Skip to main content

Advertisement

SpringerLink
Log in

Changing office practice and health care systems to facilitate diabetes self-management

  • Published:
Current Diabetes Reports Aims and scope Submit manuscript

Abstract

Diabetes is a self-managed disease for which patients provide 99% of their own care. For patients to succeed as diabetes self-managers, they need office practices and health care systems that can prepare and support them in their diabetes self-management efforts over the long term. In order to provide effective diabetes education and ongoing support, office practices and health care systems will have to fundamentally redefine the roles of health professionals and patients with diabetes, and redesign practices and systems to allow for effective long-term self-management education and support. Although it is difficult for both people and systems to change, change is essential if we are going to provide self-management support for the majority of patients suffering from this serious chronic disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Thorne SE, Paterson BL: Health care professional support for self-care management in chronic illness: insights from diabetes research. Patient Educ Couns 2001, 42:81–90.

    Article  CAS  PubMed  Google Scholar 

  2. Anderson RM, Funnell MM: Compliance and adherence are dysfunctional concepts in diabetes care. Diabetes Educ 2000, 26:597–604.

    CAS  PubMed  Google Scholar 

  3. Funnell MM, Anderson RM: MSJAMA: the problem with compliance in diabetes. JAMA 2000, 284:1709.

    Article  CAS  PubMed  Google Scholar 

  4. Funnell MM, Anderson RM: Working toward the next generation of diabetes self-management education. Am J Prev Med 2002, 22:3–6.

    Article  PubMed  Google Scholar 

  5. Norris SL, Engelgau MM, Naranyan KM: Effectiveness of self- management training in type 2 diabetes: a systematic review of randomized controlled trails. Diabetes Care 2001, 24:561–587.

    Article  CAS  PubMed  Google Scholar 

  6. Norris SL, Lau J, Smith SJ, et al.: Self-management education for adults with type 2 diabetes: a meta-analysis on the effect on glycemic control. Diabetes Care 2002, 25:1159–1171. Presents the results of a meta-analysis of the effectiveness of DSME on glycemic control for people with diabetes. Thirty interventions are reported and indicated that education is effective for reducing A1c levels for the short term.

    Article  PubMed  Google Scholar 

  7. Piette JD, Glasgow RE: Education and self-monitoring of blood glucose. In Evidence-based Diabetes Care. Edited by Gerstein HC, Haynes RB. Ontario, CA: B.C. Decker; 2001:207–251.

    Google Scholar 

  8. Brown SA: Interventions to promote diabetes self-management: state of the science. Diabetes Educ 1999, 25(suppl 5):52–61.

    CAS  PubMed  Google Scholar 

  9. Roter DL, Hall JA, Merisca R, et al.: Effectiveness of interventions to improve patient compliance: a meta-analysis. Med Care 1998, 36:1138–1161.

    Article  CAS  PubMed  Google Scholar 

  10. Hiss RG, Gillard Armbruster BA, McClure LA: Comprehensive evaluation of community-based diabetic patients: effect of feedback to patients and their physicians: a randomized controlled trial. Diabetes Care 2001, 24:690–694.

    Article  CAS  PubMed  Google Scholar 

  11. Wagner EH, Austin BT, Von Korff M: Improving outcomes in chronic illness. Manag Care Q 1996, 4:12–25.

    CAS  PubMed  Google Scholar 

  12. Wagner EH, Austin BT, Von Korff M: Organizing care for patients with chronic illness. Milbank Q 1996, 74:511–544.

    Article  CAS  PubMed  Google Scholar 

  13. Rayman KM, Ellison GC: When management works: an organizational culture that facilitates learning to self-manage type 2 diabetes. Diabetes Educ 1998, 24:612–617.

    Article  CAS  PubMed  Google Scholar 

  14. Von Korff M, Gruman J, Schaefer J, etal.: Collaborative management of chronic illness. Ann Intern Med 1997, 127:1097–1102.

