A Multidisciplinary Diabetes Clinic Improves Clinical and Behavioural Outcomes in a Primary Care Settings
Multidisciplinary Diabetes Clinics must be associated with improved outcomes for patients. The use of multidisciplinary teams is widely recommended to improve diabetes management. Studies have shown that treatment of diabetes in multidisciplinary teams with pharmacists or behavioural health professionals is associated with decreased A1c and more rapid attainment of associated goals. Hence, Shay Phillips and colleagues conducted study titled “A Multidisciplinary Diabetes Clinic Improves Clinical and Behavioural Outcomes in a Primary Care Setting” published in Journal of The American Board of Family Medicine.
Objective:
The study objective was to evaluate the effects of a multidisciplinary approach on behavioural outcomes and mean change in A1c in patients with type 2 diabetes.
Methods:
The study assessed 111 patients recruited from a safety-net primary care. A1c values were measured every 3 months, and a self-efficacy scale to measure behaviours was evaluated at baseline and 6 months.
Findings:
The use of a multidisciplinary team approach in diabetes care is correlated with a statistically significant improvement in mean A1c control and behavioural outcomes. The finding of a greater decrease in A1c is consistent with studies evaluating the role of interdisciplinary members in improving diabetes care. The clinic used multiple disciplines along with techniques of Shared Decision Making and motivational interviewing to address the many facets of diabetes management. In addition, a systematic review of multidisciplinary management found there was overall statistically improved A1c values as well as improvement in health-related quality of life, patient self-care abilities, and patient knowledge of diabetes. Practices that have a different mix of health care professionals may benefit from reviewing standard.
Limitations:
Potential cross contamination, Resident physicians where biased management may have delayed arm patients. Resident physicians who rotated through the diabetes clinic may have also served as the primary care providers for patients randomized to the delayed-start arm. Loss to follow-up was also higher than expected.
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