Impact of Advanced Diabetes Centers on the healthcare experience of patients with type 2 diabetes using the IEXPAC tool.

AIMS: To determine the experience with healthcare among patients with type 2 diabetes according to the assistance model provided in their primary care centers, and to determine factors related with their experience. METHODS: This was a cross-sectional study performed in patients with type 2 diabetes with cardiovascular or renal complications. The patients were divided in two groups according to whether they had been attended in Advanced Diabetes centers (ADC) or the traditional assistance centers. Patient's healthcare experience was assessed with the "Instrument for Evaluation of the Experience of Chronic Patients" (IEXPAC) questionnaire, with possible scores ranging from 0 (worst experience) to 10 (best experience). RESULTS: A total of 451 patients (215 from ADC and 236 from traditional assistance centers) were included. The mean overall IEXPAC scores were 5.9 ±â€¯1.7 (ADC) and 6.0 ±â€¯1.9 (traditional assistance centers; p = 0.82). In the multivariant analyses, in ADC, the regular follow-up by the same physician (p = 0.01) and follow-up by a nurse (p = 0.01), were associated with a better patient experience, whereas receiving a higher number of medications with a worse patient experience (p = 0.04). In the traditional assistance centers, only the regular follow-up by the same physician was associated with a better experience (p = 0.02). Patients from ADC centers reported a higher score in the quality of life scale (69.1 ±â€¯16.5 vs 64.6 ±â€¯17.5; p = 0.008). CONCLUSIONS: In general, the healthcare experience of type 2 diabetic patients with their sanitary assistance can be improved. Patients from ADC centers report a higher score in the quality of life scale.

Healthcare experience among patients with type 2 diabetes: A cross-sectional survey using the IEXPAC tool.

Aim: To assess the experience with health care among patients with type 2 diabetes (T2DM) and to evaluate patients' demographic variables and healthcare-related characteristics which may affect their experience. Methods: A cross-sectional survey was delivered to T2DM adults. Patient experiences were assessed with the 'Instrument for Evaluation of the Experience of Chronic Patients' (IEXPAC) questionnaire, a validated 12-item survey, which describes patient experience within the last 6 months (items 1-11) and hospitalization in the last 3 years (item 12), with possible scores ranging from 0 (worst) to 10 (best experience). Results: A total of 451 T2DM patients responded to the survey (response rate 72.3%; mean age 69.5 ± 10.1 years, 67.8% men). The mean overall IEXPAC score was 5.92 ± 1.80. Mean scores were higher for productive interactions (7.92 ± 2.15) and self-management (7.08 ± 2.27) than for new relational model (1.72 ± 2.01). Only 32.8% of patients who had been hospitalized in the past 3 years reported having received a follow-up call or visit after discharge. Multivariate analyses identified that regular follow-up by the same physician and follow-up by a nurse were associated with a better patient experience. Continuity of healthcare score was higher only in those patients requiring help from others. Conclusions: The areas of T2DM care which may need to be addressed to ensure better patient experience are use of the Internet, new technologies and social resources for patient information and interaction with healthcare professionals, closer follow-up after hospitalization, and a comprehensive multidisciplinary approach with regular follow-up by the same physician and a nurse.

Impact of diabetes mellitus on the risk of severe exacerbation in patients with chronic obstructive pulmonary disease.

INTRODUCTION: Suffering type 2 diabetes mellitus (T2DM) appears to promote the occurrence of respiratory infections. However, studies to evaluate the risk of hospital admission due to exacerbations in patients with chronic obstructive pulmonary disease (COPD) and concomitant T2DM are scarce. MATERIALS AND METHODS: Prospective, observational study with a maximum follow-up of 18 months. Information on lung function, body mass index, degree of dyspnea, number of exacerbations, comorbidities and pneumococcal vaccination was obtained. Patients were classified into the categories COPD with (COPD/+T2DM) and without T2DM (COPD/-T2DM). RESULTS: A total of 121 patients with COPD were enrolled. Forty-seven (38%) of the study participants were diabetic. The presence of T2DM increased the risk of hospital admission due to COPD exacerbation (OR 2.66; P = 0.031), but no significant difference in the total number of exacerbations was detected. CONCLUSIONS: The risk of hospital admission in the course of exacerbation seems to be higher in COPD/+T2DM patients than in COPD/-T2DM subjects.