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Pilot Pragmatic Trial of a Community Paramedic Diabetes Self-Management Education Program for Adults With Diabetes
Allison Ducharme-Smith1,2, Michael Juntunen2, Anna Espinoza3
1Division of Community Internal Medicine, Geriatrics, and Palliative Care, Department of Medicine, Mayo Clinic, Rochester, MN.
Objective:
To evaluate the impact of community paramedic (CP)-delivered, in-home diabetes self-management education and support (DSMES) for adults with poorly managed diabetes.
Research Design And Methods:
In a pragmatic, single-arm pilot trial, adults with HbA1c ≥9% and a recent emergency department or hospital visit received a 1-month CP-led DSMES intervention. Outcomes included HbA1c, health care engagement, and patient-reported satisfaction.
Results:
Seventy participants (median age 61 years, 50% rural, 84% with type 2 diabetes) completed the intervention. HbA1c declined from 9.8% to 8.2% at 4 months (P < 0.001). Engagement with primary care, endocrinology, and DSMES improved. Satisfaction was high (mean rating 9 out of 10).
Conclusions:
CP-led DSMES improved glycemic management and care engagement in underserved populations. This scalable model warrants further study.
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