the number of education program closings and the dismal numbers of people reported to have received DSME, one cannot help but wonder if there will continue to be employment opportunities for the nurses, dietitians, and pharmacists who deliver …
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using the american association of Diabetes Educators outcomes system to identify patient behavior change goals and Diabetes Educator responses
The Diabetes Educator, 2007Co-Authors: Janice C Zgibor, Linda M Siminerio, Mark Peyrot, Kristine Ruppert, William Noullet, Malinda Peeples, Janis Mcwilliams, Janice Koshinsky, Carla Dejesus, Sharlene EmersonAbstract:Purpose The purpose of this article is to ascertain patients' self-identified and mutually identified or agreed on (working with Diabetes Educators) behavior change goals and examine the Diabetes Educators' response to these goals during the provision of Diabetes self-management education. Methods The American Association of Diabetes Educators Outcome System was integrated into Web-based, touch-screen, and telephonic systems within 8 sites within the Pittsburgh Regional Initiative for Diabetes Education network. Data from patients and their Diabetes Educators were obtained from the Diabetes Self-management Assessment Report Tool (D-SMART®) and Diabetes Educator Tool (D-ET®). Results Nine hundred fifty-four individuals with Diabetes (type 1 and type 2) using the D-SMART self-identified healthy eating (74%) and being active (54%) as the most common behavior change goals. From that sample, 527 patients identified goals that were mutually identified or agreed on with their Diabetes Educator: healthy eating (94%), being active (59%), monitoring (49%), taking medication (26%), reducing risks (19%), problem solving (18%), and healthy coping (18%). Conclusion The most common behavior change goals identified by patients (self-identified or mutually identified with their Diabetes Educator) were healthy eating and being active. The behavior change goal least addressed by patients and Educators alike was healthy coping. Mutually identified goals among Educators and patients may improve targeted appropriate educational strategies to support patients in meeting their goals.
Kerry Mansell - One of the best experts on this subject based on the ideXlab platform.
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a qualitative assessment of the practice experiences of certified Diabetes Educator pharmacists
Canadian Journal of Diabetes, 2015Co-Authors: Fahad Alzahrani, Jeff Taylor, Jason Perepelkin, Kerry MansellAbstract:Abstract Objective To describe the practice experiences of Certified Diabetes Educator (CDE) pharmacists in Saskatchewan and determine what impact the CDE designation has had on their personal practices. Methods A qualitative research approach was used. All pharmacists in Saskatchewan were e-mailed about the study, and eventually, a purposive sampling method was used to select a range of CDE pharmacists. Semistructured, in-person interviews were performed. An interview guide was developed to assess the work activities performed, the benefits of becoming a CDE and the challenges and resultant solutions that optimize their CDE designations. All interviews were transcribed verbatim and coded using deductive thematic analysis to identify the main themes that described the experiences of respondents, with the aid of QSR NVivo. Results A total of 14 CDE pharmacists from various communities and work settings chose to participate. All of the participants indicated they were engaging in increased Diabetes-related activities since becoming CDEs. All participants indicated they were happy with their decisions to become CDEs and described numerous benefits as a direct result of achieving this designation. Although some solutions were offered, participants still face challenges in optimizing their role as CDEs, such as devoting enough time to Diabetes management and remuneration for providing Diabetes services. Conclusions CDE pharmacists in Saskatchewan report performing enhanced Diabetes-related activities subsequent to becoming CDEs and that obtaining this designation has had a positive impact on their personal practices. A larger, cross-country study is necessary to determine whether these results are consistent amongst all pharmacists in Canada.
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reflections of certified Diabetes Educator cde pharmacists a qualitative assessment
Canadian Journal of Diabetes, 2013Co-Authors: Kerry Mansell, Fahad Alzahrani, Jeff Taylor, Jason PerepelkinAbstract:s / Can J Diabetes 37 (2013) S13eS84 S22 lancingwas also higher than the experienced pain (median 26 [IQR 11 to 35] mm versus 18 [IQR 6 to 26] mm; p<0.05). The D-FIST questionnaire scores also decreased significantly after the exercise. Students anticipated the pain of injectionwould be higher than fingertip lancing (p<0.05); however, the experienced pain of injection was lower than fingertip lancing (p<0.05). Conclusions: Participation in this exercise significantly changed the students’ fear and pain associated with injection and fingertip lancing. The exercise provides important information for students when teaching patients about Diabetes management.
Mitch J Duncan - One of the best experts on this subject based on the ideXlab platform.
