Providers' perspective on diabetes case management: a descriptive study

To address the physicians' perspective on case management (CM) for diabetes.

A nested descriptive study in a randomized controlled trial of diabetic patients who had blood pressure >140/90 mm Hg, glycated hemoglobin >9.0%, or lowdensity lipoprotein level >100 mg/dL. Patients received CM (n = 278) versus usual care over a period of 1 year. Surveys were designed to assess physicians' comfort in working with case managers. At the end of the study physicians whose patients were randomized in the trial were mailed these surveys.

A total of 51 of the 72 providers completed the survey (70.8% response rate). The majority of the providers felt very comfortable working with case managers (91.5 %), found treatment provided by CM to be accurate (93.3%),reported that having case managers increased the likelihood of adherence to the treatment regimens (89.4%), and reported overall improved patient satisfaction with CM (93.5%). Seventy-four percent of the providers reported that working with case managers increased the number of patients who were able to achieve therapeutic goals. Almost all providers (99.74%) reported that they will likely consult case managers for management of poorly controlled diabetes.

Co-managing diabetes patients with nurse case managers did not undermine the providers' perceived professional role. In fact, having CM increased the rate of achieving therapeutic goals among patients with diabetes and cardiovascular risk factors.