Careyva, Beth, MD

Johnson, Melanie B, MPA

Shaak, Kyle, BS

Stello, Brian, MD

English

Lehigh Valley Health Network: LVHN Scholarly Works

Lehigh Valley Health NetworkLVHN Scholarly WorksDepartment of Family MedicinePatient Reported Barriers And Limitations toAttending Diabetes Group Visits (Poster)Beth Careyva MDLehigh Valley Health Network, beth_a.careyva@lvhn.orgMelanie B. Johnson MPALehigh Valley Health Network, Melanie_B.Johnson@lvhn.orgKyle Shaak BSLehigh Valley Health Network, Kyle.Shaak@lvhn.orgBrian Stello MDLehigh Valley Health Network, Brian.Stello@lvhn.orgFollow this and additional works at: http://scholarlyworks.lvhn.org/family-medicinePart of the Endocrine System Diseases Commons, Endocrinology, Diabetes, and MetabolismCommons, and the Primary Care CommonsThis Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by anauthorized administrator. For more information, please contact LibraryServices@lvhn.org.Published In/Presented AtCareyva, B., Johnson, M., Shaak, K., & Stello, B. (2014, May 3-7). Patient reported barriers and limitations to attending diabetes groupvisits. Presented at: The 47th Soceity of Teachers of Family Medicine (STFM) Annual Spring Conference, San Antonio, TX.Lehigh Valley Health Network, Allentown, PAPatient Reported Barriers to Attending Diabetes Group VisitsBeth Careyva, MD, Melanie Johnson, MPA, Kyle Shaak, BS, Brian Stello, MDReferences:1.	 	Centers	for	Disease	Control	and	Prevention.	National	diabetes	fact	sheet:	national	estimates	and	general	information	on	diabetes	and	prediabetes	in	the	United	States,	2011.	Atlanta,	GA:	U.S.	Department	of	Health	and	Human	Services,	Centers	for	Disease	Control	and	Prevention,	2011.2.	 	Holman	H,	Lorig	K.	Patients	as	partners	in	managing	chronic	disease.	Partnership	is	a	prerequisite	for	effective	and	efficient	health	care.	BMJ	2000;320:526-7.3.	 	Burke	RE,	O’Grady	ET.	Group	visits	hold	great	potential	for	improving	diabetes	care	and	outcomes,	but	best	practices	must	be	developed.	Health	Affairs	2012:31(1):103-109.INTRODUCTION:Type	2	Diabetes	is	a	complex	and	progressive	disease	that	impacts	millions	of	individuals	and	families.		Per	the	Centers	for	Disease	Control,	11.3%	of	those	over	the	age	of	20	in	the	U.S.	are	currently	living	with	diabetes.1			Diabetes	Group	Visits	provide	opportunities	outside	of	the	traditional	patient	visit	to	optimize	adherence	to	diabetes	standards	of	care	and	improve	self	management.2		Despite	evidence	that	Diabetes	Group	Visits	may	improve	satisfaction	and	key	diabetes	parameters,	many	patients	do	not	engage	in	Group	Visits	when	given	the	opportunity.3		This	exploratory	study	aimed	to	delineate	the	motivators,	concerns,	and	barriers	that	may	prevent	adult	patients	with	Type	2	Diabetes	from	attending	Diabetes	Group	Visits.		© 2014 Lehigh Valley Health NetworkMETHOD:	A	registry	was	created	of	adult	patients	with	type	2	diabetes	from	a	hospital	owned,	suburban	family	medicine	practice	in	Eastern	Pennsylvania.		A	cohort	of	50	patients	received	the	initial	pilot	survey	to	explore	barriers	to	Group	Visit	attendance.		Following	revisions	of	the	initial	survey	and	accounting	for	mailing	exclusions,	187	patients	were	invited	to	participate,	and	48	patients	returned	completed	surveys.		Data	was	summarized	with	counts	and	percentages	for	nominal	and	ordinal	data,	and	means	and	standard	deviations	for	continuous	data.DISCUSSION:More	than	half	of	the	patients	surveyed	(54%)	were	interested	in	participation	in	Diabetes	Group	Visits.		