Background: Good care of the diabetic patient reduces the incidence of long-term complications. Treatment should be interdisciplinary; in the last decade a debate has raged over how to optimize treatment and how to use the various services efficiently.
Objectives: To evaluate the quality of care of diabetic patients in primary care and diabetes clinics in the community in central Israel.
Methods: We conducted a retrospective cross-sectional study of a random sample of 209 diabetic patients in a district of the largest health management organization in Israel. Patients were divided into two groups - those treated only by their family physician and those who had attended diabetes clinics. Data included social demographics, medications, risk factors, quality of follow-up, laboratory tests, quality of diabetes and blood pressure control, and complications of diabetes.
Results: Of the 209 patients 38% were followed by a diabetes clinic and 62% by a family physician. Patients attending the specialist clinic tended to be younger (P= 0.01) and more educated (P= 0.017). The duration of their diabetes was longer (P < 0.01) and they had more diabetic microvascular complications (P= 0.001). The percentage of patients treated with insulin was higher among the diabetes clinic patients (75% vs. 14%, P= 0.0001). More patients with nephropathy received angiotensin-converting enzyme inhibitors in the diabetes clinic (94% vs. 68%, P= 0.02). Follow-up in the specialist clinic as compared to by the family physician was better in the areas of foot examination (P< 0.01), fundus examination (P= 0.0001), and hemoglobin A1c testing (P= 0.01). On a regression model only fundus examination, foot examination and documentation of smoking status were significantly better in the diabetes clinic (P< 0.05).
Conclusion: There is still a large gap between clinical guidelines and clinical practice. Joint treatment of diabetic patients between the family physician and the diabetes specialist may be a proposed model to improve follow-up and diabetes control. This model of treatment should be checked in a prospective study.
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J Urol
January 2025
Department of Population Health, NYU Grossman School of Medicine, New York, New York.
Purpose: We aimed to determine whether implementation of clinical decision support (CDS) tool integrated into the electronic health record (EHR) of a multi-site academic medical center increased the proportion of patients with American Urological Association (AUA) "high risk" microscopic hematuria (MH) who receive guideline concordant evaluations.
Materials And Methods: We conducted a two-arm cluster randomized quality improvement project in which 202 ambulatory sites from a large health system were randomized to either have their physicians receive at time of test results an automated CDS alert for patients with 'high-risk' MH with associated recommendations for imaging and cystoscopy (intervention) or usual care (control). Primary outcome was met if a patient underwent both imaging and cystoscopy within 180 days from MH result.
Rheumatol Int
January 2025
Division of Rheumatology, Department of Medicine, University of Calgary, Cumming School of Medicine, Calgary, AB, Canada.
Little is known about how patients with antiphospholipid syndrome (APS) or antiphospholipid antibodies (aPL) access and trust health information. This research aimed to: describe the sources of information most frequently accessed/trusted by patients with APS/aPL; identify if individuals with APS/aPL perceived their health had been negatively impacted by various sources and document obstacles to accessing health information. Patients meeting Revised Sapporo Criteria for APS or with ≥1 positive aPL on ≥2 occasions were recruited to an online survey regarding their health information use at diagnosis and within 6 months preceding survey completion.
View Article and Find Full Text PDFMed Educ Online
December 2025
School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
Background: Texas is one of the states with the lowest access to usual sources of primary care; most critically, family medicine (FM) has been projected to have the greatest physician shortage increase between 2018 and 2032. Texas Tech University Health Sciences Center (TTUHSC) School of Medicine developed the Family Medicine Accelerated Track (FMAT), a 3-year curriculum that culminates in the MD degree and links medical students to FM residency programs at TTUHSC campuses in Lubbock, Amarillo or the Permian Basin. This article reflects on 10 years of experience with the program, and particularly its impact on the primary care physician workforce in Texas.
View Article and Find Full Text PDFClin Orthop Relat Res
January 2025
Department of Rehabilitation, Radboud University Medical Center, Nijmegen, the Netherlands.
Background: Many patients with a lower limb socket-suspended prothesis experience socket-related problems, such as pain, chronic skin conditions, and mechanical problems, and as a result, health-related quality of life (HRQoL) is often negatively affected. A bone-anchored prosthesis can overcome these problems and improve HRQoL, but these prostheses have potential downsides as well. A valid and reliable tool to assess potential candidates for surgery concerning a favorable risk-benefit ratio between potential complications related to bone-anchored prostheses and improvements in HRQoL is not available yet.
View Article and Find Full Text PDFClin Nucl Med
January 2025
From the Molecular Imaging and Therapy, Hoag Family Cancer Institute, Irvine, CA.
A 64-year-old man with newly diagnosed prostate cancer underwent 18F-Piflufolastat PET/CT. Radiotracer avidity localized to the primary prostate malignancy and to a left rib (SUVmax, 9.0).
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!