Care Managers Nudge Diabetes Numbers

Care managers decided for people with diabetes and weight issues, but it was not a significant change, according to a study in the Journal of Primary Care & Community Health.

The study divided 10 primary care practices into two classes, five that employed maintenance management programs and five that provided care. The maintenance management included a maintenance manager, staff training, and care-management developments to the electronic medical record. Patients have been followed for a year. The study included 696 patients in each arm, 443 with diabetes and 253 with diabetes but who were overweight.

The results demonstrated a modest (12%) benefit for the care management team in control of blood sugar levels, as measured by the proportion of individuals whose HbA1c was under 7%.

One of the obese individuals, the maintenance management team had a 16 percent point advantage (26% vs. 10 percent) over the regular care group at the proportion of individuals who lost 5% of the body weight.

The before-and-after HbA1c leads to the maintenance management team were rather impressive. Before the intervention, 25% of the patients had a HbA1c under 7%. Afterward, that ratio had increased to 45%.

Several have high hopes for maintenance management, and this particular study was an effort to examine it at a primary care setting. However, the study did not incorporate any information regarding the cost of healthcare management program, so it is not possible to say whether it adds or subtracts to the signs for maintenance management being worth the trouble and expense.

Care management is generally supplied across a range of suppliers, including nurses, social workers, pharmacists, and dietitians. It can be delivered by phone or other means, even though a face-to-face assembly is generally included.

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