Exploring the Clinical Outcomes of Implementing Diabetes Self-Management Education and Support in a Primary Care Practice: A Quality Improvement Project.

Diabetes self-management education and support (DSMES) can be a very valuable service for many patients with diabetes. Unfortunately, despite its expected benefits, many patients do not receive DSMES through a quality, structured program. The purpose of this quality improvement project was to determine if integrating a diabetes education program utilizing the Association of Diabetes Care and Education Specialists (ADCES)7 Self-Care Behaviors into diabetes care in a primary care clinic could improve glycemic control and body mass index (BMI). The DSMES services provided were in accordance with the ADCES and the American Diabetes Association National Standards. The program included a 1-hour face-to-face service incorporating the ADCES7 Self-Care behaviors. A retrospective chart review was conducted to extract outcome data from = 54 random medical records. This data was then analyzed to evaluate the program's effectiveness. Pre- and postintervention data from medical records were analyzed for eligible patients who participated in the DSMES service (ages 18-75 with type 2 diabetes, hemoglobin A1c [A1c] >8%). Paired tests were used to determine significant changes in BMI and A1c parameters pre- and postintervention. Preintervention A1c ( = 9.5, = 1.7) and BMI ( = 33.2, = 7.8) and postintervention A1c ( = 7.8, = 1.5) and BMI ( = 32.2, = 7.9) indicate that DSMES significantly reduced A1c, (53) = 8.1, = <.001, and BMI, (53) = 4.4, = <.001. Models were then adjusted for pretest measures, age, gender, and time since diagnosis in a regression analysis. In models adjusted for pretest measures, age, gender, and time since diagnosis was significantly predictive of the postmeasure of BMI ( = .41, = .01, = .96) and postmeasure of A1c ( = .28, = .04, =.41). This project demonstrated that integrating a simple, cost-effective diabetes education service consisting of ADCES7 Self-Care Behaviors in a primary care practice could bridge gaps in diabetes management and significantly improve patients' BMI and A1c. Long-term utilization of this service may also enhance patient satisfaction, improve the patient's health, and reduce healthcare costs related to diabetes.