Improved Outcomes in Diabetes Care for Rural African Americans

The Article in Brief

Improved Outcomes in Diabetes Care for Rural African Americans

Paul Bray , and colleagues

Background Rural, low-income African American patients with diabetes traditionally have poorer clinical outcomes and limited access to state-of-the-art diabetes care. This study tests the effectiveness of a model of redesigned care on intermediate and long-term glycemic, blood pressure, and lipid levels for African American primary care patients with type 2 diabetes.

What This Study Found Redesigning diabetes care to incorporate interprofessional care management results in significantly improved glycemic control among rural, low-income African-American patients. Analyzing data on 727 diabetic patients at 3 rural primary care practices, researchers found patients in the intervention group who received point-of-care education, coaching, and medication intensification from a care management team comprised of a nurse, pharmacist, and dietician had significantly greater reduction in mean hemoglobin A1c levels than those receiving usual care at the 18-month and 36-month follow-ups . Moreover, a significantly greater percentage of patients in the intervention practices achieved a hemoglobin A1c value of less than 7.5 percent at the final assessments, and the proportion achieving a systolic blood pressure of less than 140 mm Hg was also substantially greater in the intervention group.

Implications

• The findings suggest that a portion of chronic diabetes management can be accomplished with an interprofessional team, potentially making clinicians more available for acute problems.