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Shared Medical Appointments: An Intervention for Diabetes Management

Abstract Background: Uncontrolled diabetes often develops into complications that are very expensive for both the patient and the healthcare system. Shared Medical Appointments (SMAs) are an evidence-based intervention that has been shown to improve participants’ biophysical outcomes and their ability to manage their disease, which can reduce long-term complications and expense. Project Goal: This project evaluated biophysical outcomes and self-efficacy among a group of primary care patients with uncontrolled diabetes who attended a pilot SMA intervention. Study design and Methods: A pre-test/post-test design utilizing a nonrandomized convenience sample over a 6-month time frame was utilized. Self-efficacy was measured using the Diabetes Empowerment Scale-Short Form (DES-SF). Biophysical measurements included: glycated hemoglobin (HgbA1c), high-density lipoprotein (HDL), low-density lipoprotein (LDL), blood pressure (both systolic and diastolic), weight, and triglycerides. Quantitative data was analyzed using the Wilcoxon-signed rank test to evaluate pre/post effects of the SMA intervention. Results: Descriptive analysis showed a significant reduction in LDL with a median difference of 11.8 mg/dL (p<0.43), and a significant increase in HDL with a median difference of 3.5 mg/dL (p<0.43). HgbA1c, self-efficacy scores, and diastolic blood pressure showed improvements, but were not found to be statistically significant (p< .128, p< .172, p< .610, respectively). There were no changes in weight. Both systolic blood pressure and triglycerides were found to have increased slightly. Conclusion: The intervention showed significant improvements in some measurable outcomes, but not in others. A larger sample size would provide stronger evidence of the impact of the SMA. A homogenous format would also help to determine which components are most effective. Keywords: diabetes, intervention, shared medical appointment, group visits