2381-PUB: Shared Medical Appointments: An Academic-Community Partnership to Improve Metabolic Outcomes among People with Type 2 Diabetes in the Central Valley of California

Abstract

Diabetes has reached epidemic proportions in the United States. Shared medical appointments are an increasingly popular model to provide access to DSMES and primary care services. The purpose of the study was to evaluate the effectiveness of a Shared Medical Appointment (SMA) intervention, compared to usual primary care (UPC), for the treatment of adults with type 2 diabetes over a 6-month period in two rural Federally Qualified Health Centers (FQHC) in the central valley of California. This study was a quasi-experimental design with a non-randomized matched control group that followed participants prospectively for 6 months. All adults living with type 2 diabetes receiving primary care at 2 FQHC clinics were eligible for inclusion. Participants in the control group were matched retrospectively on baseline A1C and age. To test the effect of group membership on A1C change, differences in change scores were compared between the ALDEA SMA intervention group and the UPC control group. Linear regression analysis was computed to assess if mean A1C change at 6 months post-intervention was greater among SMA intervention group participants compared to the UPC control group participants. The reductions in A1C were greater in the intervention group relative to the control group at 6 months. Results of the linear regression analysis revealed a net reduction A1C difference of -1.12% from baseline to 6 months (p≤0.05) in FQHC #1, and -1.06% from baseline to 6 months (p≤0.05) in FQHC #2. This study demonstrated that patients in the ALDEA program were able to achieve a significant reduction in A1C compared to those who received UPC. Despite its limitations, the ALDEA SMA program was successful in empowering patients and improving glycemic control. Disclosure C.E. Noya: None. E. Gatewood: None. A. Alkon: None. E. Castillo: None. A.C. Kuo: None. Funding Health Resources and Services Administration

American College of Lifestyle Medicine Expert Consensus Statement: Lifestyle Medicine for Optimal Outcomes in Primary Care

“…SMAs are also a clinically effective model for delivery of LM services in primary care, based on their ability to improve outcomes for obesity, cardiovascular risk factors, type 2 diabetes mellitus, heart failure, and chronic pain. 38,46–50 SMAs can improve outcomes and reduce cost in specific populations, but data are limited in primary care settings and further research is required to confidently generalize results these settings. 46,51,52…”