ORCID Profile
0000-0002-7393-4555
Current Organisations
King's College London
,
KSW Kantonsspital Winterthur
,
Health Department
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Publisher: Elsevier BV
Date: 09-2017
DOI: 10.1016/J.IENJ.2017.02.006
Abstract: For people with diabetes, severe hypoglycaemia is the most common reason for emergency service usage and emergency department (ED) presentations. Brief interventions (BI) are a recognised intervention strategy in the ED for other conditions but to date, they have not been applied to those with hypoglycemia. This review aims to identify components and outcomes of BI for people with diabetes mellitus to inform the development of BI in the ED. A systematic review of randomized controlled trials was undertaken in MEDLINE, CINAHL, PsychINFO and EMBASE. Studies that examined brief interventions for people with diabetes were considered. Eligible studies were critically appraised and included in a narrative synthesis. A total of 2475 citations were identified, 171 full papers were reviewed and four articles were included for review. The components 'advice' and 'assistance' from the five A Framework were the most frequently used BI components. Statistically significant improvements were achieved in psychological, functional, and satisfaction outcomes. However, clinical outcomes were not improved and economic outcomes like costs of BI were not evaluated. The literature review demonstrated a lack of evidence related to BI in diabetes within the emergency setting despite the ED being an ideal environment. Future research needs to be conducted to investigate the effectiveness of BI for patients with diabetes.
Publisher: Elsevier BV
Date: 03-2019
DOI: 10.1016/J.IENJ.2018.10.005
Abstract: Severe hypoglycaemic events (SHE) commonly require emergency care. This study investigates the presentation of patients with SHE to a single Swiss emergency service, including pre-hospital care with emergency medical services (EMS) and emergency department (ED) presentations. Retrospective analysis of routinely collected data by the EMS and ED during 2014. All adult patients with diabetes type 1 or type 2 with SHE were included in the analysis. 43 SHE were recorded in 38 patients with diabetes. Mean age of all patients was 65 years (SD ± 17.51), 54% (n = 23) were men, 55.8% (n = 24) were living in a relationship, and 54.8% (n = 23) were diagnosed with type 2 diabetes. Of the 43 episodes, 65% (n = 28) of the presentations used EMS and were then taken to the ED, 28% (n = 12) involved contact with the EMS only, and 7% (n = 3) were seen by the ED but did not use EMS. Patients seen by the EMS only (n = 12) were younger compared to those admitted to ED (n = 28) Md 54 years vs Md 72 years U = 98 p = .039. The same age difference was similar between patients in the ED setting discharged home (n = 11) and with in-patients (n = 20) Md 61 years vs. Md 79 years U = 51 p = .013. People most likely to suffer a SHE were men, those living with a partner, over 65 years old, and living with type 2 diabetes. Younger patients treated by EMS at home tended to remain at home, in contrast to the older patients who were admitted to hospital. This was also true for the ED where older people in particular became in-patients after such an event. Elderly care specialist brief interventions conveyed by EMS and ED healthcare professionals might be of value to prevent further SHE. Validating these findings in multiple emergency settings is warranted to support the delivery of targeted interventions.
Location: United Kingdom of Great Britain and Northern Ireland
Location: Switzerland
Location: Switzerland
Location: Switzerland
Location: Switzerland
No related grants have been discovered for Anita Keller-Senn.