Date of Publication
Matthew Perchemlides, Margaret Aitken, Lena Wasmus
Purpose: To increase the rate of diet-management by PCPs with the use of a digital diet-tool. The Global Burden of Disease Study identifies chronic disease (CD) as the leading cause of mortality in the world and diet-quality as the leading predictor of all-cause morbidity and mortality (Afshin et al., 2019). The same is true in the United States (Gicevic et al., 2021) and in Vermont (VT DOH, 2019). Low-quality diets contribute to CD while improved diet-quality reduces morbidity and premature death (Harmon et al., 2015; Wang et al., 2019). Diet is not routinely managed by PCPs (Ahmed et al., 2016) due to barriers including, limited nutrition training, limited time, competing medical-priorities, and insufficient reimbursement (Kolasa & Rickett, 2010). Digital diet-tools are a means of overcoming these barriers, per the AHA (Vadiveloo et al., 2020)
Methods: Retrospective chart-audits established the baseline-rate of diet-management by two PCPs for adult patients. A validated, digital, diet-management tool, for professionals was available for 5 consecutive weeks. Documentation of diet-assessments and diet-planning was tabulated daily. Staff provided feedback regarding workflow, functionality, and feasibility of the practice-change.
Results: The rate of diet-management increased with this practice-change. Diet-assessment increased from 0% to 40%, diet-planning from 14% to 54% for one PCP and from 0% to 15% and 14% to 29% respectively for the second. Identification of patients with low-quality diets and high-risk of developing CD increased 20-fold among one PCP’s patients and 4-fold among the other. 55% of patients with low-quality diets received diet-management for the primary prevention of CD. Providers reported a positive opinion of the tool and practice-change.
Conclusion: Diet-management by PCPs increased with use of the digital diet-tool. This practice-change lead to the identification of patients with low-quality diets who were at high-risk of adverse health outcomes and facilitated intervention toward primary prevention of CD.
Perchemlides, Matthew DNP-c, RN, MSN, ND, FABNO; Aitken, Margaret DNP, APRN, ANP-BC; and Wasmus, Lena FNP-BC, APRN, "Efficient Diet Management in Primary Care" (2023). College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications. 134.
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