Shared Medical Appointments and Their Effects on Achieving Diabetes Mellitus Goals in a Veteran Population
Limitations
This study had several limitations. The external validity was weakened by the modest sample size and the homogenous baseline characteristics of those enrolled. Another limitation was inconsistent documentation of laboratory parameters. The inability to obtain A1c values exactly at enrollment and discharge could have potentially skewed the results. In addition, incomplete documentation of interventions for dual-care patients (ie, those who obtained care outside of the VA) was an unavoidable challenge. Last, this study did not perform an assessment of SMA patient satisfaction, cost-benefit, or safety.
Conclusion
The ABJ SMA was an effective addition to standards of care in order to achieve improvements in glycemic control in a veteran population with poorly controlled T2DM. Furthermore,the data suggest that a successful program should be multidisciplinary, select poorly controlled patients, offer focused sessions, have a CPS participate in medication management, and encourage patients to complete ≥ 6 sessions. Future studies should be conducted to include more diverse patients to see whether the efficacy of this SMA format is maintained.
A safety analysis should also be conducted to ensure that the SMA format is not only effective, but also a safe means to manage medical conditions. In addition, the scope of the ABJ SMAs should be expanded to allow for evaluation of other diseases. An evaluation of patient satisfaction and cost-benefit could provide additional support for the implementation of SMAs, as improvements in quality of life and cost savings are endpoints to be desired.
Author disclosures
The authors report no actual or potential conflicts of interest with regard to this article.
Disclaimer
The opinions expressed herein are those of the authors and do not necessarily reflect those of Federal Practitioner, Frontline Medical Communications Inc., the U.S. Government, or any of its agencies. This article may discuss unlabeled or investigational use of certain drugs. Please review complete prescribing information for specific drugs or drug combinations—including indications, contraindications, warnings, and adverse effects—before administering pharmacologic therapy to patients.
