Case management is a fairly new concept for improving the care of
patients with a variety of chronic diseases including diabetes. Case
management is performed usually by one or more people (case managers)
who are not doctors or nurses but are part of a health care team. The
case manager enters all the patient information into a data base and
"mines" the data base to find out which patients need more education,
help with getting to the doctor's appointment, etc. They can get
patients into the office that have not been in for a long time,
provide education. The can remind providers that they have failed to
get testing needed on a particular patient.
I am involved in a study of diabetes patients in poor neighborhoods in
Westchester County where a case manager was used with what looks like
good results. I need to see what the larger experience in the United
States has been with case management to see where my results fit. I am
looking for articles published in traditional medical literature
(PubMed or Library of Congress search engines) that answer the
following questions:
1. Does case management work for diabetes patients?
2. What measures of good diabetes care have others used to decide if
case management works or does not work.
3. Does case management work for patients in poor communities without insurance?
I am interested in negative and positive studies i.e. in studies that
show case management does work as well as those that show case
management does not. |
Request for Question Clarification by
pafalafa-ga
on
02 Jan 2005 05:41 PST
Hello.
There are plenty of articles discussing the case
management/collaborative approach to diabetes care. However, none of
them specifically mention the data mining approach that you emphasized
in your question.
Is the data mining key to your information needs? Or are you looking
for a more general review of the literature? For instance, here's an
article that seemed relevant to me, except for the absence of anything
on data mining:
=====
Arch Gen Psychiatry. 2004 Oct;61(10):1042-9.
The Pathways Study: a randomized trial of collaborative care in patients with
diabetes and depression.
Katon WJ, Von Korff M, Lin EH, Simon G, Ludman E, Russo J, Ciechanowski P,
Walker E, Bush T.
wkaton@u.washington.edu
BACKGROUND: There is a high prevalence of depression in patients with diabetes
mellitus. Depression has been shown to be associated with poor self-management
(adherence to diet, exercise, checking blood glucose levels) and high
hemoglobin A1c (HbA1c) levels in patients with diabetes...
CONCLUSION: The Pathways collaborative care model improved depression
care and outcomes in patients with comorbid major depression and/or
dysthymia and diabetes mellitus...
=====
Let me know what you think.
pafalafa-ga
|
Clarification of Question by
worker254-ga
on
03 Jan 2005 03:24 PST
the data mining is not important to the question; it was only to give
the responder a working definition of case management. My interest is
in well structured studies (as determined by study design or quality
of the journal in which they are published) that either show
statistically significant improvement or show no improvement in the
care of diabetic patients (null hypothesis). Different studies use
different measures to track the care: hgbaic, depression scales,
percentage of people with annual eye examinations, etc. Hope this
helps. I need a list of article and then I can look over the ones i
think are relevant.
|
Clarification of Question by
worker254-ga
on
03 Jan 2005 03:28 PST
Additional clarification: I need articles which are available over the
web or at least have a detailed summery on the web.
|
Request for Question Clarification by
pafalafa-ga
on
03 Jan 2005 07:04 PST
Thanks for the additional feedback. One more question...
Is the article that I posted above [The Pathways Study: a randomized
trial of collaborative care in patients with diabetes and depression]
look like the type of article you're interested in?
If not, let me know a bit more about why this one doesn't work for you.
Thanks.
pafalafa-ga
P.S. I can answer your question by providing you a large list of
articles and abstracts on the topic of case management for diabetes
patients. Would that list meet your needs, or would you rather I
culled it to provide only the most relevant articles?
|
Clarification of Question by
worker254-ga
on
04 Jan 2005 11:46 PST
Additional clarification: article on depression is okay but it is
looking at a subset of diabetics (those with depression) and case
management. I am looking for outcomes for the general diabetic
population (as described in my other comment) affected by case
management.
|
Clarification of Question by
worker254-ga
on
08 Jan 2005 14:22 PST
pafalafa-ga
Have not heard anything. Are you going to work on this project. If so,
when do you think you will have it done? If not, please let me know as
well as why.
Thanks
|
Request for Question Clarification by
pafalafa-ga
on
08 Jan 2005 16:57 PST
I wasn't quite sure what to do with your question.
A simple search at PubMed on the terms [ "case management" diabetes ]
turns up well over 100 article. You can try the search yourself
(include the quote marks) at:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi
Beyond that, I didn't know how to cull this list (or even if you
wanted it to be culled) to best meet your needs.
What do you think is the best approach....? Let me know.
pafalafa-ga
|