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Diabetes self management smartphone application for adults with type 1 Diabetes randomized controlled trial
Journal of Medical Internet Research, 2013Co-Authors: Morwenna Kirwan, Corneel Vandelanotte, Andrew Fenning, Mitch J DuncanAbstract:Background: Persistently poor glycemic control in adult type 1 Diabetes patients is a common, complex, and serious problem initiating significant damage to the cardiovascular, renal, neural, and visual systems. Currently, there is a plethora of low-cost and free Diabetes self-management smartphone applications available in online stores. Objective: The aim of this study was to examine the effectiveness of a freely available smartphone application combined with text-message feedback from a certified Diabetes Educator to improve glycemic control and other Diabetes-related outcomes in adult patients with type 1 Diabetes in a two-group randomized controlled trial. Methods: Patients were recruited through an online type 1 Diabetes support group and letters mailed to adults with type 1 Diabetes throughout Australia. In a 6-month intervention, followed by a three-month follow-up, patients (n=72) were randomized to usual care (control group) or usual care and the use of a smartphone application (Glucose Buddy) with weekly text-message feedback from a Certified Diabetes Educator (intervention group). All outcome measures were collected at baseline and every three months over the study period. Patients’ glycosylated hemoglobin levels (HbA1c) were measured with a blood test and Diabetes-related self-efficacy, self-care activities, and quality of life were measured with online questionnaires. Results: The mean age of patients was 35.20 years (SD 10.43) (28 male, 44 female), 39% (28/72) were male, and patients had been diagnosed with type 1 Diabetes for a mean of 18.94 years (SD 9.66). Of the initial 72 patients, 53 completed the study (25 intervention, 28 control group). The intervention group significantly improved glycemic control (HbA1c) from baseline (mean 9.08%, SD 1.18) to 9-month follow-up (mean 7.80%, SD 0.75), compared to the control group (baseline: mean 8.47%, SD 0.86, follow-up: mean 8.58%, SD 1.16). No significant change over time was found in either group in relation to self-efficacy, self-care activities, and quality of life.
Shelley L Jones - One of the best experts on this subject based on the ideXlab platform.
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Diabetes case management in primary care the new brunswick experience and expanding the practice of the certified Diabetes Educator nurse into primary care
Canadian Journal of Diabetes, 2015Co-Authors: Shelley L JonesAbstract:The role of the outreach Diabetes case manager in New Brunswick, Canada, was first developed in the Moncton Area of Horizon Health Network in response to a physician-identified gap between patients' diagnoses of Diabetes and their attendance at the local Diabetes education centre. This model of collaborative interprofessional practice increases support for primary care providers and people living with Diabetes in that they are being provided the services of certified Diabetes Educators who can address knowledge gaps with respect to evidence-based guidelines and best practice, promote advancement of Diabetes and chronic-disease management therapies and support adherence to treatment plans and self-management practices. This report chronicles a review of the implementation, expansion and evaluation of the outreach Diabetes case manager model in the province of New Brunswick, Canada, along with the rationale for development of the role for registered nurses in other jurisdictions.
Jason Perepelkin - One of the best experts on this subject based on the ideXlab platform.
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a qualitative assessment of the practice experiences of certified Diabetes Educator pharmacists
Canadian Journal of Diabetes, 2015Co-Authors: Fahad Alzahrani, Jeff Taylor, Jason Perepelkin, Kerry MansellAbstract:Abstract Objective To describe the practice experiences of Certified Diabetes Educator (CDE) pharmacists in Saskatchewan and determine what impact the CDE designation has had on their personal practices. Methods A qualitative research approach was used. All pharmacists in Saskatchewan were e-mailed about the study, and eventually, a purposive sampling method was used to select a range of CDE pharmacists. Semistructured, in-person interviews were performed. An interview guide was developed to assess the work activities performed, the benefits of becoming a CDE and the challenges and resultant solutions that optimize their CDE designations. All interviews were transcribed verbatim and coded using deductive thematic analysis to identify the main themes that described the experiences of respondents, with the aid of QSR NVivo. Results A total of 14 CDE pharmacists from various communities and work settings chose to participate. All of the participants indicated they were engaging in increased Diabetes-related activities since becoming CDEs. All participants indicated they were happy with their decisions to become CDEs and described numerous benefits as a direct result of achieving this designation. Although some solutions were offered, participants still face challenges in optimizing their role as CDEs, such as devoting enough time to Diabetes management and remuneration for providing Diabetes services. Conclusions CDE pharmacists in Saskatchewan report performing enhanced Diabetes-related activities subsequent to becoming CDEs and that obtaining this designation has had a positive impact on their personal practices. A larger, cross-country study is necessary to determine whether these results are consistent amongst all pharmacists in Canada.
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reflections of certified Diabetes Educator cde pharmacists a qualitative assessment
Canadian Journal of Diabetes, 2013Co-Authors: Kerry Mansell, Fahad Alzahrani, Jeff Taylor, Jason PerepelkinAbstract:s / Can J Diabetes 37 (2013) S13eS84 S22 lancingwas also higher than the experienced pain (median 26 [IQR 11 to 35] mm versus 18 [IQR 6 to 26] mm; p<0.05). The D-FIST questionnaire scores also decreased significantly after the exercise. Students anticipated the pain of injectionwould be higher than fingertip lancing (p<0.05); however, the experienced pain of injection was lower than fingertip lancing (p<0.05). Conclusions: Participation in this exercise significantly changed the students’ fear and pain associated with injection and fingertip lancing. The exercise provides important information for students when teaching patients about Diabetes management.