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Effectiveness of Shared Medical Appointments in Diabetes Care

Shared medical appointments show promise in treating veterans with diabetes…. 

Veterans at the West Haven Veterans Affairs Medical Center of Connecticut with HbA1C > 9% or worsening diabetes control were identified and offered the opportunity to participate in shared medical appointments. Each visit was 90 minutes in length and patients were scheduled to receive education from the RN, pharmacist, health psychologist, and dietitian team as well as participate in peer support/education.

The veterans showed an average decline in HbA1C whether they attended 1, 2, 3 or 4 shared medical visits. However the decline in HbA1C was only statistically significant in those who had a baseline HbA1C >9% prior to the study. There was no comparison of HbA1C decline between those patients who attended shared medical appointments and those who did not. Since there was no control group, causality of the decline in HbA1C is difficult to assess. Also, the study failed to address patient compliance in general.

Cost effectiveness and cost benefit studies are hard to find in this subset of shared medical appointments. Studies assessing cost effectiveness of shared medical appointments are available for treatment in different disease states such as glaucoma, neuromuscular disease, and dermatology however not specifically for diabetes care. Current cost analysis models show that shared medical appointments improve mean patient census and per hour profits to clinics/offices. Further economic studies need to be completed specifically focused on diabetes care.

Practice Pearls
  • Shared medical appointments allow patients to meet in a group of like individuals to share their experiences, problems and successes.
  • Previous studies have demonstrated that shared medical appointments allow easy access to an interdisciplinary team which has been shown to be beneficial to improving diabetes-related end points compared with usual care.
  • Prior studies reveal that shared medical appointments result in a cost effective model with significantly lower healthcare and societal costs.

Guirguis, A. et al. Improving Diabetes Control Using Shared Medical Appointments. The American Journal of Medicine, published online September 26, 2013.