Group Visits and Chronic Disease Management in Adults: A Review

Abstract

Chronic disease management using the traditional 15-minute appointment is exceptionally challenging and arguably inadequate to provide comprehensive, prospective, patient-centered primary care. A model of care designed to promote patient education, patient self-management, and improved access to their physicians and other health care providers is needed. Group visits have been identified as one model that allows physicians to deliver extensive patient education and self-management instruction while enhancing financial productivity. A thorough review of the literature on group visits was performed. Fairly consistent results from level I and II quality of evidence from a revised Strength of Recommendation Taxonomy (SORT) rating system indicate that patients who attended group visits demonstrated improved standards of care, improved quality of life, greater patient and physician satisfaction, lower rates of hospitalization and emergency department utilization, and reduced specialty costs. Discrepancies from the literature review include body mass index, hemoglobin A1C, blood pressure, and lipids. Overall, group visits appear to provide an effective and complementary strategy to traditional primary care in dealing with the complexities of providing chronic disease management in an increasing complex and aging population.

Impact of Collaborative Shared Medical Appointments on Diabetes Outcomes in a Family Medicine Clinic

“…SMAs can represent an opportunity for the patient to have encounters with multiple providers as well as improved access, productivity, education, and cost savings for the practice. [3][4][5][6][7][8][9] SMAs can be organized in diverse ways, but the typical format combines witnessed and individualized interactions between patients and providers as well as group educational components. 10 SMAs have been shown to improve provider adherence to American Diabetes Association (ADA) guidelines, [11][12][13] but randomized controlled trials are mixed as to whether or not SMAs improve clinical outcomes for patients with diabetes.…”

How to ask: Older adults’ preferred tools in health outcome prioritization

“…One possibility is expanding beyond the patient-physician dyad and including other providers, such as patient coaches [36]. A second option would be group visits or self-management classes [37], and reviewing the patient’s chosen tool at an individual appointment. Tool implementation and impact on care is a valuable area for future research.…”

Lifestyle Medicine Shared Medical Appointments

“…12 Delivering LM in group settings has been shown to be financially viable and effective in addressing chronic disease. [13][14][15] The term lifestyle-based group visits has been previously used to describe this model. 16 To emphasize lifestyle being used as medicine, increase awareness of LM as a medical specialty, and to highlight the shared experience of participants, the authors propose that this type of visit be referred to as a Lifestyle Medicine Shared Medical Appointment (LMSMA).…”