Care Management For Patients With Type 2 Diabetes: The Roles Of Nurses, Pharmacists, And Social Workers

Area of Science:

• Endocrinology
• Primary Care Medicine
• Health Services Research

Background:

• Managing type 2 diabetes (T2DM) is time-intensive, posing challenges for primary care clinicians.
• Diabetes care managers (nurses, pharmacists, social workers) support clinicians and improve glycemic control.
• Care management involving medication adjustment by nurses or pharmacists is particularly effective.

Purpose of the Study:

• To explore key questions surrounding type 2 diabetes care management.
• To review existing evidence on the effectiveness of diabetes care management.
• To examine barriers to widespread implementation and propose policy solutions.

Main Methods:

• Review of published evidence on diabetes care management.
• Analysis of barriers to workforce, scope of practice, and financial models.
• Exploration of policy solutions, including payment reform.

Main Results:

• Diabetes care management, especially with medication adjustment authority, improves glycemic control.
• Significant barriers hinder widespread implementation, including workforce shortages, regulatory limits, and inadequate financial models.
• Policy interventions, particularly payment reform, are essential for expanding care management.

Conclusions:

• Diabetes care management is a valuable strategy for improving T2DM outcomes in primary care.
• Addressing workforce, regulatory, and financial barriers is critical for successful implementation.
• Policy changes, including new fee-for-service codes and increased primary care investment, are needed to support and scale diabetes care management programs.