| Title | Implementing the chronic care model for improvements in diabetes care and education in a rural primary care practice. | | Author(s) | Siminerio LM, Piatt G, Zgibor JC | | Institution | Department of Medicine, Division of Endocrinology, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA. simineriol@msx.dept-med.pitt.edu | | Source | Diabetes Educ 2005 Mar-Apr; 31(2):225-34. | | MeSH | Aged
Chronic Disease
Diabetes Mellitus, Type 2
Educational Measurement
Family Practice
Female
Guideline Adherence
Health Knowledge, Attitudes, Practice
Hemoglobin A, Glycosylated
Humans
Male
Middle Aged
Models, Organizational
Outcome Assessment (Health Care)
Patient Education
Pennsylvania
Pilot Projects
Practice Guidelines
Primary Health Care
Program Development
Program Evaluation
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Rural Health Services
Total Quality Management
| | Abstract | PURPOSE: The purpose of this pilot study was to determine the impact of implementing elements of the chronic care model (CCM; decision support, self-management, and delivery system redesign) on providers' diabetes care practices and patient outcomes in a rural practice setting.
METHODS: In this pilot study, 104 patients with type 2 diabetes and 6 providers in a rural primary care practice were involved in an intervention that included a certified diabetes educator (CDE) who educated and supported providers on diabetes management and adherence to the American Diabetes Association (ADA) Standards of Care over the year of the project. The CDE also provided diabetes self-management education (DSME) at the office site for 29 of the 104 patients who received their care in the practice. The following variables were evaluated: provider perceived barriers to care and adherence to ADA standards of care and patient A1C, blood pressure, cholesterol, knowledge, and empowerment levels.
RESULTS: Provider adherence to ADA Standards of Care increased significantly across all process measures. Patients who received DSME at point of service in the primary care practice setting gained improvements in knowledge, empowerment, A1C, and high-density lipoprotein cholesterol levels.
CONCLUSIONS: Implementing systems to support decision support, self-management education, and delivery system redesign has a positive influence on practices and patient outcomes in outlying rural communities. | | Language | eng | | Pub Type(s) | Evaluation Studies
Journal Article
| | PubMed ID | 15797851 |
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