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Group medical visits fail to improve outcomes in patients with diabetes

Group medical visits — the combination of group self-management education and one-on-one consultations with clinicians — did not improve several medical outcomes in patients with diabetes, according to findings recently published in the Journal of the American Board of Family Medicine.

“While diabetes group visits have been evaluated before, most evaluations have been pilots or randomized-controlled trials. This is one of the first studies evaluating the impact of a diabetes group visit in a ‘real world’ clinical setting,” Amy T. Cunningham, PhD, MPH, of the department of family and community medicine, Sidney Kimmel Medical College at Thomas Jefferson University, told Healio Family Medicine.

Data from 230 patients (mean age, 59 years) enrolled in The Diabetes Information and Support for Your Health program and its four, 2-hour sessions was compared to a similar group that did not attend the sessions. Eighty-seven percent of the participants were African-American and 69.1% were women. Group medical visit participants had lower systolic BP (133.23 vs. 135.04 mm Hg) and higher LDL (117.84 vs. 109.45 mg/dL); rates of microalbuminuria screening (87% vs. 59.7%) and A1C (9.37% vs. 8.24%) vs. the comparison group participants at baseline.

Researchers found that only 3.9% of participants went to all four sessions, and 63.8% of participants went to only one. In addition, session attendance did not significantly predict improvements in systolic BP, LDL, A1C, receipt of microalbuminuria screening, BMI or lower ED visits or admissions 1 year after the session.

“The findings illustrate the challenges of implementing a group visit in a busy, resource-limited primary care practice; as well as the challenges that patients may face in attending and completing health education programs,” Cunningham said in the interview.

“Most providers do not have time to perform in-depth diabetes education during clinical visits; therefore, it's crucial to develop and evaluate other means of providing diabetes education and support for patients,” she said, adding that PCPs follow-up with their patients after these interventions to discuss barriers that could hinder patients’ future participation. – by Janel Miller

Disclosure: The authors report no relevant financial disclosures.