scholarly journals Shared Medical Appointments and Prediabetes: The Power of the Group

2021 ◽  
Vol 19 (3) ◽  
pp. 258-261
Author(s):  
Aphrodite Papadakis ◽  
Elizabeth R. Pfoh ◽  
Bo Hu ◽  
Xiaobo Liu ◽  
Michael B. Rothberg ◽  
...  
Keyword(s):  
Shared Medical Appointments

scholarly journals Evaluating the Effectiveness of Diabetes Shared Medical Appointments (SMAs) as Implemented in Five Veterans Affairs Health Systems: a Multi-site Cluster Randomized Pragmatic Trial

2021 ◽  
Author(s):  
Michele Heisler ◽  
Jennifer Burgess ◽  
Jeffrey Cass ◽  
John F. Chardos ◽  
Alexander B. Guirguis ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Usual Care ◽  
Health Systems ◽  
Pragmatic Trial ◽  
Veterans Affairs ◽  
Control Group ◽  
Shared Medical Appointments ◽  
Site Cluster ◽  
Cluster Randomized

Abstract Objective To examine whether diabetes shared medical appointments (SMAs) implemented as part of usual clinical practice in diverse health systems are more effective than usual care in improving and sustaining A1c improvements. Research Design and Methods A multi-site cluster randomized pragmatic trial examining implementation in clinical practice of diabetes SMAs in five Veterans Affairs (VA) health systems was conducted from 2016 to 2020 among 1537 adults with type 2 diabetes and elevated A1cs. Eligible patients were randomly assigned to either: (1) invitation to participate in a series of SMAs totaling 8–9 h; or (2) continuation of usual care. Relative change in A1c (primary outcome) and in systolic blood pressure, insulin starts, statin starts, and anti-hypertensive medication classes (secondary outcomes) were measured as part of usual clinical care at baseline, at 6 months and at 12 months (~7 months after conclusion of the final SMA in four of five sites). We examined outcomes in three samples of SMA participants: all those scheduled for a SMA, those attending at least one SMA, and those attending at least half of SMAs. Results Baseline mean A1c was 9.0%. Participants scheduled for an SMA achieved A1c reductions 0.35% points greater than the control group between baseline and 6-months follow up (p = .001). Those who attended at least one SMA achieved reductions 0.42 % points greater (p < .001), and those who attended at least half of scheduled SMAs achieved reductions 0.53 % points greater (p < .001) than the control group. At 12-month follow-up, the three SMA analysis samples achieved reductions from baseline ranging from 0.16 % points (p = 0.12) to 0.29 % points (p = .06) greater than the control group. Conclusions Diabetes SMAs as implemented in real-life diverse clinical practices improve glycemic control more than usual care immediately after the SMAs, but relative gains are not maintained. Our findings suggest the need for further study of whether a longer term SMA model or other follow-up strategies would sustain relative clinical improvements associated with this intervention. Trial Registration ClinicalTrials.gov ID NCT02132676

Implementation of Shared Medical Appointments to Offer Battlefield Acupuncture Efficiently to Veterans with Pain

2018 ◽  
Vol 36 (2) ◽  
pp. 124-126 ◽  
Author(s):  
Daniel Glenn Federman ◽  
Lorie M Poulin ◽  
Christopher B Ruser ◽  
Jeffrey D Kravetz
Keyword(s):  
Shared Medical Appointments

Abstract 131: Shared Medical Appointments for Heart Failure Patients Improve Cardiac Health Status

2015 ◽  
Vol 8 (suppl_2) ◽  
Author(s):  
Sandesh Dev ◽  
Kathryn E Williams ◽  
Helen M Hatseras ◽  
Matthew Weyer ◽  
Sona S Hepfinger ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Health Status ◽  
Physical Function ◽  
Summary Score ◽  
Shared Medical Appointments ◽  
Group Visits ◽  
Average Change ◽  
Specific Health

