Development and Implementation of a Collaborative Team Care Model for Effective Insulin Use in an Academic Medical...

Area of Science:

• Primary Care
• Endocrinology
• Health Services Research

Background:

• Glycemic control in primary care diabetes populations presents significant challenges.
• Effective insulin management is crucial for patients with hyperglycemia.

Purpose of the Study:

• To describe the development, implementation, and outcomes of the Diabetes Care Collaborative Model (DCCM).
• To evaluate the DCCM's impact on glycemic control and insulin use in a patient-centered medical home setting.

Main Methods:

• Development and pilot testing of the DCCM, a collaborative team care process.
• Implementation across 18 primary care practices affiliated with an academic medical center.
• Longitudinal analysis of glycemic control (HbA1c) and insulin prescription patterns.

Main Results:

• Implementation of DCCM was associated with improved glycemic control.
• A significant increase in insulin prescription rates was observed.
• A >1% reduction in the proportion of patients with glycated hemoglobin >9% at 2 years post-implementation (P < .001).

Conclusions:

• The DCCM is an effective strategy for improving glycemic control in primary care diabetes management.
• Collaborative team care, focusing on insulin optimization, yields positive clinical outcomes.
• Stakeholder engagement and theoretical underpinnings facilitated successful implementation.