Standardized Follow-Ups Lower HbA1c in Adults With Type 2 Diabetes Living in a Rural Community: A Pilot Study.

Abstract

To implement and evaluate the use of a standardized process, which includes the teach-back method for follow-up among patients with type 2 diabetes in rural health care settings in order to reduce glycosylated hemoglobin A1c (HbA1c) in adults with diabetes. It remains unclear whether or not controlled patient follow-up among patients with type 2 diabetes between office visits (at 3-month intervals) is effective in reducing their HbA1c. This study recruited 12 participants from a rural health family practice in Northern Illinois to participate in a pretest-posttest study to evaluate if close patient follow-up with reinforced education was effective in helping patients reduce their HbA1c. The preintervention for HbA1c and postintervention HbA1c mean difference was found to be statistically significant. The HbA1c level decreased from preintervention to postintervention (p < .05). Further, the mean and standard deviation from the preintervention for HbA1c and postintervention HbA1c were used to calculate an effect size using Cohen's d found that there was a medium to large effect size d = .67. The change in HbA1c levels was of clinical significance as well as statistical significance. The use of a standardized process for patient follow-up as part of routine management of type 2 diabetes appears to have had a clinically as well as statistically significant impact in reducing HbA1c levels.