Structured Group Education Research Articles

Confronting Disparities in Diabetes Care: The Clinical Effectiveness of Redesigning Care Management for Minority Patients in Rural Primary Care Practices

Diabetes mellitus and its complications disproportionately affect minority citizens in rural communities, many of whom have limited access to comprehensive diabetes management services. To explore the efficacy of combining care management and interdisciplinary group visits for rural African American patients with diabetes mellitus. In the intervention practice, an advanced practice nurse visited the practice weekly for 12 months and facilitated diabetes education, patient flow, and management. Patients participated in a 4-session group visit education/support program led by a nurse, a physician, a pharmacist, and a nutritionist. The control patients in a separate practice received usual care. Median hemoglobin A1c (HbA1c) was not significantly different at baseline in the intervention and control groups but was significantly different at the end of the 12-month follow-up period (P < .05). In the intervention group, median HbA1c at baseline was 8.2 +/- 2.6%, and median HbA1c at an average follow-up of 11.3 months was 7.1 +/- 2.3%, (P < .0001). In the control group, median HbA1c increased from 8.3 +/- 2.0% to 8.6 +/- 2.4% (P < .05) over the same time period. In the intervention group, 61% of patients had a reduction in HbA1c, and the percentage of patients with a HbA1c of less than 7% improved from 32% to 45% (P < 05). These findings suggest that a redesigned care management model that combines nurse-led case management with structured group education visits can be successfully incorporated into rural primary care practices and can significantly improve glycemic control.

Efectividad de un programa de educación grupal estructurada en personas con diabetes mellitus tipo 2

Objective To assess the effectiveness of structured group education in individuals with type 2 diabetes (DM2) as a complement to the individual education given by nurses in consulting rooms. Method A quasi-experimental, before-and-after study was performed in five primary care centers in Girona. The sample consisted of 73 individuals with DM2 managed in the Basic Care Units of each health center. Questionnaires on knowledge of the disease and patient satisfaction with the course were administered. Metabolic values (HbA 1c) were measured before the course, 6 months after the course and after 1 year. Results Attendance at workshops was high (72.6%). Metabolic control was substantially improved at 6 and 12 months after the course (HbA 1c before the course, 6.95%; at 6 months, 6.2%, and at 1 year, 6.5%). The questionnaires revealed that knowledge of the disease was already high before the workshop and remained high. Satisfaction with the workshop among participating patients and nurses was high. Conclusions Structured group education, as a complement to individual education, significantly improves metabolic control of diabetes and therefore it could also reduce microvascular complications. Consequently, structured group education should be included in nursing activities. Both patients and nurses were satisfied with the course contents and organization.

Normalization of Pregnancy Outcome in Pregestational Diabetes Through Functional Insulin Treatment and Modular Outpatient Education Adapted for Pregnancy

Howorka, K; Pumprla, J; Gabriel, M; Feiks, A; Schlusche, C; Nowotny, C; Schobert, E; Waldhoer, T; Langer, M

Comparison of blood or urine testing by patients with newly diagnosed non-insulin dependent diabetes: patient survey after randomised crossover trial

Guidelines for the management of non-insulin dependent diabetes mellitus often contain little information as to which is the preferred method of monitoring glucose at home.1 Although there is much enthusiasm...