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Cytological Techniques↗
Biomedical subjects
Jean Taylor
Publications and source records attributed to Jean Taylor.
Pro-active call center treatment support (PACCTS) to improve glucose control in type 2 diabetes: a randomized controlled trial.
OBJECTIVE: To determine whether Pro-Active Call Center Treatment Support (PACCTS), using trained nonmedical telephonists supported by specially designed software and a diabetes nurse, can effectively improve glycemic control in type 2 diabetes. RESEARCH DESIGN AND METHODS: A randomized controlled implementation trial of 1-year duration was conducted in Salford, U.K. The trial comprised 591 randomly selected individuals with type 2 diabetes. By random allocation, 197 individuals were assigned to the usual care (control) group and 394 to the PACCTS (intervention) group. Lifestyle advice and drug treatment in both groups followed local guidelines. PACCTS patients were telephoned according to a protocol with the frequency of calls proportional to the last HbA(1c) level. The primary outcome was absolute reduction in HbA(1c), and the secondary outcome was the proportion of patients reducing HbA(1c) by at least 1%. RESULTS: A total of 332 patients (84%) in the PACCTS group and 176 patients (89%) in the control group completed the study. Final HbA(1c) values were available in 374 patients (95%) in the PACCTS group and 180 patients (92%) in the usual care group. Compared with usual care, HbA(1c) improved by 0.31% (95% CI 0.11-0.52, P = 0.003) overall in the PACCTS patients. For patients with baseline HbA(1c) >7%, the improvement increased to 0.49% (0.21-0.77, P < 0.001), whereas in patients with baseline HbA(1c) <7% there was no change. The difference in the proportions of patients achieving a >/=1% reduction in HbA(1c) significantly favored the PACCTS intervention: 10% (4-16, P < 0.001) overall and 15% (7-24, P < 0.001) for patients with baseline HbA(1c) >7%. CONCLUSIONS: In an urban Caucasian trial population with blood glucose HbA(1c) >7%, PACCTS facilitated significant improvement in glycemic control. Further research should extend the validity of findings to rural communities and other ethnic groups, as well as to smoking and lipid and blood pressure control.
Adult↗
Acceptability and satisfaction with a telecarer approach to the management of type 2 diabetes.
OBJECTIVE: To examine patients' views of the acceptability of and satisfaction with telephone care center support provided to improve blood glucose control in type 2 diabetes. RESEARCH DESIGN AND METHODS: The Pro-Active Call-Center Treatment Support (PACCTS) Trial randomized patients from 47 general practices in a deprived urban area in northwest England to usual care or to proactive call center support in addition to usual care. Satisfaction with care was assessed in all 591 patients at baseline and the end of the study using the Diabetes Satisfaction and Treatment Questionnaire (DTSQ). Acceptability was assessed in 394 intervention patients after at least three proactive calls from the call center and at the end of the trial. A purposive sample of 25 patients took part in in-depth semistructured interviews. RESULTS: The response rates to the questionnaires were 79% (DTSQ) and 65% (acceptability). Persons receiving the intervention continued to report high levels of satisfaction with their treatment (95% CI 32.3-33.2 at 1 year), and >90% strongly agreed or agreed that the telecarer approach was acceptable. Qualitative comments pointed to the importance of a personalized service; increased feelings of well-being, including confidence and self-control; help with problem-solving; and patients developing rapport and a strong bond with the telecarers. CONCLUSIONS: A personalized PACCTS approach is acceptable to patients. A service giving priority to the interpersonal dimension leads to increased commitment from patients to improve long-term glycemic control.
Aged↗
Learning from the experience of working with consumers in educational developments.
AIM: The aim of this paper is to report the experience of working with local parents as collaborators in an educationally focussed research study. This work subsequently led to the development of a new module aimed at professionals providing parenting support. The ensuing discussion centres on the involvement of healthcare consumers in the development of educational programmes. METHODS: Focus group interviews were held with local parents to identify their various experiences of parenting support services. In addition the interviews were used as a means of recruiting local parent volunteers willing to join the research advisory group. This group had the task of guiding both the research and development of the educational programme. FINDINGS: Involvement of the parents introduced fresh insights to both the understanding of the content of parent education module and the necessary ingredients needed for effective consumer involvement. CONCLUSION: Lecturers have gained first hand experience of working collaboratively with parents in carrying out a research study and curriculum development. Three key issues emerged from this experience. These included the identification of who the consumer is, the approaches and skills required by professionals and lastly the importance of resources to support this commitment.
Attitude of Health Personnel↗
Development of a screening tool to assess risk of tardive dyskinesia.
This article gives an overview of antipsychotic medication and of tardive dyskinesia (TD). It examines the research available on TD as it relates to people with a learning disability (PWLD). The evidence identifies that specific groups of people are at an increased risk of developing TD. It also shows that 45-50% of PWLD who are treated with antipsychotic medication will be affected by TD. The evidence is used in the formulation of an assessment tool designed for use by the community learning disability nurse to identify an individual's risk of developing TD before commencing medication. Litigation in the USA has led to a $6.7 m award for sound, clinically effective practice and evidence-based interventions requires that practitioners are accountable for their practice, but are also seen to transform existing services in a way which improves the delivery of quality interventions and care.
Adult↗