Medicina comunitaria y educación para la salud

Abstracto

Primary Care Provider Feedback of Training to Identify and Manage Pre-Diabetes

Nancy Sohler, Yelena Zubatov, Jordan Sill, Julian Botta, Brenda Matti-Orozco, Edwin Young and Jeanine Albu

Introduction: Disease-specific training to improve management of chronic diseases is essential in the context of the patient-centered medical home. Achieving provider and staff satisfaction with practices and training is critical for successful patient care. Models for assessing satisfaction in the context of diabetes management have been reported. Here we extend this work to diabetes prevention.
Materials and methods: We administered a questionnaire to all provider and staff involved in a new pre-diabetes management program implemented in an inner city primary care network before, immediately after, and six months after a one-hour training session that was developed following American Diabetes Association guidelines. The questionnaire was adapted for pre-diabetes from the Provider Satisfaction Inventory, an instrument previously used to evaluate perceived ability to manage diabetes on four scales: chronic disease management, collaborative team practice, outcomes, and supportive environment.
Results: Fifty-six attending physicians, 133 residents, and 28 office staff participated. Mean scores on two of the four scales (chronic disease management and supportive environment) improved significantly immediately after the training. Improvement was noted on the other scales, but the changes did not consistently reach statistical significance. Continued improvement in scores after six months was evident in most scales for the attending physicians and residents, but not for the office staff.
Discussion: We successfully adapted a diabetes management satisfaction instrument to the evaluation of prediabetes management, and primary care providers and staff reported improved ability to manage pre-diabetes after our training. However, ongoing training after the initial session might be warranted for the office staff.