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Improving Diabetes Control Using Shared Medical Appointments

Published:September 26, 2013DOI:https://doi.org/10.1016/j.amjmed.2013.06.019
      The management of diabetes mellitus is often complex and requires significant self-management skills. The American Diabetes Association recommends that patients with diabetes receive self-management education and support.
      Standards of medical care in diabetes—2013.
      Effectively teaching patients to apply self-management skills poses a significant challenge.
      • Klein H.A.
      • Jackson S.M.
      • Street K.
      • Whitacre J.C.
      • Klein G.
      Diabetes self-management education: miles to go.
      To varying degrees, patients with diabetes often need to use healthy eating recommendations, self-monitoring of blood glucose, adherence to medication regimens that include oral or injectable agents, and attendance to specialist appointments. A shared medical appointment is a format for healthcare delivery that allows patients to relate their experiences with others who share similar circumstances and challenges. In addition, shared medical appointments allow patients to access an interdisciplinary team in a short period of time. Several controlled studies have demonstrated benefits of shared medical appointments in improving diabetes-related end points compared with usual care.
      • Cohen L.B.
      • Taveira T.H.
      • Khatana S.A.
      • Dooley A.G.
      • Pirraglia P.A.
      • Wu W.C.
      Pharmacist-led shared medical appointments for multiple cardiovascular risk reduction in patients with type 2 diabetes.
      • Sanchez I.
      Implementation of a diabetes self-management education program in primary care for adults using shared medical appointments.
      • Kirsh S.
      • Watts S.
      • Pascuzzi K.
      • et al.
      Shared medical appointments based on the chronic care model: a quality improvement project to address the challenges of patients with diabetes with high cardiovascular risk.
      • Clancy D.E.
      • Huang P.
      • Okonofua E.
      • Yeager D.
      • Magruder K.M.
      Group visits: promoting adherence to diabetes guidelines.
      • Trento M.
      • Passera P.
      • Tomalino M.
      • et al.
      Group visits improve metabolic control in type 2 diabetes: a 2-year follow-up.
      We sought to assess the effectiveness of implementation of a diabetes group shared medical appointment in a veteran population.
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