Improving Diabetes Control Using Shared Medical Appointments

Guirguis, Alexander B.; Lugovich, Joan; Jay, Jennifer W.; Sanders, Kathryn A.; Cioffi, Seth T.; Jeffery, Sean M.; Kravetz, Jeffrey D.

doi:10.1016/j.amjmed.2013.06.019

Cited by 12 publications

(11 citation statements)

References 5 publications

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“…SMAs provide education and clinical care in an interactive environment with patient groups and multidisciplinary teams, permitting sharing of experiences through social learning or modeling, and integrating peer, healthcare provider, and family support into longer appointment times . In adults with T1D and T2D, SMAs show significant improvement or stabilization in HbA1c, better QOL, and attainment of measurable goals . However, there is no standardized framework for SMAs in adolescent T1D and even less data on their use, with variable efficacy .…”

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confidence: 99%

Stabilization of glycemic control and improved quality of life using a shared medical appointment model in adolescents with type 1 diabetes in suboptimal control

et al. 2016

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confidence: 99%

Stabilization of glycemic control and improved quality of life using a shared medical appointment model in adolescents with type 1 diabetes in suboptimal control

et al. 2016

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“…The recommended medication therapy options for HCV have grown and evolved immensely, with some of the newer regimens showing up to 99% sustained viral response at 12 weeks (SVR12) success rate for some genotypes that previously showed only 40-70% SVR12 success rates in 2011 [5]. This rapidly changing and costly field requires careful monitoring and drug selection, accurate diagnosis and genotyping, as well as interdisciplinary collaboration [6,7]. Today, there are oral combination medication regimens that carry treatment durations that range from 8 to 24 weeks without the need for interferon.…”

Section: Introductionmentioning

confidence: 99%

“…With much dependent upon adherence, cost, disease monitoring, and drug selection, pharmacists are in a unique position for participation in interdisciplinary collaboration [6]. A study conducted by Langness et al examined a pharmacist's role in identifying drug-drug interactions (DDIs) in patients being actively treated with HCV medication regimens.…”

Section: Introductionmentioning

confidence: 99%

Impact of Pharmacist Interventions on the Treatment of Hepatitis C Patients at a Veterans Affairs Healthcare Facility

Doughty¹,

Kuszewski²,

Cioffi³

2018

ujph

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The purpose of this project is to demonstrate the impact of pharmacy interventions and interdisciplinary care on the treatment of hepatitis C virus (HCV) within the outpatient liver clinic at VA Connecticut Healthcare System (VA CT). Methods: This project consisted of a retrospective analysis of patient data conducted from 1/1/2014-8/1/2016 within the outpatient liver clinic at VA CT. The following information was collected and analyzed for patients referred to the clinic through the initial consult notes within the VA's Computerized Patient Record System (CPRS): HCV genotype, human immunodeficiency virus (HIV) status, cirrhosis status, treatment history, adherence pattern per refill histories and appointment attendance, initially requested therapy, pharmacist approved therapy, drug-drug interactions (DDIs) identified by a pharmacist, and sustained viral response at 12 weeks (SVR12). Patients excluded from the above data collection included those that were not chosen to begin treatment after referral to the clinic due to issues such as significant DDIs, history of non-adherence, etc. After data collection, pharmacist recommendations were quantified over the study population and compared to the primary endpoint of SVR12 status. All data was analyzed and presented as percentages in this frequency analysis, requiring no formal statistical analysis software. Results: After comparing the initially requested regimens to those prescribed, 20% of the total 510 regimens were adjusted by a pharmacist. Changes were made for various reasons, including guideline changes, resulting labs (i.e. hemoglobin, platelets, etc.), side effects, and adherence. Approximately 73% of patients had at least one drug interaction identified. Of these identified, 31% of the interacting medications were adjusted by the provider. Finally, SVR12 status through 3/2016 was achieved in 94% of the total patient population, excluding those who did not initiate or complete therapy. Conclusion: This study concludes that the pharmacists involved in patient care within the outpatient liver clinic at VA CT have been a valuable asset to patient care and should continue to provide pharmacy services in a provider role to patients.

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“…In lieu of the traditional visit between a single healthcare provider and patient, a provider engages a group of patients with similar healthcare needs in an extended visit that allows more time for patient-centered education and discussion [6]. Although shared medical appointments were initially piloted in the primary care setting, this model has now been applied to more specific diagnoses and conditions such as diabetes [7–11], heart failure [12], and pregnancy [13]. It has also been utilized in various surgical subspecialties including urology [14,15], bariatric surgery [16], and cardiac surgery [17].…”

Section: Introductionmentioning

confidence: 99%

“…It has also been utilized in various surgical subspecialties including urology [14,15], bariatric surgery [16], and cardiac surgery [17]. Published studies comparing traditional models of care to shared medical appointments have shown improved clinical outcomes such as lower hemoglobin A1c [7], increased exercise [18], improved blood pressure control [18], decreased preterm birth [19], improved access to care and decreased costs [20]. Despite the potential benefits of shared medical appointments for both patients and providers, there have been few attempts to utilize this model in oncology [21–24].…”

Section: Introductionmentioning

confidence: 99%

Fighting cancer together: Development and implementation of shared medical appointments to standardize and improve chemotherapy education

Prescott

Dickens

Guerra

et al. 2016

Gynecologic Oncology

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Objective Shared medical appointments offer a novel approach to improve efficiency and quality of care consistent with the goals of the Institute of Medicine. Our objective was to develop and implement a shared medical appointment for gynecologic cancer patients initiating chemotherapy. Methods We first assessed the level of interest in shared medical appointments among our patients and providers through qualitative interviews. Both patients and providers identified pre-chemotherapy as an optimal area to pilot shared medical appointments. We subsequently created a multidisciplinary team comprised of physicians, advanced practice providers, nurses, pharmacists, administrators, health education specialists and members of the Quality Improvement Department to establish a Shared Medical Appointment and Readiness Teaching (SMART) program for all gynecologic oncology patients initiating chemotherapy with platinum- and/or taxane-based regimens. We developed a standardized chemotherapy education presentation and provided patients with a tool kit that consisted of chemotherapy drug education, a guide to managing side effects, advance directives, and center contact information. Results From May 9, 2014 to June 26, 2015, 144 patients participated in 51 SMART visits. The majority of patients had ovarian cancer and were treated with carboplatin/paclitaxel. Surveyed patients reported being highly satisfied with the group visit and would recommend shared medical appointments to other patients. Conclusions This model of care provides patient education within a framework of social support that empowers patients. Shared medical appointments for oncology patients initiating chemotherapy are both feasible and well accepted.

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Improving Diabetes Control Using Shared Medical Appointments

Cited by 12 publications

References 5 publications

Stabilization of glycemic control and improved quality of life using a shared medical appointment model in adolescents with type 1 diabetes in suboptimal control

Stabilization of glycemic control and improved quality of life using a shared medical appointment model in adolescents with type 1 diabetes in suboptimal control

Impact of Pharmacist Interventions on the Treatment of Hepatitis C Patients at a Veterans Affairs Healthcare Facility

Fighting cancer together: Development and implementation of shared medical appointments to standardize and improve chemotherapy education

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