Partnering with charity-care services to manage cirrhosis with ascites in an adult experiencing homelessness: A case report.

Charity care services can be an important tool for reducing healthcare disparities among populations with housing instability.

Effectiveness of Shared Medical Appointments Targeting the Triple Aim Among Patients With Overweight, Obesity, or Diabetes.

BACKGROUND: Obesity and diabetes are epidemic in the United States, with many treatment options having limited long-term efficacy. A possible effective medical management tool is the shared medical appointment (SMA), which offers an efficient and cost-effective approach to behavior change and aligns with the Triple Aim (reduce costs, improve population health, and improve patient care experience) set forth by the Institute for Healthcare Improvement. OBJECTIVES: To assess the effectiveness of SMAs to achieve the Triple Aim and to improve the management of overweight/obesity or diabetes. METHODS: Peer-reviewed literature from PubMed was searched by the keywords shared medical appointments, group medical appointment, and group medical visit, with no date restrictions and limited to English publications with sample sizes greater than or equal to 20. RESULTS: Eight articles met inclusion criteria. The Triple Aim was not referenced in the studies, but most reported some combination of reduced costs, improved care, and improved outcomes or patient satisfaction. CONCLUSIONS: Potential benefits of SMAs include improved patient outcomes and satisfaction. Osteopathic and, in particular, primary care medicine could likely benefit from moving toward greater adoption of SMAs; however, more randomized controlled trials are needed to assess their effectiveness with regard to the Triple Aim.

Goal setting education and counseling practices of diabetes educators.

PURPOSE: The purpose of this study was to identify goal setting education practices used by diabetes educators working with type 2 diabetes patients. METHODS: Data were collected by a mail questionnaire with 179 diabetes educators purposively selected from the 2008 American Association of Diabetes Educators membership listing. RESULTS: Many diabetes educators (52%) reported that more than 75% of their patients set goals for diabetes control. Independent factor patterns for the frequency of information collected from the patient for the first diabetes education session showed that educators either focused on patients' self-management practices (exercise and dietary practices, knowledge, and social impacts of diabetes) or issues with learning about self-management, such as understanding the patient's learning style and motivation for managing diabetes. Factor patterns overall showed diverse approaches to working with patients, including strategies used with patients struggling with dietary goals and the importance of tasks to complete during the first patient session. CONCLUSION: Although most educators reported practices that were largely patient centered as promoted by the American Diabetes Association (ADA) and models of chronic disease management, patterns of practice suggest that diabetes educators vary considerably in how they apply education practices, especially with dietary self-management education.

Assessing diabetes dietary goals and self-management based on in-depth interviews with Latino and Caucasian clients with type 2 diabetes.

Latino (n = 10) and Caucasian (n = 8) clients with type 2 diabetes receiving care at a community health clinic participated in individual in-depth interviews assessing diabetes dietary self-management goal behaviors. Themes from interviews were identified using content analysis, which revealed current and future goals, influencing factors, and motivators and barriers to dietary modification for diabetes management. Implications for practice include simplifying goal setting to those goals with the greatest potential clinical impact or the greatest significance to the patient, in a socially supportive environment. Results contribute to future survey development and understanding how to optimize diabetes education for these populations.