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Structured Outpatient Diabetes Education and Telehealth Follow-up to Improve HbA 1c
Marina B Harris-Hardaway1, Nancy L Novotny, Jennifer Dana Sawyer
1Mennonite College of Nursing, Edwards Hall, Illinois State University, Normal (Ms Harris-Hardaway and Dr Novotny); Fortis College, Baltimore, Maryland (Dr Sawyer); and OSF Medical Group-Gastroenterology, Bloomington, Illinois (Ms Schmitt).
Background:
More than 10% of Americans have diabetes, with higher rates in Hispanics and African Americans. National Healthy People 2030 goals for expected decrease in HbA 1c levels have not been met.
Local Problem:
No standardized diabetes education or follow-up existed at a free clinic. Patients exhibited diabetic self-management inadequacies and elevated HbA 1c levels.
Methods:
A pre/postimplementation study design was used to evaluate changes in HbA 1c levels, medication adherence, missed appointments, and emergency department visits.
Interventions:
Structured diabetes education and follow-up text/phone messages for patients with HbA 1c levels 8% or higher were implemented over 3 months.
Results:
Outcome data were available for 27 of the 34 participants. Postimplementation, there was a significant 1.7% decrease in mean HbA 1c levels ( P < .001). No significant differences were found for the other outcome measures.
Conclusions:
Structured diabetes education and follow-up text/phone messages in a free clinic improved patients' HbA 1c levels.
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