03 January 2011

Is There a Need for Team Treatments?

Yes, research is proving the need for people specially trained to work with people with diabetes. In this case it is nurses. Anyone that has special training to work with people with diabetes and in this case depression and heart disease can have an effect on the health of these individuals. Nurses without special training often cause more problems than aiding people with diabetes.

In the study being published in the New England Journal of Medicine, these nurses worked closely with the patients to coordinate their health care needs. They were trained to pay special attention to optimizing treatment of depression, blood pressure, blood glucose, and cholesterol.

As they say, the proof is in the outcome. In this they showed that after one year, the patients who worked with the nurse coaches had less depression and managed their diabetes and heart disease risk factors better than patients who got standard care.

One participant in the study stated that “the biggest difference was that I have one person who knows everything that is going on with me.”

As those of us with Type 2 diabetes already know, depression can be part of our lives. However, its total impact is not as well known or understood. In general, those of us with diabetes can experience more of the complications. Having a nurse case manager whose role is to integrate depression and diabetes treatment can have a more positive outcome.

In the study, the nurse coaches adjusted medications as needed and worked with the patients to set and achieve attainable health goals. This positive influence with more frequent adjustments to insulin dosages, medications for depression, blood pressure, and cholesterol had a very positive effect.

The researchers are now conducting a cost-benefit analysis if the intervention and they are saying that the savings to the health care system could be substantial.

I feel that this is a study that needs attention to serve as an incentive for the new rules and regulations coming out of the Affordable Care Act. This along with the Share Medical Appointments (SMAs) that I blogged about here could have some real and not imaginary help in obtaining better health outcomes at a significant reduction in overall costs.

To go along with this, I also think there is room for other groups like peer-to-peer help. I have blogged about this here. Although the results are not as great as this study, it still would be possible to get good results and could possibly have greater results with more training for the peer-to-peer groups. With the peer-to-peer groups, these are all volunteer and therefore the cost effectiveness could even be greater.

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