Impact of Shared Medical Appointment among Persons with Diabetes

Abstract Background Gastroesophageal reflux disease (GERD), dyspepsia and irritable bowel syndrome (IBS) are common gastrointestinal disorders accounting for a significant demand for specialty care. The aim of this study was to evaluate safety, access and outcomes of patients assessed by a nurse-led, shared medical appointment. Methods This prospective observational study utilized a sample of 770 patients referred to a gastroenterology Central Access and Triage for routine GERD, dyspepsia or IBS from 2011 to 2014. Patient demographics, clinical indication, frequency and outcomes of endoscopy, quality of life, wait times and long-term outcomes (>2 years) were compared between 411 patients assigned to a nurse-led, shared medical appointment and 359 patients assigned to clinic for a gastroenterology physician consultation. Results The nurse-led, shared medical appointment pathway compared with usual care pathway had shorter median wait times (12.6 weeks versus 137.1 weeks, P < 0.0001), fewer endoscopic exams (50.9% versus 76.3%, P < 0.0001), less gastroenterology re-referrals (4.6% versus 15.6%, P < 0.0001), and reduced visits to the emergency department (6.1% versus 12.0%, P = 0.004). After two years of follow-up, outcomes were no different between the pathways. Conclusions Patients with GERD, IBS or dyspepsia who attend the nurse-led, shared medical appointment have improved access to care and reduced resource utilization without increased risk of significant gastrointestinal outcomes after two years of follow-up.

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A Pilot Study: Reports of Benefits from a 6-Month, Multidisciplinary, Shared Medical Appointment Approach for Heart Failure Patients

Military Medicine ◽

10.7205/milmed.173.12.1210 ◽

2008 ◽

Vol 173 (12) ◽

pp. 1210-1213 ◽

Cited By ~ 22

Author(s):

Andrew Lin ◽

Jeffrey Cavendish ◽

Denise Boren ◽

Trish Ofstad ◽

Daniel Seidensticker

Keyword(s):

Heart Failure ◽

Pilot Study ◽

Heart Failure Patients ◽

Medical Appointment ◽

Shared Medical Appointment

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1288-P: Novel Culturally Sensitive Shared Medical Appointment Model for High-Risk Latino Youth with Type 1 Diabetes: One-Year Follow-Up Postpilot Intervention

Diabetes ◽

10.2337/db20-1288-p ◽

2020 ◽

Vol 69 (Supplement 1) ◽

pp. 1288-P

Author(s):

RYAN JENSEN ◽

KRISTEN CAMPBELL ◽

LAURA PYLE ◽

ANDREA GERARD GONZALEZ

Keyword(s):

Type 1 Diabetes ◽

High Risk ◽

Latino Youth ◽

Culturally Sensitive ◽

Medical Appointment ◽

Shared Medical Appointment ◽

One Year

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A Low-threshold Comprehensive Shared Medical Appointment Program for Perinatal Substance Use in an Underserved Population

Journal of Addiction Medicine ◽

10.1097/adm.0000000000000912 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Valerie S. Ganetsky ◽

Jessica Heil ◽

Brianna Yates ◽

Iris Jones ◽

Krystal Hunter ◽

...

Keyword(s):

Substance Use ◽

Underserved Population ◽

Medical Appointment ◽

Shared Medical Appointment ◽

Low Threshold

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Impact of Pharmacist Care in a Shared Medical Appointment Model for the Management of Type 2 Diabetes in a Micronesian Population

Californian Journal of Health Promotion ◽

10.32398/cjhp.v12i2.2146 ◽

2014 ◽

Vol 12 (2) ◽

pp. 13-21

Author(s):

Candace Tan ◽

Deborah T. Juarez ◽

Stacy Haumea ◽

Charlotte Grimm

Keyword(s):

Health Care ◽

Clinical Pharmacy ◽

Standard Care ◽

The United States ◽

Pacific Islanders ◽

Management Service ◽

Medical Appointment ◽

Shared Medical Appointment ◽

Significant Difference ◽

Pharmacist Care

More than 25 million people have diabetes in the United States and its complications make it a leading cause of death. Pacific Islanders, specifically Micronesians, experience even higher rates of diabetes, and pharmacist care for these individuals may improve health outcomes. Objective: To better address health disparities in this population, a health center serving Hawaii Island added clinical pharmacy services into their shared medical appointment program for diabetes management. Methods: Standard care (n= 21) consisted of weekly education sessions for patients provided by a multi-disciplinary team, after which patients had one-on-one appointments with a primary care provider if they met threshold clinical criteria. The intervention group (n=36) received the same services, plus a medication management service provided by a pharmacist during the one-on-one appointments. Results: There was no statistically significant difference between the pharmacist care and standard care groups on clinical measures including glycosylated hemoglobin, low density lipoprotein and blood pressure at the end of the eighteenmonth intervention period. Conclusion: Pacific Islanders face unique health care challenges including low socioeconomic status, language barriers and differences in cultural perceptions of health care. The value of clinical pharmacy has been well-documented in the literature but further study of the role and impact of these services is warranted for high-risk populations.

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