    Google Scholar 

  15. Wagner EH, Glasgow RE, David C, et al.: Quality improvement in chronic illness care: a collaborative approach. Jt Comm J Qual Improv 2001, 27:63–80. Describes the chronic disease model and effective strategies used by 23 teams to make improvements in their practice and health care system during the chronic illness BTS. The rapid cycle model for improvement is also discussed and examples of common and innovative strategies are included.

    CAS  PubMed  Google Scholar 

  16. Glasgow RE, Funnell MM, Bonomi AE, et al.: Self-management aspects of the Improving Chronic Illness Care Breakthrough series: design and implementation with diabetes and heart failure teams. Ann Behav Med 2002, 24:80–87. Describes efforts to integrate self-management support into routine medical care by diabetes and congestive heart failure teams in the chronic illness care BTS. The experiences and strategies used by 21 health care teams are reported.

    Article  PubMed  Google Scholar 

  17. Glasgow RE, Hiss RG, Anderson RM, et al.: Report of health care delivery work group: behavioral research related to the establishment of a chronic disease model for diabetes care. Diabetes Care 2001, 24:124–130.

    Article  CAS  PubMed  Google Scholar 

  18. Wagner EH: More than a case manager. Ann Intern Med 1998, 129:654–656.

    CAS  PubMed  Google Scholar 

  19. Renders CM, Valk GD, Griffin S, et al.: Interventions to improve the management of diabetes mellitus in primary care, outpatient and community settings. Cochrane Database Syst Rev 2001, (1):CD001481.

  20. Renders CM, Valk GD, Griffin SJ, et al.: Interventions to improve the management of diabetes in primary care, outpatient, and community settings: a systematic review. Diabetes Care 2001, 24:1821–1833. Presents the results of a systematic review of practice-based interventions to improve the care of people with diabetes. Forty-one intervention studies are reported and common strategies are identified.

    Article  CAS  PubMed  Google Scholar 

  21. Glasgow RE, Eakins EG: Medical office-based interventions. In Psychology in Diabetes Care. Edited by Snoek FJ, Skinner TC. Chichester, England: JW Wiley and Sons; 2000:141–168. Describes effective medical office-based interventions for psychological or behavioral care. Studies of effective interventions in diabetes and other chronic illnesses are described, as are practical interventions.

    Chapter  Google Scholar 

  22. National Diabetes Education Program: Team Care: Comprehensive Lifetime Management for Diabetes. Bethesda, MD: National Institutes of Health and the Centers for Disease Control and Prevention; 2001. This booklet describes the importance of team care for improving outcomes and includes strategies for team development and team building.

    Google Scholar 

  23. Wagner EH: The role of patient care teams in chronic disease management. BMJ 2000, 320:569–572.

    Article  CAS  PubMed  Google Scholar 

  24. Centers of Disease Control and Prevention: Strategies for reducing morbidity and mortality from diabetes through health-care system interventions and diabetes self-management education in community settings: a report on recommendations of the Task Force on Community Preventive Services. Morb Mortal Wkly Rep 2001, 50(RR-16):1–15.

    Google Scholar 

  25. Norris SL, Nichols PJ, Caspersen CJ, et al.: The effectiveness of disease and case management for people with diabetes: a systematic review. Am J Prev Med 2002, 22:15–38. Presents the results of a systematic review of the effectiveness and economic efficiency of disease management and case management for people with diabetes. Twenty-seven interventions for disease management and 15 for case management are reported.

    Article  PubMed  Google Scholar 

  26. Graber AL, Elasy TA, Quinn D, et al.: Improving glycemic control in adults with diabetes: shared responsibility in primary care practices. South Med J 2002, 95:684–690.

    PubMed  Google Scholar 

  27. Parchman ML, Pugh JA, Noel PH, Larme AC: Continuity of care, self-management behaviors, and glucose control in patients with type 2 diabetes. Med Care 2002, 40:137–144.

