Implementation of a diabetes self-management education program in primary care for adults using shared medical appointments

Diabetes Educ. May-Jun 2011;37(3):381-91. doi: 10.1177/0145721711401667. Epub 2011 Mar 31.


Purpose: The purpose of this study was to implement diabetes self-management education in primary care using the Chronic Care Model and shared medical appointments (SMA) to provide evidence-based interventions to improve process and measure outcomes.

Methods: A quality improvement project using the Plan-Do-Check-Act cycle was implemented in a primary care setting in South Texas to provide diabetes self-management education for adults. Biological measures were evaluated in 70 patients at initiation of the project and thereafter based on current practice guidelines.

Results: The results of the project were consistent with the literature regarding the benefits, sustainability, and viability of SMA. As compared with that in studies presented in the literature, the patient population who participated in SMA had similar outcomes regarding improvement in A1C, self-management skills, and satisfaction. SMA are an innovative system redesign concept with the potential to provide comprehensive and coordinated care for patients with multiple and chronic health conditions while still being an efficient, effective, financially viable, and sustainable program.

Conclusions: As the incidence and prevalence of diabetes increase, innovative models of care can meet the growing demand for access and utilization of diabetes self-management education programs. Programs focusing on chronic conditions to improve outcomes can be replicated by health care providers in primary care settings. SMA can increase revenue and productivity, improve disease management, and increase provider and patient satisfaction.

MeSH terms

  • Adult
  • Aged
  • Diabetes Mellitus, Type 2 / therapy*
  • Health Plan Implementation
  • Humans
  • Middle Aged
  • Models, Theoretical
  • Outcome and Process Assessment, Health Care*
  • Patient Education as Topic / methods*
  • Patient Education as Topic / organization & administration
  • Primary Health Care
  • Self Care*
  • Texas