Characteristics and Delivery of Diabetes Shared Medical Appointments in North Carolina.
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BACKGROUND Successful diabetes care requires patient engagement and health self-management. Diabetes shared medical appointments (SMAs) are an evidence-based approach that enables peer support, diabetes group education, and medication management to improve outcomes. The purpose of this study is to learn how diabetes SMAs are being delivered in North Carolina, including the characteristics of diabetes SMAs across the state.METHOD Twelve health systems in the state of North Carolina were contacted to explore clinical workflow and intervention characteristics with a member of the SMA care delivery team. Surveys were used to assess intervention characteristics and delivery.RESULTS Diabetes SMAs were offered in 10 clinics in 5 of the 12 health systems contacted with considerable heterogeneity across sites. The majority of SMAs were open cohorts (80%), offered monthly (60%) for 1.5 hours (60%). SMAs included a mean of 7.5 ± 3.4 patients with a maximum of 11.2 ± 2.7 patients. Survey data revealed barriers (cost-sharing and provider buy-in) to, and facilitators (leadership support and clinical champions) of, clinical adoption and sustained implementation.LIMITATIONS External validity is limited due to the small sample size and geographic clustering.CONCLUSION There is significant heterogeneity in the delivery and characteristics of diabetes SMAs in North Carolina with only modest uptake across the health systems. Further research to determine best practices and effectiveness in diverse, real-world clinical settings is required to inform implementation and dissemination efforts.
Published Version (Please cite this version)10.18043/ncm.80.5.261
Publication InfoEdelman, David; Spratt, Susan; Drake, Connor; Kirk, Julienne K; Buse, John B; Shea, Christopher M; ... Kahkoska, Anna R (2019). Characteristics and Delivery of Diabetes Shared Medical Appointments in North Carolina. North Carolina medical journal, 80(5). pp. 261-268. 10.18043/ncm.80.5.261. Retrieved from https://hdl.handle.net/10161/19480.
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Research Program Leader, Tier 1
Connor Drake is a health services researcher within the Duke University School of Medicine Center for Personalized Health Care. His training has focused on primary care health services research and implementation science. His research interests include evaluating the role of primary care in population health management with an emphasis on chronic care, the implementation of evidence-based interventions, and care redesign to support health self-management and respond to social and economic driver
Professor of Medicine
My general interests are in the improve quality of care for chronic illness, using diabetes as a model. While I have performed research on screening for, diagnosis of, and clinical severity of unrecognized diabetes in patient care settings, my current line of work is in using health systems interventions to prevent cardiovascular disease, and to improve outcomes from comorbid diabetes and hypertension.
Associate Professor of Medicine
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