Patient perspectives of an individualized diabetes care management plan

Ashley N Saucier; Benjamin Ansa; Janis Coffin; Mariam Akhtar; Andre Miller; Holly Mahoney; Denise M Hodo; Carla Duffie; Brittney Fontenot; Holly E Andrews; Selina A Smith

doi:10.5750/ejpch.v5i2

Patient perspectives of an individualized diabetes care management plan

Eur J Pers Cent Healthc. 2017;5(2):213-219. doi: 10.5750/ejpch.v5i2.

Authors

Affiliations

¹ Associate Professor & Associate Director of Medical Student Education, Department of Family Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia, USA.
² Senior Research Associate, Institute of Public & Preventative Health, Medical College of Georgia at Augusta University, Augusta, Georgia, USA.
³ Professor & Family Medicine Clinic Director, Department of Family Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia, USA.
⁴ Assistant Professor, Department of Family Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia, USA.
⁵ Chief Resident, Department of Family Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia, USA.
⁶ Research Associate, Department of Family Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia, USA.
⁷ Clinic Coordinator, Department of Family Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia, USA.
⁸ Research Associate, Institute of Public & Preventative Health, Medical College of Georgia at Augusta University, Augusta, Georgia, USA.
⁹ Director of Research, Professor & Curtis G. Hames, MD, Distinguished Chair, Department of Family Medicine Medical College of Georgia at Augusta University; President, Georgia Public Health Association & Editor, Journal of the Georgia Public Health Association, Augusta, Georgia, USA.

Abstract

Purpose: This cross sectional study examines patients' knowledge, attitudes and beliefs about a diabetic care management plan (DCMP) that was developed to provide patient education on diabetes guidelines and display individual diabetic core measures. Secondary objectives included a comparison of diabetic core measures [hemoglobin A1C (HbA1C), systolic and diastolic blood pressure (SBP, DBP), low-density lipoprotein (LDL) and urine microalbumin (Um)] before and after DCMP implementation. We hypothesize this tool will contribute to patients' awareness of current disease status, diabetes knowledge and diabetic core value improvement over time.

Methods: A consecutive sample of 102 adult patients with diabetes mellitus type 2 in a primary care setting participated. Patients' perspectives on the care plan and knowledge about diabetes was collected via survey after care plan implementation. A comparison of selected diabetic core measures was conducted at baseline and post-DCMP. Descriptive statistics summarized survey response and diabetic core measures. A repeated measures ANOVA was used to assess change in diabetic core measures over time.

Results: Participants understood the DCMP (96%), found it important because it explained their laboratory results and medications (89%) and believed it would help them to have better diabetic control (99%). There was a significant interaction between time and being at goal pre-DCMP for HbA1c, SBP and LDL. Patients not at goal pre-DCMP for the above measures decreased significantly over time (P = <0.01 for HbA1c, SBP and LDL). Participants at goal for all diabetic core measures increased pre- to post-DCMP from 13% to 20% (P = 0.28).

Conclusion: Patients perceived the diabetic care management plan favorably and their diabetic core measurements improved over time. This simple and reproducible self-management intervention can enhance self-management in a patient population with diabetes mellitus type 2.

Keywords: Chronic care management; diabetes mellitus; medical home; patient self-management support; patient-centered outcomes research; person-centered healthcare.

Grants and funding

R01 CA166785/CA/NCI NIH HHS/United States