Objective: Heart Failure Shared Medical Appointments (HF SMAs) are group visits in which several HF patients are treated by a clinician(s) at the same time. This intervention is a system redesign that addresses growing health system and patient care burdens in chronic HF management. Group visits have been associated with greater adherence to select HF medications and hospitalization-free survival during the intervention. However, there is little data on patient-reported outcomes such as HF-specific health status, an important outcome that quantifies the impact of the patient’s HF on his or her life. The objective of this pilot study is to determine whether HF SMA is associated with a change in HF-specific health status. The short version Kansas City Cardiomyopathy Questionnaire (KCCQ-12) measures HF-specific health status, including symptoms, physical and social function, and quality of life. Methods: We retrospectively collected patient characteristics by review of medical records for all patients in a VA hospital that completed the full HF SMA intervention (4 visits across 8 weeks). Each patient completed the KCCQ-12 at the beginning of each clinic visit. The primary outcome was change in KCCQ Summary Score(range 0 to 100; higher scores indicate better health status; 5 points is a clinically meaningful change). The secondary outcome was change in KCCQ subscales. Results: Twenty-eight patients (median age 64, median LVEF 35%) completed all four HF SMA visits. The mean KCCQ at baseline was 51. From pre- to post-SMA, the average change in KCCQ-12 Summary Score was +8 (p=0.001). The Quality of Life Subscale was associated with the greatest change (average change,+15, p=0.0003), followed by Symptom Scale (average change +10, p=0.002). There was no significant change in Social Limitation (average change +6, p=0.08) or Physical Function (average change +2, p=0.48). Conclusions: Preliminary findings suggest that a novel group intervention in patients with HF is associated with mild to moderate clinically significant changes in HF-specific health status. Further, HF SMA appears to specifically improve quality of life and symptoms more than physical function. Future clinical trials will be required to determine how these improvements compare to usual care.

Abstract TP419: Shared Medical Appointments: Supporting Stroke Care Transitions Through Improved Knowledge and Peer Support

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Kathleen Burns ◽  
Karen S Theodore
Keyword(s):  
Risk Factors ◽  
Transitional Care ◽  
Care Transitions ◽  
Individual Risk ◽  
Stroke Severity ◽  
Stroke Patients ◽  
Shared Medical Appointments ◽  
Complex Needs ◽  
Improved Outcomes ◽  
Hospital To Home

Background: Stroke patients have complex needs and are at high risk for complications, making transitional care critical to achieving improved outcomes. Although shared medical appointments (SMAs) are known to improve outcomes for other patient populations, evidence supporting SMA benefit for stroke patient transition from hospital to home is lacking. This study’s purpose was to examine feasibility of participation, patient satisfaction and understanding of key stroke topics following a transitional stroke SMA. Methods: Inclusion criteria for this study included: age 18 years or older, hospitalized for stroke/TIA, and planned discharge to home. Individuals with deficits impairing group participation were excluded. Eligible patients were educated on and invited to attend a SMA occurring 1-2weeks after hospital discharge. The SMA included a private exam and interactive group session to address key stroke topics: 1) medication compliance 2) individual risk factors, 3) secondary prevention, 4) signs of stroke and 5) actions for signs of stroke. Following the SMA, participants completed a two-part survey seeking a) a yes/no response to assess increased understanding of stroke topics, and b) level of agreement on satisfaction with the SMA format. Responses were analyzed using descriptive statistics. Results: While 15 patients agreed to participate prior to discharge, only eight attended the SMA. Attendees were primarily male (75%) with an ischemic stroke diagnosis (63%). The majority who did not attend were female (71%) and without family present during in-hospital education and invitation (86%). Age, stroke severity and stroke risk factors for both groups were otherwise similar. All participants reported an increased understanding of all stroke topics and 95% were satisfied with the SMA. Conclusion: Findings support use of SMAs for stroke patients transitioning from hospital to home. Reinforcing key stroke topics in a peer supported environment may increase understanding and compliance, leading to improved outcomes. Additional research is warranted to explore barriers to SMA participation.

Shared medical appointments for Innu patients with well-controlled diabetes in a Northern First Nation Community

2021 ◽  
Vol 26 (1) ◽  
pp. 19
Author(s):  
Yordan Karaivanov ◽  
EmilyE Philpott ◽  
Shabnam Asghari ◽  
John Graham ◽  
DavidM Lane
Keyword(s):  
First Nation ◽  
Shared Medical Appointments

scholarly journals Adapting Diabetes Shared Medical Appointments to Fit Context for Practice-Based Research (PBR)

2020 ◽  
Vol 33 (5) ◽  
pp. 716-727
Author(s):  
Bethany M. Kwan ◽  
Jenny Rementer ◽  
Natalie D. Ritchie ◽  
Andrea L. Nederveld ◽  
Phoutdavone Phimphasone-Brady ◽  
...  
Keyword(s):  
Shared Medical Appointments ◽  
Practice Based Research

Games as a Unique Teaching Strategy Used in Diabetes Shared Medical Appointments

2019 ◽  
Vol 7 (2) ◽  
pp. 12-17 ◽  
Author(s):  
Amy M. Egras ◽  
Neva White ◽  
Victor Diaz ◽  
Kyle Holsinger
Keyword(s):  
Teaching Strategy ◽  
Shared Medical Appointments
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