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Newly Designed Primary Care Services to Optimize A1c

A cohort study of 727 African-American patients with type 2 diabetes was conducted using interventions such as point-of-care education, coaching, and medication intensification from a team of a nurse, pharmacist, and dietitian…. 

In the study, 368 participants received the intervention and there were 359 controls.

The results showed that patients who received the intervention had a greater reduction in A1c as compared with the controls. At 18 months, the reduction in A1C among the intervention and controls was −0.5 versus −0.2 percent, respectively. At 36 months, the reduction in A1C among the intervention and controls was −0.5 versus −0.1 percent, respectively. In addition, the intervention group achieved more A1c levels that were less than 7.5% and systolic blood pressure less than 140 mm Hg compared to the controls.

The researchers state, "Redesigning care strategies in rural fee-for-service primary care practices for African American patients with established diabetes results in significantly improved glycemic control relative to usual care."

Improved Outcomes in Diabetes Care for Rural African Americans. doi: 10.1370/afm.1470. Ann Fam Med March/April 2013 vol. 11 no. 2; 145-150