A	diverse	number	of	barriers	to	attendance	were	selected.		The	most	frequently	cited	reason	to	not	attend	was	“diabetes	under	control.”		It	is	unclear	if	that	is	objectively	correct	for	patients	in	this	population.	Work	and/or	other	responsibilities	and	time	restraint	barriers	may	be	addressed	by	providing	classes	at	various	time	points	and	by	utilizing	technology	to	hold	online	classes	that	may	be	more	conducive	for	younger	working	adults,	who	potentially	have	the	most	to	benefit	from	improvement	in	diabetes	self	efficacy.	Most	of	the	respondents,	and	particularly	those	under	the	age	of	65	would	prefer	evening	classes.		This	is	noteworthy,	given	that	younger	patients	were	more	interested	in	attending	group	visits	than	those	over	the	age	of	65.		This	study	has	clarified	that	there	is	no	“one	size	fits	all”	Group	Visit	model	that	will	work	for	all	patients.	While	multiple	barriers	to	attending	group	visits	were	identified,	most	patients	surveyed	stated	that	they	would	be	interested	in	Diabetes	Group	Visits	if	available	to	them.		Strategies	to	address	the	patient	identified	system	barriers	including	time,	transportation,	and	copays,	may	increase	participation	in	Diabetes	Group	Visits.Table 1. Baseline Characteristics of Women Undergoing Cell-free Fetal DNA Testing*Mean maternal age (years) 32.3±6.5Advanced maternal age 52%Ethnicity	   Caucasian 72%   Black 7%   Asian/Indian 6%   American Indian 2%   Arabic 1%   Mixed 2%   Unknown 11%Non-hispanic 83%Multiparous 64%Married 58%Private obstetrician 77%Private insurance 52%Singleton gestation 95%High school graduate 89%College graduate 42%Median gestational age (weeks) 18.64	(10.29	–	28.43)TrimesterFirst 25%Second 71%Third 4%Potential Barriers to Attending a Group Visit(Surveyed Participants Indicating No Previous Group Visits, n=42)Figure 3: Likelihood of Group Visit attendance based on Copay as a Barrier.Figure 1: Participant Barriers to Attending  Diabetes Group Visits. Figure 2: Likelihood of Group Visit Attendance based on Self-Reported Diabetes Control.Figure 4: Most Convenient Time of Day for Group Visit by Age.Interested in Attending a Group Visit?(Answered “yes” to “Is Your Diabetes Under Control?”)Likelihood of Attending Group Visit(Copay Would be a Barrier vs. CoPay Wouldn’t be a Barrier)Most Convenient Time of Day for Goup Visits(by Age Group)Interested in Attending a Group Visit?(Answered “Sometimes” to “Is Your Diabetes Under Control?”)35.71%23.81%14.29%45.24%40.48%19.05%11.90% 11.90% 11.90%0.00%10 .00%20 .00%30 .00%40 .00%50 .00%60 .00%70 .00%80 .00%Time Barrier Cost of co-paywould be a problemHas work and/orotherresponsibilitiesTransportationIssuesOther4.75 4.825012345678910Copay would be a problem Copay wouldn’t be a problemLikelihoodScale1 1025514137905101520253031-49 50-64 65+M issingE ven ingA fte rnoonM orn ingMissingNotInterestedNotInterestedInterestedInterested

Patient Reported Barriers And Limitations to Attending Diabetes Group Visits (Poster)

https://scholarlyworks.lvhn.org/cgi/viewcontent.cgi?article=1162&context=family-medicine

Patient Reported Barriers And Limitations to Attending Diabetes Group Visits (Poster)

Abstract

Similar works

Full text

Available Versions

Lehigh Valley Health Network: LVHN Scholarly Works