Self care outcomes for patients in a diabetes self management education program
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Self Care Outcomes for Patients in a Diabetes Self-Management Education Program. Frank West, M.D., Morgan Arvidson, M.D. Leah Jacobson, M.D. Trident/MUSC Family Medicine Residency Program . Background. Epidemiology Diabetes is everywhere. Guidelines

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Self care outcomes for patients in a diabetes self management education program l.jpg
Self Care Outcomes for Patients in a Diabetes Self-Management Education Program

Frank West, M.D., Morgan Arvidson, M.D.

Leah Jacobson, M.D.

Trident/MUSC Family Medicine Residency

Program


Background l.jpg
Background Self-Management Education Program

  • Epidemiology

    • Diabetes is everywhere.

  • Guidelines

    • ADA has guidelines for both medical and behavioral health components of diabetes.

  • Problem

    • We’re missing treatment opportunities


Purpose l.jpg
Purpose Self-Management Education Program

  • To evaluate the effect of a Diabetes Self Management Education (DSME) program on self-care, behavioral health, and mental health of patients with diabetes.


Methods l.jpg
Methods Self-Management Education Program

  • Identified patients with diabetes through the University Family Medicine electronic health record.

  • Patients voluntarily enrolled in a comprehensive DSME program

  • Educational material was drawn from an American Diabetes Association certified curriculum

    • Material presented by a multi-disciplinary team in a group visit setting

  • This project was approved as exempt research by the MUSC IRB


Program structure l.jpg
Program Structure Self-Management Education Program

INDIVIDUAL

ASSESSMENT & COUNSELING

(RN, PharmD, RD)

4-HOUR GROUP

VISIT

(RN, RD)

SHARED

MEDICAL VISIT

(MD, Residents,

students)

6-8 Weeks

SUPPORT

GROUP

(RN, patients)

1-2 Weeks

6-8 Weeks

Monthly


Methods6 l.jpg
Methods Self-Management Education Program

  • Prior to starting the educational curriculum, participants completed validated surveys on:

  • self-care and behavioral changes

    • Behavior Assessment 7-day Scale

  • mental health issues

    • Diabetes Psychosocial Distress Scale

    • Patient Health Questionnaire (PHQ-9) Depression Screen

  • Surveys were repeated four to eight weeks after completion of the DSME program


  • Outcome measures l.jpg
    Outcome Measures Self-Management Education Program

    • Survey scores (pre vs. post) for three assessment tools:

      • Behavior Assessment 7-day Scale

      • Diabetes Psychosocial Distress Scale

      • PHQ-9 Depression Scale


    Demographics l.jpg
    Demographics Self-Management Education Program

    • -115 Adults with type 2 DM completed the program

      • -Mean age: 50.9+12.4 years

      • -51% AA, 49% Caucasians

      • -60% female, 40% male

      • -Baseline HbA1c 8.6%, LDL 114 mg/dL, blood pressure 139/81 mmHg


    Behavior outcomes 7 day behavior assessment scale l.jpg
    Behavior Outcomes Self-Management Education Program7 Day Behavior Assessment Scale

    * Student t-test, p<0.05


    Behavior outcomes diabetes psychosocial distress scale l.jpg
    Behavior Outcomes Self-Management Education ProgramDiabetes Psychosocial Distress Scale


    Behavior outcomes diabetes psychosocial distress scale11 l.jpg
    Behavior Outcomes Self-Management Education ProgramDiabetes Psychosocial Distress Scale


    Behavior outcomes depression assessment l.jpg
    Behavior Outcomes Self-Management Education ProgramDepression Assessment

    PHQ-9 Depression Scale:

    Improvements were not noted

    24% of patients found to be moderately or severely depressed and referred to Psychologist or PCP for further evaluation


    Discussion l.jpg
    Discussion Self-Management Education Program

    Patients who completed the DMSE program showed statistically significant improvement in the following areas of diabetes self care:

    Diet

    Exercise

    Foot care

    No improvements were shown in medication compliance, glucose monitoring or smoking

    Implications?


    Conclusion l.jpg
    Conclusion Self-Management Education Program

    • Care for patients with diabetes provides a multi-faceted challenge for primary care physicians.

    • Behavioral health is an important component of diabetes care

    • A significant impact can be made in the behaviors of patients with diabetes through a DMSE system.


    Special thanks to l.jpg
    Special thanks to: Self-Management Education Program

    • Michael Aho, MS3

    • Maria Gibson, M.D.

    • Lori Dickerson, Pharm.D.


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