Care Utilization Patterns and Diabetes Self-Management Education Duration

Abstract

Objective. Previous studies have shown that receiving diabetes self-management education (DSME) is associated with increased care utilization. However, the relationship between DSME duration and care utilization patterns remains largely unexamined. Our purpose is to characterize DSME duration and examine the relationship between DSME duration and clinical- and self-care utilization patterns.Methods. The study sample included 1,446 adults who were ≥18 years of age, had diabetes, and had participated in the 2008 Florida Behavioral Risk Factor Surveillance System survey. Clinical- and self-care outcomes were derived using responses to the survey’s diabetes module and were based on minimum standards of care established by the American Diabetes Association. The outcomes examined included self-monitoring of blood glucose at least once per day; receiving at least one eye exam, one foot exam, A1C tests, and an influenza vaccination in the past year; and ever receiving a pneumococcal vaccination. DSME duration was categorized as no DSME, >0 to <4 hours, 4–10 hours, and >10 hours.Results. After adjusting for sociodemographic variables, compared to those who did not receive DSME, those who had 4–10 or 10+ hours of DSME were more likely to receive two A1C tests (odds ratio [95% CI] 2.69 [1.30–5.58] and 2.63 [1.10–6.31], respectively) and have a pneumococcal vaccination (1.98 [1.03–3.80] and 1.92 [1.01–3.64], respectively). Those receiving 10+ hours of DSME were 2.2 times (95% CI 1.18–4.09) as likely to have an influenza vaccination.Conclusion. These data reveal a positive relationship between DSME duration and utilization of some diabetes clinical care services.

<p>Effectiveness of Diabetes Self-Management Educational Programs For Type 2 Diabetes Mellitus Patients In Middle East Countries: A Systematic Review</p>

“…DSME was categorized based on total contact time as short (less than 4 hrs) or long (more than 4 hrs). 18 Regarding the covered self-management topics, the AADE7 self-care behaviors (diet, medication consumption, exercise, healthy coping with stress, self-monitoring of blood glucose (SMBG)), resolving problems (such as hypoglycemia and sick days management), and reducing diabetes risks were covered either completely or partially by the included studies; the studies were categorized based on the percent of covered topics into either poor with coverage of less than 50% of AADE7 self-care topics (ie, 3 topics or less) or good with coverage of at least 50% of AADE7 self-care topics (ie, 4 topics or more). 19 Follow-Up Period DSME programs had a wide range of follow-up periods; for this review, DSME studies were categorized according to follow-up period as short (3 months or less), intermediate (>3-6 months) and long (>6 months).…”

Trends and Rural-Urban Differences in Participation in Diabetes Self-management Education Among Adults in North Carolina: 2012-2017

“…Research is needed to determine the most effective number of sessions that a patient should attend, length for each session, spacing of sessions, and reevaluate curriculum content. 17 Studies are also needed to determine patients' preferences regarding DSME delivery and the effectiveness of different delivery modes. Despite these limitations, this study provided an update on the current status of DSME participation by rural-urban residents.…”

Implementation and Evaluation of Diabetes Clinical Practice Guidelines in a Primary Care Clinic Serving a Hispanic Community

“…With an increase in the diagnosis of diabetes and high cost of treatment, diabetes uses 20% of the nation's healthcare dollars (American Diabetes Association [ADA], ). With over 30 million patients at risk or diagnosed with diabetes, disease management is important to improve outcomes and minimize long‐term effects for both patients and healthcare systems (Baptista et al., ; Johnson, Richards, & Churilla, ).…”

“…Providers can use evidence‐based tools and education such as clinical practice guidelines (CPG) to provide high‐quality care (Melnyk & Fineout‐Overholt, ; Melnyk, Gallagher‐Ford, Long, & Fineout‐Overholt, ). However, many barriers exist to the efficient use of CPG and include patient and provider relationships, time‐consuming delivery, the impracticality of use, and PCPs attitudes toward using CPG (Johnson et al., ). A major problem is that healthcare providers in clinic settings often lack knowledge of how to implement CPG.…”