评估家庭医学住院医师计划中糖尿病组的医疗访问。

Elfie Wegner, Adonis Cheng, Christina Johnson, Antonia Carbone, Nick Florio, Judy C Washington
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摘要

背景:团体医疗访问(GMV)已被证明可以改善2型糖尿病(DM)患者的指标。一个名为Overlook Family Medicine的住院医师教学项目预计,接受跨学科团队成员GMV护理模式培训的住院医师可能会改善患者的胆固醇、HbA1C、BMI和血压。本研究的目的是比较第1组GMV糖尿病患者的主要护理提供者(PCP)是主治医师/执业护士(NP)和第2组GMV糖尿病患者的主要护理提供者是接受GMV培训的家庭医学(FM)住院医生之间的指标。我们寻求在住院医师教学实践中提供GMV实施的指导。方法:对2015-2018年GMV患者的总胆固醇、LDL、HDL、TG、BMI、HbA1C和BP进行回顾性分析。我们用t检验比较两组的结果。由一个跨学科团队为家庭医学住院医师提供糖尿病培训。结果:共有113例患者入组,1组53例,2组60例。2组LDL和甘油三酯降低,HDL升高,差异有统计学意义(PP=.0622)。结论:有冠军糖尿病教育专家可实现GMV的可持续性。跨学科团队成员在培训住院医师和解决患者障碍方面是不可或缺的。GMV培训应纳入家庭医学住院医师计划,以改善糖尿病患者的指标。接受跨学科培训的FM住院医生与没有接受培训的患者相比,GMV患者的指标有所改善。因此,GMV培训应纳入家庭医学住院医师计划,以改善糖尿病患者的指标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluating Diabetes Group Medical Visits in a Family Medicine Residency Program.

Background: Group medical visits (GMV) have been shown to improve metrics in patients with type 2 diabetes mellitus (DM). Overlook Family Medicine, a teaching residency program, anticipated that medical residents trained in the GMV model of care by interdisciplinary team members may improve cholesterol, HbA1C, BMI, and blood pressure in patients. The objective of this study was to compare metrics between group 1: GMV patients with DM whose primary care provider (PCP) was an attending physician/nurse practitioner (NP) and group 2: GMV patients with DM whose PCP was a family medicine (FM) medical resident receiving GMV training. We seek to provide guidance on implementation of GMV in residency teaching practices.

Methods: We performed a retrospective analysis to evaluate total cholesterol, LDL, HDL, TG, BMI, HbA1C, and BP in GMV patients between 2015-2018. We used a t test to compare outcomes between the two groups. Diabetes training was provided to family medicine residents by an interdisciplinary team.

Results: There were 113 patients enrolled in the study: 53 in group 1 and 60 in group 2. There was a statistically significant decrease in LDL and triglycerides, and an increase in HDL in group 2 (P<.05). There was a clinically significant decrease in HbA1C in group 2 (-0.56, P=.0622).

Conclusion: Sustainability of GMV can be achieved with a champion diabetes education specialist. Interdisciplinary team members are integral in training residents and addressing patients' barriers. GMV training should be incorporated into family medicine residency programs to improve metrics for patients with diabetes. FM residents who received interdisciplinary training had improved metrics in GMV patients compared to patients whose providers did not. Therefore, GMV training should be incorporated into family medicine residency programs to improve metrics for patients with diabetes.

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