PMID- 27577736
OWN - NLM
STAT- MEDLINE
DCOM- 20171030
LR  - 20180203
IS  - 1934-8150 (Electronic)
IS  - 1551-7411 (Linking)
VI  - 13
IP  - 3
DP  - 2017 May-Jun
TI  - Use of secondary clinical data for research related to diabetes self-management 
      education.
PG  - 494-502
LID - S1551-7411(16)30212-1 [pii]
LID - 10.1016/j.sapharm.2016.07.002 [doi]
AB  - BACKGROUND: Diabetes self-management education (DSME) is a key component of 
      ensuring optimal diabetes outcomes. Electronic medical record (EMR) systems have 
      transformed diabetes management by providing organized and useful data. However, 
      important gaps remain in the process of how practice settings track referrals and 
      attendance to DSME. PURPOSE: The purpose of this study was to use EMR data to 
      examine patients' demographic, behavioral, and diabetes risk factors by referral 
      pattern to a DSME program in a large midwestern Academic Medical Center. METHODS: 
      A retrospective cross-sectional design using 2006-2013 EMR data from a Clinical 
      Research Data Warehouse (CRDW). Data on 10,000 patients with type 2 diabetes 
      mellitus (T2DM) were randomly extracted from the CRDW for analysis. Multiple 
      logistic regression analysis was employed to explore adjusted associations with 
      referral to DSME. RESULTS: Seven hundred forty patients with T2DM were referred 
      to DSME. Results show that age at diagnosis, insurance status, race/ethnicity, 
      language, alcohol use, use of insulin, HbA1c, LDL, systolic blood pressure, 
      ophthalmology appointment, coronary artery disease, neuropathy, 
      diabetic-retinopathy, and nephropathy were found to be factors significantly 
      associated with a referral to DSME. Language emerged as a significant result; 
      non-English speakers were more likely to receive a referral to DSME. CONCLUSIONS: 
      Patients referred for DSME had appropriate medical complications or social needs 
      that would benefit from intensive education; however, there remains a 
      considerable opportunity for improving the DSME referral process. Aspects of the 
      physician decision-making process to refer or not refer patients to DSME warrant 
      further investigation.
CI  - Copyright (c) 2016 Elsevier Inc. All rights reserved.
FAU - Azam, Laila S
AU  - Azam LS
AD  - Institute for Health and Society, Medical College of Wisconsin, 8701 Watertown 
      Plank Road, Milwaukee, WI 53226, USA. Electronic address: lsazam@mcw.edu.
FAU - Jackson, Tourette A
AU  - Jackson TA
AD  - Institute for Health and Society, Medical College of Wisconsin, 8701 Watertown 
      Plank Road, Milwaukee, WI 53226, USA.
FAU - Knudson, Paul E
AU  - Knudson PE
AD  - Department of Medicine, Division of Endocrinology, Medical College of Wisconsin, 
      9200 W. Wisconsin Ave, SCB, Milwaukee, WI 53226, USA.
FAU - Meurer, John R
AU  - Meurer JR
AD  - Institute for Health and Society, Medical College of Wisconsin, 8701 Watertown 
      Plank Road, Milwaukee, WI 53226, USA.
FAU - Tarima, Sergey S
AU  - Tarima SS
AD  - Institute for Health and Society, Medical College of Wisconsin, 8701 Watertown 
      Plank Road, Milwaukee, WI 53226, USA.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, P.H.S.
DEP - 20160727
PL  - United States
TA  - Res Social Adm Pharm
JT  - Research in social & administrative pharmacy : RSAP
JID - 101231974
SB  - IM
MH  - Academic Medical Centers
MH  - Cross-Sectional Studies
MH  - Decision Making
MH  - Diabetes Mellitus, Type 2/*therapy
MH  - Female
MH  - Humans
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Patient Education as Topic/*methods
MH  - Referral and Consultation/*statistics & numerical data
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Self Care/*methods
OTO - NOTNLM
OT  - Diabetes self-management education programs
OT  - Referrals
OT  - Type 2 diabetes
EDAT- 2016/09/01 06:00
MHDA- 2017/10/31 06:00
CRDT- 2016/09/01 06:00
PHST- 2016/07/08 00:00 [received]
PHST- 2016/07/14 00:00 [accepted]
PHST- 2016/09/01 06:00 [pubmed]
PHST- 2017/10/31 06:00 [medline]
PHST- 2016/09/01 06:00 [entrez]
AID - S1551-7411(16)30212-1 [pii]
AID - 10.1016/j.sapharm.2016.07.002 [doi]
PST - ppublish
SO  - Res Social Adm Pharm. 2017 May-Jun;13(3):494-502. doi: 
      10.1016/j.sapharm.2016.07.002. Epub 2016 Jul 27.