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Integrating nurse-directed diabetes management into a primary care setting
Mayer B Davidson1, Maria Blanco-Castellanos, Petra Duran
1Department of Internal Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA. mayerdavidson@cdrewu.edu
The American Journal of Managed Care
|September 30, 2010
Summary
Integrated diabetes care models improve patient outcomes. Nurse-led primary care integration achieved similar glycosylated hemoglobin (A1C) levels to nonintegrated models, with better achievement of multiple treatment goals.
Area of Science:
- Endocrinology
- Primary Care Medicine
- Health Services Research
Background:
- Diabetes management requires effective models to improve patient outcomes.
- Comparing integrated versus nonintegrated care delivery is crucial for optimizing diabetes care.
Purpose of the Study:
- To compare nurse-directed diabetes management outcomes between integrated and nonintegrated models.
- To evaluate the effectiveness of a nurse practitioner in primary care for diabetes management.
Main Methods:
- Observational study comparing two nurse-directed diabetes management models.
- Nonintegrated model: separate diabetes clinic; Integrated model: nurse within primary care.
- Nurses had prescription authority and followed treatment algorithms.
Main Results:
- Both models achieved similar final glycosylated hemoglobin (A1C) levels (7.0% vs 7.2%).
- The integrated model showed higher achievement of low-density lipoprotein cholesterol (96%) and blood pressure (90%) goals.
- 47% of patients in the integrated model met all three goals (A1C, LDL-C, BP).
Conclusions:
- An integrated model of diabetes care is generalizable and effective.
- Policy makers should consider integrated models to enhance diabetes outcomes.
- Integrated care may particularly benefit underserved minority populations.
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