Physician Assistants as Chronic Care Coordinators - An Interdisciplinary Patient Centered Approach to Managing Diabetes
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Published:
May 11, 2016
Keywords:
Primary Care, Chronic Illness, Physician Assistants, Diabetes Education
Main Article Content
Abstract
With an aging population and an increasing number of people living with chronic disease, Canada’s primary care system is in need of change. Healthcare must better incorporate prevention and patient education in the battle against chronic disease. This article explores
the growing role of Physician Assistants (PAs) in enhancing access to appropriate care for the chronically ill, using an example of a PA working as part of a family physician practice in Northern Ontario to improve the care of its diabetic patients.
Avec une population vieillissante et un nombre croissant de personnes vivant avec une maladie chronique, le système de soins primaires canadien est en besoin de changement. Les soins de santé doivent mieux intégrer la prévention et l’éducation des patients dans la lutte contre les maladies chroniques. Cet article explore le rôle croissant des adjoints au médecin (AM) dans l’amélioration de l’accès aux soins appropriés pour les patients vivants avec des malades chroniques. Ceci sera illustré par le biais d’un exemple d’un AM travaillant dans une pratique de médecine familiale au Nord de l’Ontario pour améliorer les soins de ses patients diabétiques.
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References
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3. Doan Q, Hooker RS, Wong H, et al. Canadian’s willingness to receive care from physician assistants. Can Fam Physician. 2012;58(8):e459–e464.
4. Hooker RS, Everett CM. The contributions of physician assistants in primary care systems. Health Soc Care Community. 2012;20(1):20–31.
5. Doan Q, Sabhaney V, Kissoon N, Sheps S, Singer J. A systematic review: the role and impact of the physician assistant in emergency department. Emerg Med Australas. 2011;23(1):7–15.
6. Wagner EH, Austin BT, Davis C, Hindmarsh M, Schaefer J, Bonomi A. Improv¬ing chronic illness care: translating evidence into action. Health Affairs. 20, no.6 (2001):64–78.
7. Everett CM, Thorpe CT, Palta M, Carayon P, Gilchrist VJ, Smith MA. Divi¬sion of primary care services between physicians, physician assistants, and nurse practitioners for older patients with diabetes. Med Care Res Rev. 2013;70(5):531–541.
8. Manns BJ, Tonelli M, Zhang J, et al. Enrolment in primary care networks: im¬pact on outcomes and processes of care for patients with diabetes. CMAJ. 2012;184(2)E144–E151.
9. McBrien KA, Manns BJ, Chui B, et al. Health care costs in people with diabe¬tes and their association with glycemic control and kidney function. Diabe¬tes Care. 2013;36(5):1172–1180.
10. Reid RJ, Wagner EH. Strengthening primary care with better transfer of in¬formation. CMAJ. 2008;179(10):987–988.
11. Ministry of Health and Long Term Care, Ontario, Canada. Inter-Professional Health Provider Funding Application For Primary Health Care Patient Enrol¬ment Model Groups. Queen’s Printer for Ontario; 2009-2010 [updated 2013 Aug 19; cited 2015 Mar 10]. Available from: http://www.health.gov.on.ca/ en/pro/programs/ihp/.
12. Improving Chronic Illness Care. The Chronic Care Model. “Copyright 1996- 2015 The MacColl Center. The Improving Chronic Illness Care program is supported by The Robert Wood Johnson Foundation, with direction and technical assistance provided by Group Health’s MacColl Center for Health Care Innovation”. [cited 2015 Mar 10]. Available from: http://www.improv¬ingchroniccare.org.
13. Canadian Diabetes Association. Living with Type 2 Diabetes. 2015. [cited 2015 Mar 10]. Available from: http://www.diabetes.ca/diabetes-and-you/ living-with-type-2-diabetes.
14. Merakou K, Knithaki A, Karageorgos G, Theodoridis D, Barbouni A. Group patient education: effectiveness of a brief intervention in people with type 2 diabetes mellitus in primary health care in Greece: a clinically controlled trial. Health Educ Res 2015 Feb 26. pii: cyv001. [Epub ahead of print].
15. Molsted S, Tribler J, Poulsen PB, Snorgaard O. The effects and costs of a group-based education programme for self-management of patients with type 2 diabetes. A community-based study. Health Educ Res 2012;27(5):804–813.
16. Gold DT and McClung B. Approaches to patient education: emphasizing the long-term value of compliance and persistence. Am J Med. 2006;119(4 Suppl 1):S32–S37.
