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Retrospective Analysis of a Virtual Lifestyle Medicine Shared Medical Appointment Series on Prediabetes and Type 2
Jacob Mirsky1,2, Nancy Haff1,2,3, Meekang Sung3
1Department of Medicine, Massachusetts General Hospital, Boston, MA, USA (JM, NH).
Abstract:
Purpose: Reimbursable in-person Shared Medical Appointments, where multiple patients meet with a provider to receive general education and individualized care, are effective at reducing glycated hemoglobin A1c (HbA1c) for patients with prediabetes and type 2 diabetes mellitus. There is little research on improving HbA1c control using Lifestyle Medicine Shared Medical Appointment (LMSMA) series, especially with virtual sessions. Setting: We describe the glycemic outcomes of a virtual LMSMA series for patients with prediabetes and type 2 diabetes mellitus in an academic primary care setting. Intervention: The intervention group consisted of patients attending ≥1 virtual LMSMA session; the control group was propensity-matched patients who were referred but did not schedule. Outcomes: The intervention led to a non-significant 0.09% greater HbA1c reduction (95% CI: -0.32, 0.14) vs control. However, intervention patients were 9% (95% CI: 1.01-1.17, control 85.3% vs intervention 91.4%) more likely to achieve HbA1c <7.0% approximately 1.5 years after the intervention and, in the setting of similar antihyperglycemic medication doses as baseline, had 0.51 fewer active antihyperglycemic medications over follow-up vs control patients (95% CI: -0.96, -0.06). Lessons Learned: These findings support further exploration of virtual LMSMA series as a care delivery strategy for improving blood sugar control.
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