    Article  PubMed  Google Scholar 

  28. Sikka R, Waters J, Moore W, et al.: Renal assessment practices and the effect of nurse case management of health maintenance organization patients with diabetes. Diabetes Care 1999,22:1–6.

    Article  CAS  PubMed  Google Scholar 

  29. Williams GC, Zeldman A: Patient-centered diabetes self-management education. Curr Med 2002, 2:145–152.

    Article  Google Scholar 

  30. Piette JD, Weinberger M, McPhee SJ: The effect of automated calls with telephone nurse follow-up on patient-centered outcomes of diabetes care: a randomized, controlled trial. Med Care 2000, 38:218–230.

    Article  CAS  PubMed  Google Scholar 

  31. Dickey LL, Gemson DH, Carney P: Office system interventions supporting primary care-based health behavior change counseling. Am J Prev Med 1999, 17:299–308.

    Article  CAS  PubMed  Google Scholar 

  32. Smith L, Weinert C: Telecommunication support for rural women with diabetes. Diabetes Educ 2000, 26:645–655.

    CAS  PubMed  Google Scholar 

  33. Whitlock WL, Brown A, Moore K, et al.: Telemedicine improved diabetic management. Mil Med 2000, 165:579–584.

    CAS  PubMed  Google Scholar 

  34. Kalten MR, Ardito DA, Cimino C, Wylie-Rosett J: A web-accessible core weight management program. Diabetes Educ 2000, 26:929–936.

    CAS  PubMed  Google Scholar 

  35. Lehmann ED: Spontaneous comments from users of the AIDA interactive educational diabetes simulator. Diabetes Educ 2000, 26:633–638.

    CAS  PubMed  Google Scholar 

  36. Iafusco D, Ingenito N, Prisco F: The chatline as a communication and educational tool in adolescents with insulin-dependent diabetes: preliminary observations. Diabetes Care 2000, 23:1853.

    Article  CAS  PubMed  Google Scholar 

  37. Beck A, Scott J, Williams P, et al.: A randomized trial of group outpatient visits for chronically ill older HMO members: the Cooperative Health Care Clinic. J Am Geriatr Soc 1997, 45:543–549.

    CAS  PubMed  Google Scholar 

  38. Trento M, Passera P, Tomalino M, et al.: Group visits improve metabolic control in type 2 diabetes: a 2 year follow-up. Diabetes Care 2001, 24:995–1000.

    Article  CAS  PubMed  Google Scholar 

  39. Wagner EH, Grothaus LC, Sandhu N, etal.: Chronic care clinics for diabetes in primary care: a system-wide randomized trial. Diabetes Care 2001, 24:695–700.

    Article  CAS  PubMed  Google Scholar 

  40. McDiarmid T, Chambliss ML, Koval PB, Houck S: Improving office-based preventive care for diabetes. The beneficial results of a patient questionnaire and a flow chart. N C Med J 2001, 62:8–13.

    CAS  PubMed  Google Scholar 

  41. Buck TF: Public health strategies to enhance diabetes clinical preventive services. Tenn Med 2000, 93:417–418.

    CAS  PubMed  Google Scholar 

  42. Kaufman MW, All AC, David H: The scope of practice of diabetes educators in the state of Georgia. Diabetes Educ 1999, 25:56–64.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Michigan Diabetes Research and Training Center, 1331 E. Ann Street, Box 0580, 48109-0580, Ann Arbor, MI, USA

    Martha M. Funnell MS, RN, CDE

Authors
  1. Martha M. Funnell MS, RN, CDE
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Robert M. Anderson EdD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Funnell, M.M., Anderson, R.M. Changing office practice and health care systems to facilitate diabetes self-management. Curr Diab Rep 3, 127–133 (2003). https://doi.org/10.1007/s11892-003-0036-7

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11892-003-0036-7

Keywords

Search

Navigation