The most significant effect observed is with the change from baseline results .
Some evidence suggests post-intervention and change from baseline systolic blood pressure improvement at the nine to twelve month interval and change from baseline improvement at the 4 year timeframe .
There is no evidence that group visits improve LDL cholesterol values of the group visit participants .
IMPLICATION S FOR PRACTICE The evidence suggests that the most powerful model of Group medical visits ( GMV ) is when a clinician prescriber is present during or immediately after GMV sessions for medication reconciliation or individual patient needs .
BACKGROUND The prevalence of diabetes mellitus is ubiquitous .
Complications and costs of diabetes are rising and are depleting limited re sources .
It is imperative for healthcare professionals and patients alike to confront this chronic condition by exploring new interventions .
An innovative health care delivery model has emerged in the last 25 years in the form of the group medical visit .
Group medical visits can range from of six to twenty patients scheduled together with time allotted for individual care as well as in the group setting .
A randomised controlled clinical trial of nurse-, dietitian- and pedagogistled Group Care for the management of Type 2 diabetes
Aim : To verify if Group Care , a model to manage Type 2 diabetes ( T2DM ) by systemic continuing group education , can be administered by nurses and dieticians under pedagogic guidance , and improve metabolic control , quality of life , Locus of Control , and insulin resistance . Material and subjects : Twenty-five patients with non-insulin-treated T2DM were r and omized to Group Care and 24 to continued habitual individual care and education delivered by a diabetes specialist and pedagogist , respectively . Six nurses and 1 dietician received training by an accredited programme , a detailed operating manual and pedagogical supervision throughout the study . Follow-up was for 2 yr and included measurements of fasting blood glucose , glycated hemoglobin ( HbA1c ) , body mass index , waist circumference , lipids , creatinine , blood pressure , serum insulin , homeostasis model assessment ( HOMA ) index of insulin resistance , health behaviors , quality of life , state and trait anxiety , and Locus of Control . Results : One patient on Group Care and 3 controls dropped out . At the end of study , the patients on Group Care had lower HbA1c ( 7.6± 0.8 vs 8.4± 1.3 , p<0.05 ) , insulin ( 18.0± 9.6 vs 24.3± 13.7 , p<0.001 ) , HOMA index ( 6.9± 5.4 vs 9.2± 6.6 , p<0.05 ) , and fatalistic attitude ( 17.2± 5.9 vs 24.9± 4.2 , p<0.001 ) and better quality of life ( 65.0± 11.0 vs 78.4± 19.6 , p<0.001 ) than controls . Conclusions : Group Care delivered by trained nurses and dietitan is associated with better outcomes than those obtained by a medically and pedagogically qualified team . It may offer a model for health operators to re-organize clinical practice and for patients to improve lifestyle and strengthen the therapeutic alliance with their carers
The most significant effect observed is with the change from baseline results .
Some evidence suggests post-intervention and change from baseline systolic blood pressure improvement at the nine to twelve month interval and change from baseline improvement at the 4 year timeframe .
There is no evidence that group visits improve LDL cholesterol values of the group visit participants .
IMPLICATION S FOR PRACTICE The evidence suggests that the most powerful model of Group medical visits ( GMV ) is when a clinician prescriber is present during or immediately after GMV sessions for medication reconciliation or individual patient needs .
BACKGROUND The prevalence of diabetes mellitus is ubiquitous .
Complications and costs of diabetes are rising and are depleting limited re sources .
It is imperative for healthcare professionals and patients alike to confront this chronic condition by exploring new interventions .
An innovative health care delivery model has emerged in the last 25 years in the form of the group medical visit .
Group medical visits can range from of six to twenty patients scheduled together with time allotted for individual care as well as in the group setting .