Issue 112 Item 15 Effectiveness of a Physician – Patient Education Program in Di

Study demonstrates that physician and patient education from a Diabetes Health Educator is effective in the private practice Management of diabetic patients is often complicated by factors such as cost, patient compliance, and physician education. This study was conducted to determine if an external Diabetes Health Educator (DHE) within a private practice could improve the health outcomes of diabetics within the practice.

A DHE working 24 hours per week using chart reviews to identify patients and perform physician-patient education programs. Variables including; hemoglobin (HbA1c), creatinine, blood pressure (BP), lipids, micro-albumin, Body Mass Index (BMI) and compliance with other diabetic care indicators were measured at baseline, 6 and 12 months. The practice contained 476 diabetics, and were divided into Education (n-305) and Non-education (n=171) groups. Non-Equivalent Control group, significance testing included repeated measures Analysis of Variance or Analysis of Covariance (ANOVA and ANCOVA) and between group t-tests. McNemar Change Tests (MCT) were performed on stratified risk and non-risk groupings using cut-points for clinical values.

The results showed that there were no demographic differences between groups for gender, ethnicity or age (all p>0.30). Baseline comparisons indicated no significant differences BMI, systolic or diastolic BP, cholesterol, HDL, LDL or, triglycerides (all p>0.10). There was a baseline difference in HbA1c (p<0.001) between Education and Non-education groups (8.13±1.96 and 7.09±1.52, respectively, mean±sd). ANOVA and ANCOVA (for HbA1c) indicated significant improvement in the education group for HbA1c (p<0.001), HDL (p=0.050), LDL (p<0.001), cholesterol (p=0.001) and Diastolic BP (p=0.002). MCT revealed significant that risk factor reduction for HbA1c, HDL and DBP occurred in the first six months, while cholesterol and LDL effects occurred at the end of the first year. Non-education group showed a significant improvement for HDL (p=0.028) and Diastolic BP (p=0.043), however MCT indicated that these effects were not sustained, nor did they improve patient condition below risk factor range.

This study demonstrates that physician and patient education from a DHE is effective in the private practice management of the diabetic population. This model of care allows for determination of program effectiveness and reports on the timing of treatment effects, allowing clinicians to know when treatment effects will occur. ENDO 2002 [P3-674]