Diabetes Complications, Diabetic Retinopathy
Conditions
Brief summary
The overarching purpose of this project is to provide diabetes education to the diverse patient population at the Lions Eye Clinic, a resident-run ophthalmology practice at California Pacific Medical Center. Because of high clinic volume in a teaching environment, our patients often experience long wait times. The goal of this program is to utilize this wait time for diabetes education, a much-needed corollary to the eye care that patients receive at our clinic. This pilot project will investigate the impact of a program like this in our patient population. Specifically, the investigators are investigating whether diabetes education delivered in an ophthalmology setting enhances patient understanding of diabetes (via knowledge surveys) and/or leads to improved blood glucose control (via hemoglobin A1c). This is a 6-month study that runs through April 2015, and looks at the impact of an interactive diabetes education iPad app +/- in-person sessions with a diabetes educator. A subset of patients who meet with a diabetes educator will also be shown their own retinal images (compared to a normal retina).
Interventions
BEHAVIORALiPad app
Provided by the Patient Education Institute, the X-plain iPad app includes modules on healthy eating for diabetics, eye complications, foot care, and others.
BEHAVIORALEducator sessions
A certified diabetes educator and/or registered dietitian will meet with patients for 30-60 minutes prior to their ophthalmology visits, when scheduling permits.
BEHAVIORALRetinal photos
A resident ophthalmologist will spend approximately 5 minutes showing patient their own retinal photos, compared to a normal retina, and explaining the pathology present (if applicable).
Sponsors
Pacific Vision Foundation
California Pacific Medical Center Research Institute
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Type 1 or Type 2 diabetes (as defined by evident systemic findings OR recent hemoglobin A1c OR patient report, as specific blood sugar data and knowledge of particular medications are often limited in this population) * Age 18-75 * Able and willing to provide informed consent * Speak English, Spanish, or any other language for which a translator is present
Exclusion criteria
* Advanced visual acuity loss in both eyes which prevents adequate use of educational tools * Pregnant women, elderly patients (\>75 years old), children and adolescents (17 or younger) * Non-English/Spanish speakers for whom a translator is not present
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change from Baseline in Patient Knowledge about Diabetes at 3 months (via multiple-choice surveys) | Participants will be re-surveyed at their next follow-up eye appointment, an expected average of 3 months post-intervention | Objective assessment of patient knowledge about diabetes using 13 multiple-choice questions |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change from Baseline Hemoglobin A1c at 3 months | Participants will have repeat lab drawn at their next follow-up eye appointment, an expected average of 3 months post-intervention | Provides estimate of patient's average blood sugar over past three months |
| Patient Satisfaction / Motivation / Subjective Improvement in Knowledge (brief surveys) | 1 day | Brief 3-4 question surveys to assess patient satisfaction with services offered, motivation to manage their disease process, and subjective improvement in knowledge after using educational services |
| Change from Baseline in Patient Knowledge about Diabetes Immediately after using Educational Services (via multiple-choice surveys) | 1 day | Objective assessment of patient knowledge about diabetes using 13 multiple-choice questions |
Outcome results
None listed