Journal of General Internal Medicine

, Volume 22, Issue 5, pp 620–624

Group Visits: Promoting Adherence to Diabetes Guidelines

  • Dawn E. Clancy
  • Peng Huang
  • Eni Okonofua
  • Derik Yeager
  • Kathryn Marley Magruder
Original Article

DOI: 10.1007/s11606-007-0150-3

Cite this article as:
Clancy, D.E., Huang, P., Okonofua, E. et al. J GEN INTERN MED (2007) 22: 620. doi:10.1007/s11606-007-0150-3

Abstract

BACKGROUND

Current diabetes management guidelines offer blueprints for providers, yet type 2 diabetes control is often poor in disadvantaged populations. The group visit is a new treatment modality originating in managed care for efficient service delivery to patients with chronic health problems. Group visits offer promise for delivering care to diabetic patients, as visits are lengthier and can be more frequent, more organized, and more educational.

OBJECTIVE

To evaluate the effect of group visits on clinical outcomes, concordance with 10 American Diabetes Association (ADA) guidelines [American Diabetes Association, Diabetes Care, 28:S4–36, 2004] and 3 United States Preventive Services Task Force (USPSTF) cancer screens [U.S. Preventive Services Task Force, http://www.ahrq.gov/clinic/uspstf/resource.htm, 2003].

RESEARCH DESIGN AND METHODS

A 12-month randomized controlled trial of 186 diabetic patients comparing care in group visits with care in the traditional patient–physician dyad. Clinical outcomes (HbA1c, blood pressure [BP], lipid profiles) were assessed at 6 and 12 months and quality of care measures (adherence to 10 ADA guidelines and 3 USPSTF cancer screens) at 12 months.

RESULTS

At both measurement points, HbA1c, BP, and lipid levels did not differ significantly for patients attending group visits versus those in usual care. At 12 months, however, patients receiving care in group visits exhibited greater concordance with ADA process-of-care indicators (p < .0001) and higher screening rates for cancers of the breast (80 vs. 68%, p = .006) and cervix (80 vs 68%, p = .019).

CONCLUSIONS

Group visits can improve the quality of care for diabetic patients, but modifications to the content and style of group visits may be necessary to achieve improved clinical outcomes.

KEY WORDS

group visitsguideline concordancetype 2 diabetes control

Copyright information

© Society of General Internal Medicine 2007

Authors and Affiliations

  • Dawn E. Clancy
    • 1
    • 5
  • Peng Huang
    • 2
  • Eni Okonofua
    • 1
  • Derik Yeager
    • 3
  • Kathryn Marley Magruder
    • 4
  1. 1.Department of MedicineMedical University of South Carolina (MUSC)CharlestonUSA
  2. 2.Department of Biometry and EpidemiologyMedical University of South Carolina (MUSC)CharlestonUSA
  3. 3.Medical University of South Carolina (MUSC)CharlestonUSA
  4. 4.Department of Psychiatry and Behavioral SciencesMedical University of South Carolina (MUSC)CharlestonUSA
  5. 5.University Internal Medicine ClinicMedical University of South CarolinaCharlestonUSA