Shared medical appointments for patients with diabetes: Glycemic reduction in high‐risk patients. Issue 8 (27th January 2015)

• Record Type: Journal Article
• Authors: Watts, Sharon A.; Strauss, Gerald J.; Pascuzzi, Kristina; O'Day, Mary Ellen; Young, Kevin; Aron, David C.; Kirsh, Susan R.
• Is Part Of: Journal of the American Association of Nurse Practitioners. Volume 27:Issue 8(2015)
• Page Start: 450
• Page End: 456
• Publication Date: 2015-01-27
• Subjects: Nurse practitioners -- Periodicals; Nursing -- Periodicals; 610.730692
• DOI: 10.1002/2327-6924.12200
• Languages: English
• ISSNs: 2327-6886

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="jaan12200-sec-0010" sec-type="section"> <title>Purpose</title> <p>To assess the impact on glycemic control (A1c, %) in a primary care urban Veterans Affairs (VA) shared medical appointments (SMAs).</p> </sec> <sec id="jaan12200-sec-0020" sec-type="section"> <title>Data sources</title> <p>A retrospective pretest/posttest study included all patients who had attended ≥1 SMA from 4/06 to 12/10. A1cs 810 days pre‐ and postinitial SMA were obtained from 90‐day time periods. A1c levels were averaged within patient in these 90‐day intervals and data were aggregated based upon corresponding time intervals.</p> </sec> <sec id="jaan12200-sec-0030" sec-type="section"> <title>Conclusions</title> <p>Of 1290 individuals seen in SMAs, 1288 (99.8%) had ≥1 A1c levels and 1170 (90.7%) individuals had ≥1 level collected both before and after attendance. The sample was predominantly (96%) male and middle aged or older (mean [±1 SD] age of 62.6 + 9.09 years) with a mean Diabetes Severity Index 3.01 (2.34). There were significant A1c reductions (∼1%) in A1c overall (<italic>n</italic> = 1170) and for patients with ≥1 measurement in the 180‐day periods preceding and following their first SMA appointment (<italic>n</italic> = 815). Linear regression analysis showed a significant (<italic>p</italic> < .001) pre‐SMA positive trend (<italic>r</italic><sup>2</sup> = 0.90).</p> </sec> <sec id="jaan12200-sec-0040" sec-type="section"> <title>Implications for practice</title> <p>Limitations notwithstanding (single site and design lacking a control group), the large number of patients demonstrates SMA clinical effectiveness in improving A1c for high‐risk patients with diabetes.</p> </sec> </abstract>