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- Annersten Gershater, Magdalena, et al.
(författare)
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Treatment satisfaction with insulin glargine in patients with diabetes mellitus in a university hospital clinic in Sweden
- 2009
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Ingår i: European Diabetes Nursing. - : Wiley-Blackwell. - 1551-7853 .- 1551-7861. ; 6:1, s. 17-22
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Tidskriftsartikel (refereegranskat)abstract
- Background: Few studies evaluate patients' perspectives when a new drug is introduced to treat chronic diseases such as diabetes mellitus. The clinical role of a new insulin treatment, in terms of the relationship between higher cost and better treatment outcomes (as defined from the patient perspective) has been discussed. We sought to explore patient satisfaction with a new insulin treatment (insulin glargine). At its launch in 2002/3 it was purported to provide constant, peakless insulin release following once- or twice-daily administration, thus leading to fewer hypoglycaemic episodes while providing metabolic control equivalent to that achieved with NPH human basal insulin. Aims: To investigate the indications used for prescription of a new drug and its clinical effects on glycosylated haemoglobin (HbA1c) levels, perceived hypoglycaemic events and patient satisfaction. Methods: The Diabetes Treatment Satisfaction Questionnaire (Status Version, DTSQ-s), which measures satisfaction with treatment regimen, and perceived frequency of hyperglycaemia and hypoglycemia, was circulated to all living patients who had ever started treatment with insulin glargine at the Department of Endocrinology at Malmö University Hospital. Medical records of 913 patients were assessed for HbA1c levels at 0 and 12 months after starting insulin glargine therapy. Results: Completed questionnaires were returned by 615 of 960 patients (64%) who had ever started insulin glargine. The main indications for starting treatment were physicians' or nurses' initiatives, desire for fewer fluctuations and improved metabolic control. HbA1c levels fell by 0.41% for patients with type 1 diabetes and by 0.68% for those with type 2 diabetes. The mean DTSQ-s score was 28.45 for satisfaction, whereas the mean perceived hypoglycaemic/hyperglycaemic events score was 3. Conclusion: Treatment satisfaction was very high and perceived frequency of hypoglycaemia/hyperglycaemia was very low. The indications for treatment of insulin glargine are being followed in accordance with national recommendations..
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| 2. |
- Annersten, Magdalena, et al.
(författare)
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Structured diabetes education in Sweden : a national inquiry involving 583 nurses working with diabetes patients in hospitals and primary care facilities.
- 2006
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Ingår i: Practical Diabetes International. - : John Wiley & Sons. - 1357-8170 .- 1528-252X. ; 23:3, s. 138-141
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Tidskriftsartikel (refereegranskat)abstract
- The overall goals for the treatment of diabetes are to prevent acute and long-term complications and maintain a good quality of life. The St Vincent Declaration and the Swedish National Guidelines for the Treatment of Diabetes Mellitus describe patient education in self-treatment as a prerequisite for the achievement of these goals. This survey aimed to evaluate the presence of structured patient education (in advance planned education), its organisation, staffing and goals, and the results in out-patient diabetes care in Sweden.A questionnaire consisting of 35 open and closed questions was mailed to 1250 diabetes educated nurses working in hospitals and primary health care in the entire country.Responses were received from 583 (47%) nurses. Structured diabetes patient education was performed by 486 nurses. It was usually organised by nurses and performed in co-operation with doctors (55%), dietitians (38%), chiropodists (36%), and social workers (9%). The sessions took place individually at pre-scheduled visits (80%), or as group education (26%). Fifty-one percent described explicit goals for the education, most commonly: general knowledge about diabetes, improved metabolic control and increased safety. The structured education was evaluated by 51% of which the HbA[1]c level at the next scheduled visit was the most frequently used evaluation method (44%), followed by home monitored blood glucose values (37%) and a structured evaluation form (17%). The goals had been achieved to a great or quite great extent by 67% of the responding nurses.To the extent that structured patient education takes place, nurses are usually responsible for its performance. It takes place individually as well as in groups. Many nurses lack evident goals for the education and sufficient evaluation methods.It was concluded that there is confusion about the content of structured education vs information activity.
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| 3. |
- Hjelm, Katarina, et al.
(författare)
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Beliefs about health and illness in women managed for gestational diabetes in two organisations.
- 2008
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Ingår i: Midwifery. - : Elsevier. - 0266-6138 .- 1532-3099. ; 24:2, s. 168-192
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to explore beliefs about health, illness and health care in women with gestational diabetes mellitus (GDM) managed in two different organisations based on diabetology or obstetrics.Semi-structured interviews were made in two different clinics. clinic A: a specialist diabetes clinic with regular contact with a diabetologist and antenatal care provided by a midwifeclinic B: a specialist maternity clinic providing regular contact with a midwife, a structured programme for self-monitoring of blood glucose and insulin treatment, and a 1-day diabetes class by an obstetrician, a diabetologist, a midwife and a dietician. The clinics were located at two different university hospitals in Sweden.Participants were a consecutive sample of Swedish women diagnosed with GDM; 13 managed in clinic A and 10 managed in clinic B.The findings showed that women described their perceptions of as well-being, being healthy and freedom from disease. All respondents reported a delay in the provision of information about GMD and an information gap about GDM and the management of the condition, from diagnosis until the start of treatment at the specialist clinic. Respondents from clinic A expressed fear about future development of type 2 diabetes. Women from clinic B discussed different causes of GDM, and many claimed that health-care staff informed them that GDM was a transient condition during pregnancy. Respondents from clinic A reported a conflict in their treatment of pregnancy and GDM as two different conditions.Beliefs differed and were related to the health-care model chosen.
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