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 .
Diabetes management in a health maintenance organization. Efficacy of care management using cluster visits.
OBJECTIVE To evaluate the effectiveness of a cluster visit model led by a diabetes nurse educator for delivering outpatient care management to adult patients with poorly controlled diabetes . RESEARCH DESIGN AND METHODS This study involved a r and omized controlled trial among patients of Kaiser Permanente 's Pleasanton , CA , center who were aged 16 - 75 years and had either poor glycemic control ( HbA1c > 8.5 % ) or no HbA1c test performed during the previous year . Intervention subjects received multidisciplinary outpatient diabetes care management delivered by a diabetes nurse educator , a psychologist , a nutritionist , and a pharmacist in cluster visit setting s of 10 - 18 patients /month for 6 months . Outcomes included change ( from baseline ) in HbA1c levels ; self-reported changes in self-care practice s , self-efficacy , and satisfaction ; and utilization of inpatient and outpatient health care . RESULTS After the intervention , HbA1c levels declined by 1.3 % in the intervention subjects versus 0.2 % in the control subjects ( P < 0.0001 ) . Several self-care practice s and several measures of self-efficacy improved significantly in the intervention group . Satisfaction with the program was high . Both hospital ( P = 0.04 ) and outpatient ( P < 0.01 ) utilization were significantly lower for intervention subjects after the program . CONCLUSIONS A 6-month cluster visit group model of care for adults with diabetes improved glycemic control , self-efficacy , and patient satisfaction and result ed in a reduction in health care utilization after the program
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 .