17. Dijkstra RF, Braspenning JC, Huijsmans Z, et al. Introduction of diabetes passports involving both patients and professionals to improve hospital outpatient diabetes care. Diabetes Res Clin Pract. 2005;68(2):126–134.
18. Dijkstra R, Braspenning J, Grol R. Implementing diabetes passports to focus practice reorganization on improving diabetes care. Int J Qual Health Care. 2008;20(1):72–77.
2. Health Force Ontario. Ontario’s Physician Assistant Initiative. Queen’s Print¬er For Ontario, 2015. [Last Modified: March 10, 2015]. [Cited April 4, 2015]. Available from: http://www.healthforceontario.ca/en/M4/Ontario%27s_ Physician_Assistant_Initiative.
3. Doan Q, Hooker RS, Wong H, et al. Canadian’s willingness to receive care from physician assistants. Can Fam Physician. 2012;58(8):e459–e464.
4. Hooker RS, Everett CM. The contributions of physician assistants in primary care systems. Health Soc Care Community. 2012;20(1):20–31.
5. Doan Q, Sabhaney V, Kissoon N, Sheps S, Singer J. A systematic review: the role and impact of the physician assistant in emergency department. Emerg Med Australas. 2011;23(1):7–15.
6. Wagner EH, Austin BT, Davis C, Hindmarsh M, Schaefer J, Bonomi A. Improv¬ing chronic illness care: translating evidence into action. Health Affairs. 20, no.6 (2001):64–78.
7. Everett CM, Thorpe CT, Palta M, Carayon P, Gilchrist VJ, Smith MA. Divi¬sion of primary care services between physicians, physician assistants, and nurse practitioners for older patients with diabetes. Med Care Res Rev. 2013;70(5):531–541.
8. Manns BJ, Tonelli M, Zhang J, et al. Enrolment in primary care networks: im¬pact on outcomes and processes of care for patients with diabetes. CMAJ. 2012;184(2)E144–E151.
9. McBrien KA, Manns BJ, Chui B, et al. Health care costs in people with diabe¬tes and their association with glycemic control and kidney function. Diabe¬tes Care. 2013;36(5):1172–1180.
10. Reid RJ, Wagner EH. Strengthening primary care with better transfer of in¬formation. CMAJ. 2008;179(10):987–988.
11. Ministry of Health and Long Term Care, Ontario, Canada. Inter-Professional Health Provider Funding Application For Primary Health Care Patient Enrol¬ment Model Groups. Queen’s Printer for Ontario; 2009-2010 [updated 2013 Aug 19; cited 2015 Mar 10]. Available from: http://www.health.gov.on.ca/ en/pro/programs/ihp/.
12. Improving Chronic Illness Care. The Chronic Care Model. “Copyright 1996- 2015 The MacColl Center. The Improving Chronic Illness Care program is supported by The Robert Wood Johnson Foundation, with direction and technical assistance provided by Group Health’s MacColl Center for Health Care Innovation”. [cited 2015 Mar 10]. Available from: http://www.improv¬ingchroniccare.org.
13. Canadian Diabetes Association. Living with Type 2 Diabetes. 2015. [cited 2015 Mar 10]. Available from: http://www.diabetes.ca/diabetes-and-you/ living-with-type-2-diabetes.
14. Merakou K, Knithaki A, Karageorgos G, Theodoridis D, Barbouni A. Group patient education: effectiveness of a brief intervention in people with type 2 diabetes mellitus in primary health care in Greece: a clinically controlled trial. Health Educ Res 2015 Feb 26. pii: cyv001. [Epub ahead of print].
15. Molsted S, Tribler J, Poulsen PB, Snorgaard O. The effects and costs of a group-based education programme for self-management of patients with type 2 diabetes. A community-based study. Health Educ Res 2012;27(5):804–813.
16. Gold DT and McClung B. Approaches to patient education: emphasizing the long-term value of compliance and persistence. Am J Med. 2006;119(4 Suppl 1):S32–S37.
17. Dijkstra RF, Braspenning JC, Huijsmans Z, et al. Introduction of diabetes passports involving both patients and professionals to improve hospital outpatient diabetes care. Diabetes Res Clin Pract. 2005;68(2):126–134.
18. Dijkstra R, Braspenning J, Grol R. Implementing diabetes passports to focus practice reorganization on improving diabetes care. Int J Qual Health Care. 2008;20(1):72–77.