ORLANDO, Fla. — Videoconferencing educational programs led by diabetes specialists help primary care providers gain confidence in their ability to treat patients with complex diabetes, according to findings presented at the Endocrine Society Annual Meeting.
“We know that diabetes is a manageable condition; we can prevent all of the complications of diabetes. Yet, today nearly half of the 30 million Americans with diabetes have ‘uncontrolled’ diabetes by current standards,” Matthew Bouchonville, MD, CDE, endocrinologist and assistant professor at the University of New Mexico School, told Endocrine Today. “These are often the ones with more complex diabetes who are referred to a diabetes specialist. The problem is we are short about 1,500 endocrinologists in the United States — and the ‘access gap’ for these patients is expected to continue widening over the next 10 years. This is not a sustainable system of health care delivery.”
Part of Project ECHO (Extension for Community Healthcare Outcomes) trains primary care clinicians and community health workers in complex disease to provide specialty care in underserved populations.
In the study, primary care providers from 10 rural health care centers in New Mexico were connected with endocrinologists, nurses, certified diabetes educators, behavioral health specialists and social workers, who are part of Endo ECHO, to become a local “endocrine expert” for managing complex diabetes at their center. The program consisted of weekly 2-hour videoconferencing sessions and mentoring on specific cases. The program is designed to progress for 4 years.
Participants were asked to complete a survey at baseline and 1 year into the program.
Survey respondents (n = 23) reported improvement in all measures of self-efficacy for the management of complex diabetes. Self-efficacy measures included confidence in their ability to manage complex insulin regimens and to screen for diabetes complications. Mean scores improved from 2.59 at baseline to 6.02 (P < .0001) at 1 year in community health care workers and from 3.66 to 5.84 (P < .0001) in primary care providers.
“Our study demonstrates we can equip these primary care providers with the skills and confidence needed to manage patients with complex diabetes they would otherwise have referred elsewhere for their care,” Bouchonville said. “We have enrolled almost 900 patients with type 1 and complex type 2 diabetes in Endo ECHO and are tracking their outcomes in collaboration with an external evaluation team at New York University. We believe that Endo ECHO is improving diabetes care in New Mexico and that this model is applicable to underserved regions around the globe.”
The Endo ECHO program sessions are free and open to providers anywhere. – Cassie Homer
Bouchonville MF, et al. SH02-5. Presented at: The Endocrine Society Annual Meeting; April 1-4, 2017; Orlando.
Disclosure: Bouchonville reports no relevant financial disclosures. The Endo ECHO program is supported by The Helmsley Charitable Trust.