Improving the health of diabetic patients through resident-initiated group visits.
OBJECTIVE
Group visits have the potential to benefit patients with chronic illnesses. Our objective was to implement resident-run diabetic group visits that would improve patient education and help patients become more involved in their care.


METHODS
We developed systems to promote, coordinate, and lead the visits. Residents' responsibilities were delegated through a preparation checklist. A standardized progress note was developed to encourage patient goal setting and to track relevant laboratory test results. To evaluate our program, we conducted surveys to determine patients' behavioral changes and satisfaction levels and assessed the effect on group visit participants' glycated hemoglobin (HbA1c) and low-density lipoprotein (LDL) levels.


RESULTS
Group visit patient survey results showed that 72% of the patients in the group visit cohort reported making a lifestyle change; 88% felt that the group visit helped them achieve better control of their diabetes, and 100% stated that they would come to a group visit again. However, no significant changes were noted in HbA1c or LDL levels.


CONCLUSIONS
Residents can overcome challenges and implement, organize, and run effective group visits that increase patients' self-reported self-management abilities, but we could demonstrate no statistically significant improvement on measurable biochemical parameters of glucose or lipid control.
Wheelock
Chris
C
Te Korowai Health Center, Thames, New Zealand. chriswheelock@yahoo.com
Savageau
Judith A
JA
Silk
Hugh
H
Lee
Scott
S
D000328:Adult; D000368:Aged; D003920:Diabetes Mellitus / Q000097:blood / Q000453:epidemiology*; D005194:Family Practice / Q000193:education; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006040:Goals; D006126:Group Processes; D015438:Health Behavior; D006801:Humans; D007396:Internship and Residency; D008019:Life Style; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D017060:Patient Satisfaction; D015397:Program Evaluation; D014505:Urban Population
D006442:Glycated Hemoglobin; D008077:Lipoproteins, LDL; C517652:hemoglobin A1c protein, human