Diabetes is prevalent, costly, and deadly. Patients living with chronic conditions can benefit from interventions that are intended to empower them to self-manage their conditions outside of their primary care visits as well as interventions that allow them to better communicate with their primary care physicians.
197 Diabetes patients were recruited and followed from 2015 to 2016 from a primary care center of a hospital in downtown Atlanta and randomized into one of two study arms. Intervention patients were provided with personalized, color coded printouts of their A1c, systolic blood pressure, and LDL cholesterol numbers over the last year or so at each visit. These materials were intended to help them understand their lab values, remind them of how to self manage their diabetes outside of their visits, and facilitate conversations with their providers about their trajectory and management. Control patients were given the same interviews as intervention patients, but not given the roadmap printouts.
Difference in differences methods were employed to assess the change in systolic blood pressure (SBP) from baseline to 3 and 6 month follow up times between groups. SBP was used as a marker for diabetes control because it was reliably taken at every visit (unlike A1c), used in the roadmaps employed by the study, and subject to fewer validity concerns than POCT glucose for this sample.
The difference in differences tests were not found to be significant, however the intervention group did experience a small decrease of about 3 mmHg from baseline to 6 months while the control group stayed nearly identical.
Qualitatively, patients tended to have very positive reactions to the roadmap, however they also seemed to benefit from having additional time to discuss the roadmap with study interviewers. While the D-I-D models were insignificant, there may be different findings if a different metric were used in a future model for a similar study, such as fasting glucose or A1c.
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About this Master's Thesis
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|File download under embargo until 12 June 2019||2018-08-28||File download under embargo until 12 June 2019|