Co-design, implementation, and evaluation of a nested diabetes model of care for adults with cystic fibrosis: a mixed methods pre-post implementation study.
Background: Cystic fibrosis (CF) is a genetic disease with increasing life expectancy due to advances in treatment. However, this increased life expectancy has led to new health challenges, especially diabetes. Nearly 25% of adults with CF develop diabetes, but only a minority receive endocrinology...
| Publicado en: | JBI Evidence Implementation Vol. 24; no. 3; pp. 547 - 559 |
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| Autores principales: | , , , |
| Formato: | pictorial research tables/charts Journal Article |
| Publicado: |
Lippincott Williams & Wilkins
Jul2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=195416593&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 195416593 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 26913321 MO0F jtl: JBI Evidence Implementation issn: 26913321 maglogo: N pubinfo: dt: Jul2026 vid: 24 iid: 3 pid: 433 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 195416593 195416593 195416593 10.1097/XEB.0000000000000551 195416593 ppf: 547 ppct: 12 formats: tig: atl: Co-design, implementation, and evaluation of a nested diabetes model of care for adults with cystic fibrosis: a mixed methods pre-post implementation study. aug: au: Kumar, Shanal Smith, Daniel Moore, Vanessa Matson, Angela affil: The Adult Cystic Fibrosis Centre (ACFC), The Prince Charles Hospital, Brisbane, Qld, Australia sug: subj: Cystic Fibrosis Therapy Diabetes Mellitus Therapy Multidisciplinary Care Team Health Care Delivery, Integrated Program Implementation Program Evaluation Human Adult Multimethod Studies Validation Studies Comparative Studies Descriptive Statistics Pretest-Posttest Design Queensland Academic Medical Centers Hospital Programs Thematic Analysis Continuous Glucose Monitoring Biological Markers Glycated Hemoglobin Forced Expiratory Volume Implementation Science Funding Source Adult: 19-44 years ab: Background: Cystic fibrosis (CF) is a genetic disease with increasing life expectancy due to advances in treatment. However, this increased life expectancy has led to new health challenges, especially diabetes. Nearly 25% of adults with CF develop diabetes, but only a minority receive endocrinology care. Objective: This study aimed to co-design, implement, and evaluate a nested diabetes model of care (MOC) for adults with CF and diabetes in a single tertiary adult CF center in Australia. Methods: We used several implementation frameworks to co-design the MOC with consumer and provider end-users. Following MOC implementation, we used database-driven analytics to evaluate changes in the primary clinical outcome (HbA1c) pre and post study at 1 year. A mixed methods approach was used to evaluate secondary clinical and non-clinical outcomes. Results: The MOC promoted multidisciplinary collaboration and streamlined patient journeys, leading to high engagement. Thus, 76.7% of the entire CF cohort with confirmed diabetes was reviewed within the first year of operationalization. Engagement with the MOC was associated with a statistically significant decline in HbA1c (−0.54% vs +0.33%, p- value 0.004) and a 0.22% [95% CI 0.19 −0.32] per month increment in percent predicted forced expiratory volume (ppFEV1). Conclusion: Our co-designed MOC demonstrated high engagement as well as improving glycemic management and lung function in adults with CF and diabetes. Our approach to CF diabetes care may reduce the treatment burden in the order of initiating a new diabetes medication while concurrently enhancing end-user experiences of health care. http://links.lww.com/IJEBH/A473 pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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