Clinical trial NCT01497301: Efficacy Study of Diabetes Group Visits
Official title: Initiating Diabetic Group Visits in Newly Diagnosed Diabetics in an Urban Academic Medical Practice
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Diabetes Mellitus, Type 2
Keywords: Diabetes
Group Visit
Shared Medical Appointment
Lead sponsor: Oregon Health and Science University
Sponsor class: OTHER
First posted: 2011-12-22
Enrollment: 22
Sex: ALL
Minimum age (years): 18
Maximum age (years): 80
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: Much evidence exists that new, more effective methods of delivering care to diabetics are necessary. In our current system of delivering care, diabetes care is often done in the context of multiple other issues addressed during a regular office visit. Providers often lack the time to properly educate patients on diabetes self management topics. This project hopes to show that group visits can improve clinical outcomes, patient satisfaction, provider satisfaction, and patient's self management knowledge, while decreasing cost. This group visit method can make care more patient-centered and team based which is in alignment with our organization's goal of becoming a true patient centered medical home. If successful, this could expand to our other family medicine clinic sites and provide a valuable learning opportunity for the family medicine residents at OHSU.

The investigators will first identify newly diagnosed diabetics (diagnosed within the last 12 months) at the South Waterfront and Gabriel Park family medicine clinics using EPIC. The investigators will invite those diabetics identified from the South Waterfront clinic to participate in 6 group visits that will follow a curriculum that the investigators created based on the National Standards for Diabetes Self Management Education and the ACP Diabetes Care Guide. This curriculum will address basic pathophysiology of diabetes, the "ABCs to Better Diabetic Care" as defined by the ACP Diabetes Care Guide, setting goals, nutrition, exercise, diabetic medications, and complications of diabetes. This intervention group will be compared to a control cohort identified at the Gabriel Park clinic that will continue to receive standard diabetes care from their primary physician. The investigators will look at and compare clinical outcomes (Hemoglobin A1C, blood pressure (BP), and LDL cholesterol levels), adherence to recommended preventive measures for diabetics (foot exams, eye exams, yearly microalbumin, and immunizations), patient and provider satisfaction, as well as cost. Cost data will be collected using EPIC to look at the costs involved in group visits compared to the cost of delivering diabetic care through the standard individual medical appointment. The investigators may also use EPIC to look at utilization of specialty services, emergency room visits, and inpatient admissions and compared utilization across groups.


Eligibility criteria: Inclusion Criteria:

* Diagnosis of diabetes mellitus, type 2 after 11/01/2010
* English speaking

Exclusion Criteria:

* Dementia
* Unable to come to all 6 preschedule group visits

Primary outcomes:
measure: Change in Hemoglobin A1C
timeFrame: baseline, 6 months, and 12 months
Secondary outcomes:
measure: Number of patients that are in compliance with all recommended preventive measures for diabetics
timeFrame: baseline, 6 months, and 12 months
measure: Patient satisfaction with diabetes group visits
timeFrame: 6 months and 12 months
measure: Provider Satisfaction with Diabetes Group Visits
timeFrame: baseline, 6 months, 12 months
measure: Difference in costs of delivering care to diabetics through group visits compared to standard individual medical appointments
timeFrame: 6 months, 12 months
measure: Change in blood pressure
timeFrame: baseline, 6 months, 12 months
measure: Change in LDL cholesterol
timeFrame: baseline, 6 months, 12 months
Other outcomes:
Locations:
city: Portland
country: United States
facility: Oregon Health and Science University
state: Oregon
Study officials:
affiliation: Oregon Health and Science University
name: Scott Fields, MD
role: PRINCIPAL_INVESTIGATOR
References: