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Abstract #147997

Kalpana Manthiram¹, Brad Walsh, MPH², Renuka Khurana, MD, MPH², Nora Gimpel, MD¹, and Mark DeHaven, Ph D¹. (1) Department of Family and Community Medicine, University of Texas Southwestern Medical Center, 6263 Harry Hines Blvd., Dallas, TX 75390, 214-350-3192, kalpana.manthiram@utsouthwestern.edu, (2) Department of Strategic Planning and Population Medicine, Parkland Health and Hospital System, 5201 Harry Hines Blvd., Dallas, TX 75235

Introduction: The Shared Medical Appointment (SMA) is considered an efficient alternative to conventional one-on-one appointments. During an SMA, 90-minute primary care appointments are conducted in a group setting among 8 to 17 patients. Although studies indicate high levels of patient and provider satisfaction with SMAs, few studies have examined their clinical outcomes. We investigated the clinical effectiveness of SMAs.

Methods: Medical records of patients (N=63) with type 2 diabetes who attended at least two SMAs in the Parkland Community Oriented Primary Care clinics were reviewed. Clinical parameters pertaining to glycemic control, presence of co-morbid conditions, adherence to preventive guidelines, and presence of complications were recorded before and after SMA attendance.

Results: Analysis revealed no change in the level of glycemic control or co-morbid conditions following SMA attendance. Adherence to preventive guidelines improved in regard to influenza vaccinations (31% before vs. 53% after SMA, P=0.018). The number of complications declined; of these, the decrease in cardiovascular disease events was statistically significant (2.20 vs 1.88, P=0.014). LDL levels improved in unmarried patients and females but worsened in married patients and males after SMA attendance (-9.9 mg/dl for unmarried vs. +12.5 for married, P = 0.115); (-4.1mg/dl for females vs. +9.6 for males, P=0.357).

Conclusions: Although many of the clinical outcomes improved following SMA attendance, the overall patient improvement was similar to or slightly better than that prior to SMA attendance. In addition, unmarried and female patients may benefit more from the social interaction during SMAs than married and male patients.

Learning Objectives:

• Describe and discuss the characteristics of the Shared Medical Appointment (SMA) versus the conventional one-on-one appointment.
• Evaluate clinical outcomes of Shared Medical Appointments used in a primary care setting.
• Learn how to develop a collaborative community-based research project.

Keywords: Health Care Delivery,

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.