Time requirements for diabetes self-management: Too much for many?

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    • Abstract:
      Background: In 'Crossing the Quality Chasm,' the Institute of Medicine laid out principles to improve quality of care and identified chronic diseases as a staring point. One of those principles was the wise use of patient time, but current recommendations for chronic conditions do not consider time spent on self-care or its impact on patients' lives. Objective: To estimate the time required for recommended diabetes self-care. Methods: A convenience sample of 8 certified diabetes educators derived consensus-based estimates of the time required for all self-care tasks recommended by the American Diabetes Association. Results: For experienced patients with type 2 diabetes controlled by oral agents, recommended self-care would require more than 2 extra hours daily. Elderly patients and those with newly diagnosed disease, or those with physical limitations, would need more time. Exercise and diet, required for self-care of many chronic conditions, are the most time-consuming task. Conclusion: The time required by recommended self-care is substantial. 'Crossing the Quality Chasm' suggests how clinicians and guideline developers can help patients make the best use of their self-care time: elicit the patient's perspective; develop evidence on the health consequences of self-care tasks; and respect patients' time. [ABSTRACT FROM AUTHOR]
    • Abstract:
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