Treating Type 2 Diabetes: A Cross-sectional Audit of Naturopathic Standards of Care Using the Naturopathic Patient Database

Abstract

The Naturopathic Patient Database is a data management tool developed by the Canadian College of Naturopathic Medicine to collect patient data from its teaching clinic, the Robert Schad Naturopathic Clinic. This study investigated how type 2 diabetes mellitus was managed at the Robert Schad Naturopathic Clinic from May 2009 to February 2011. Cases of type 2 diabetes mellitus from the Robert Schad Naturopathic Clinic reported in the Naturopathic Patient Database were extracted based on an International Classification of Diseases, 10th revision code assessment of E11 (non-insulin-dependent diabetes mellitus) and files were audited. The American Diabetes Association 2010 standards of medical care in diabetes were used as guidelines for the audit. Multiple categories in diagnosis, physical exam, laboratory tests, and management were graded on a 0 to 2 scale. The average audit score was 55.5/90. The most common interventions being used are diet and aerobic exercise, followed by supplements (omega-3 fatty acids) and botanicals. These data suggest that the American Diabetes Association standards of care for type 2 diabetes mellitus are not followed stringently. Education and creation of a naturopathic standard of care may improve audit performance and patient outcomes.

Assessing the Utility of an Electronic Research Database to Capture Whole Systems Practice at Two Naturopathic Outpatient Teaching Clinics

“…Through comparisons of data housed in the Naturopathic Patient Database and that contained in patient charts, it is clear that the Naturopathic Patient Database–based data are predictive of trends seen in patient charts. The diabetes audit 9 reports comparable scoring based on the Naturopathic Patient Database and on patient charts, whereas the profile of Adjunctive Cancer Care patients demonstrates parity between prescription trends in the Naturopathic Patient Database and in patient charts.…”

“…In addition, the development of this tool toward the study of specific conditions has led to the systematic adoption of validated questionnaires for people with cancer at the Adjunctive Cancer Care at the Canadian College of Naturopathic Medicine (unpublished) as well as to a more effective audit of care for patients with diabetes at the Canadian College of Naturopathic Medicine. 9 Numerous applications for data mining are available for this tool, and to date, the potential yield of this database has been minimally exploited. Even when incomplete, files within the Naturopathic Patient Database can flag specific patient charts for researchers to review further in their investigations.…”