title: Evaluation of an inpatient psychiatric hospital physician education program and adherence to American Diabetes Association practice recommendations.
abstract: OBJECTIVE
  This study evaluated adherence to American Diabetes Association (ADA) recommendations for diabetes monitoring following an educational intervention for physicians in an inpatient psychiatric hospital.
  
  
  METHODS
  This retrospective chart review was conducted in an inpatient psychiatric institution from July 1, 2010-January 15, 2011. A total of 120 subjects (60 subjects each in the pre- and post-intervention groups) meeting the inclusion criteria served as the study sample. Included subjects were admitted and discharged from an inpatient psychiatric institution within 90 days prior to (pre-intervention) and following (post-intervention) the physician education program. The medical staff was presented an educational program intervention, consisting of a 30 minute overview of the ADA 2010 Standards of Care recommendations and distribution of laminated treatment reminders. Electronic grouped order sets for patients with diabetes were also created and implemented.
  
  
  RESULTS
  The primary outcome was change (pre-intervention to post-intervention) in frequency of hemoglobin A1c documentation on admission following the intervention. Secondary outcomes included the change in frequency of documentation of fasting plasma glucose, serum creatinine, urine creatinine/microalbumin ratio (UMA), fasting lipid profile (FLP), and change in days on sliding scale insulin. Regarding change in frequency of documentation of A1c values on admission, chi-square analysis revealed a significant increase from pre-intervention to post-intervention period of 30% (n = 18) to 61.7% (n = 37), respectively (p = 0.0005). Documentation of FLP also significantly increased [73.3% vs. 91.7% (p = 0.0082)]. There were no significant differences in the documentation of fasting plasma glucose, serum creatinine, and UMA or days treated with sliding scale insulin.
  
  
  CONCLUSIONS
  The physician education program was successful in increasing the assessment of A1c values and lipid profiles for patients with diabetes mellitus in a psychiatric institution.
authors.affiliation: Assistant Clinical Professor of Pharmacy Practice, Harrison School of Pharmacy, Auburn University, Auburn, AL Rlk0005@auburn.edu.
authors.forename: Robin L
authors.initials: RL
authors.lastname: Koffarnus
authors.affiliation: Assistant Director of Pharmacy, Austin State Hospital, Austin, TX.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Mican
authors.affiliation: Clinical Associate Professor of Health Outcomes and Pharmacy Practice, The University of Texas at Austin College of Pharmacy, Austin, TX.
authors.forename: Debra A
authors.initials: DA
authors.lastname: Lopez
authors.affiliation: Professor of Health Outcomes and Pharmacy Practice, The University of Texas at Austin College of Pharmacy, Austin, TX.
authors.forename: Jamie C
authors.initials: JC
authors.lastname: Barner
mesh_terms: D000328:Adult; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D004502:Education, Medical, Continuing / Q000379:methods / Q000592:standards*; D005260:Female; D006778:Hospitals, Psychiatric / Q000592:standards*; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000592:standards*; D017410:Practice Guidelines as Topic / Q000592:standards*; D012189:Retrospective Studies; D012955:Societies, Medical / Q000592:standards*; D014481:United States / Q000453:epidemiology