Inpatient diabetes care in a Swiss multi-site hospital: is there room for improvement?

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ID Serval
serval:BIB_90137D7E08E8
Type
Actes de conférence (partie): contribution originale à la littérature scientifique, publiée à l'occasion de conférences scientifiques, dans un ouvrage de compte-rendu (proceedings), ou dans l'édition spéciale d'un journal reconnu (conference proceedings).
Sous-type
Abstract (résumé de présentation): article court qui reprend les éléments essentiels présentés à l'occasion d'une conférence scientifique dans un poster ou lors d'une intervention orale.
Collection
Publications
Titre
Inpatient diabetes care in a Swiss multi-site hospital: is there room for improvement?
Titre de la conférence
ESCP-GSASA 38th symposium on clinical pharmacy 30 years of clinical pharmacy; a bright future ahead
Auteur(s)
Zaugg C., Devaud J.C., Beney J.
Adresse
Geneva, Switzerland, November 3-6, 2009
ISBN
0928-1231
Statut éditorial
Publié
Date de publication
2010
Volume
32
Série
Pharmacy World and Science
Pages
237-238
Langue
anglais
Notes
Meeting Abstract
Résumé
Background and objective:
Optimal care of diabetic patients (DPs) decreases the risk of complications. Close blood glucose monitoring can improve patient outcomes and shorten hospital stay. The objective of this pilot study was to evaluate the treatment of hospitalized DPs according to the current standards, including their diabetic treatment and drugs to prevent diabetes related complications [=guardian drugs: angiotensin converting enzyme inhibitors (ACEI) or Angiotensin II Receptor Blockers (ARB), antiplatelet drugs, statins]. Guidelines of the American Diabetes Association (ADA) [1] were used as reference as they were the most recent and exhaustive for hospital care.
Design:
Observational pilot study: analysis of the medical records of all DPs seen by the clinical pharmacists during medical rounds in different hospital units. An assessment was made by assigning points for fulfilling the different criteria according to ADA and then by dividing the total by the maximum achievable points (scale 0-1; 1 = all criteria fulfilled).
Setting:
Different Internal Medicine and Geriatric Units of the (multi-site) Ho^pital du Valais.
Main outcome measures:
- Completeness of diabetes-related information: type of diabetes, medical history, weight, albuminuria status, renal function, blood pressure, (recent) lipid profile.
- Management of blood glucose: Hb1Ac, glycemic control, plan for treating hyper-/hypoglycaemia.
- Presence of guardian drugs if indicated.
Results:
Medical records of 42 patients in 10 different units were analysed (18 women, 24 men, mean age 75.4 ± 11 years). 41 had type 2 diabetes.
- Completeness of diabetes-related information: 0.8 ± 0.1. Information often missing: insulin-dependence (43%) and lipid profile (86%).
- Management of blood glucose: 0.5 ± 0.2. 15 patients had suboptimal glycemic balance (target glycaemia 7.2-11.2 mmol/ l, with values[11.2 or\3.8 mmol/l, or Hb1Ac[7%), 10 patients had a deregulated balance (more than 10 values[11.2 mmol/l or \3.8 mmol/l and even values[15 mmol/l).
- Presence of guardian drugs if indicated: ACEI/ARB: 19 of 23 patients (82.6%), statin: 16 of 40 patients (40%), antiplatelet drug: 16 of 39 patients (41%).
Conclusions:
Blood glucose control was insufficient in many DPs and prescription of statins and antiplatelet drugs was often missing. If confirmed by a larger study, these two points need to be optimised. As it is not always possible and appropriate to make those changes during hospital stay, a further project should assess and optimise diabetes care across both inpatient and outpatient settings.
Mots-clé
Diabetes Care, In-Hospital Care, Guidelines
Web of science
Création de la notice
23/06/2010 11:04
Dernière modification de la notice
03/03/2018 19:24
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