Alliance to Reduce Disparities in Diabetes

American Diabetes Association's 73rd Scientific Sessions - Camden

Group diabetes visits to support self-management goals: a model for care in an urban, resource-poor community
Kaufman, S., Grabowski, F., Ali, N., & Katz, A.

The Camden Coalition of Healthcare Providers initiated a program of group diabetes visits (GDVs) in an urban, resource-poor community (Camden, NJ) to provide a team approach to ongoing patient-centered diabetes (DM) care and offer a structure for sustaining behavioral change after diabetes self-management education (DSME).Patients who complete 6.5 hrs of DSME are offered a quarterly GDV with their primary care provider (PCP) and a certified diabetes educator (CDE). The CDE and a program assistant review charts prior to the class to develop a detailed DM Care Plan based on history, lab results and goals. The PCP and CDE then discuss the patient’s clinical measure and behavior goals in advance of the GDV. Each two-hour program is divided into three components: DSME, clinical care, and an interactive Question and Answer session. During the program, the PCP completes the care plan for each patient. An endocrinologist attends the GDV for the first 6 months to model clinical decision making. After the program the CDE and PCP review the medical decisions, behavior goals and plan follow up care. Patient’s demographics, clinical measures (HbA1C, blood pressure and lipids) are measured at baseline and every six months. In the initial six months of the program.Thirty patients with previous DSME participated in the GDV. Complete pre and post A1c data was able to be collected for 16 patients (72% African American, 11% Hispanic, and 17% White; 50% male and 50% female; average age of 53.63 + 12.47; average A1c of 9.1). 14 GDV were held over a 2- year period.Attendance: 63% attended 2+ visits, and 36% attended 3+ visits.Change in HbA1c: Pre HbA1cA1c 9.10 + 2.17; Post HbA1c7.98 +1.78 (p=.085).GDVs were investigated as a novel method for delivering DM care in an urban, resource-poor community. GDV allow for medical care, peer-to-peer support and continued emphasis on behavior change. Although the decrease in HbA1c was not statistically significant many patients had a reduction in their HbA1c. Combining education with the medical components of a visit improves glycemic control in an underserved patient population.