Article Reflection: Group visit Program and Outcomes of Diabetes Care (Article Critique Sample)

Group visit Program and Outcomes of Diabetes Care
Name
Institution Affiliation
Reitz, J., Sarfaty, M., Diamond, J., & Salzman, B. (2012). The Effects of a Group Visit Program on Outcomes of Diabetes Care in an Urban Family Practice. Journal of Urban Health, 89(4), 709-716. http://dx.doi.org/10.1007/s11524-012-9675-9
INTRODUCTION
Diabetic mellitus is one of the chronic health conditions that have reduced the quality of life for many people in the world. It is a disease that is caused by multiple factors many of which are lifestyle related such as consumption of junk food and alcohol, sedentary life style, cigarette smoking among others. The main pathophysiology of the disease results from the inability of the tissues to respond to insulin or a reduced production of insulin. Consequently, blood sugar levels rise way above the normal resulting to symptoms of hyperglycemia. My interest in the topic is due to the fact that Diabetes mellitus is a major problem in our country affecting the lives of many people. It’s also among the top causes of death in the country and poses a heavy economic burden on the country. I am therefore eager to read any material and participate in any research aimed at coming up with strategies to improve the lives of diabetic patients as well reducing its prevalence.
A 2009 Thomas Jefferson University affiliated program was launched to see the impact of diabetic support groups in the achievement of hemoglobin AIC concentration, low density lipoproteins concentration, blood pressure targets as well as weight changes several months after cessation of the program. A visiting team consisting of a nurse, pharmacist, diabetic education instructor and physicians met the patients weekly in a 4 week program. Patients were taught diabetic management aspects such as diet and drugs in each visit.
The writers conclude that there is need for further research so as to confirm group based training programs’ efficacy in the African- American society or any other minority community. Such studies in these societies are relevant since older African- Americans have an increased incidence of diabetics and a higher rate of hospitalization than the whites. More research is necessary since this research has not covered all aspects related to the topic. Consistence of results from other researches done increase the reliability of the results therefore correct guidelines concerning self-management and diabetic support groups can be given using adequate supporting evidence. Furthermore, no research is free from errors so more studies are required to be done to come up with the most appropriate results and conclusions.
The main objective of the article was to determine the impact of an adult support and education visit program that is a component of urban academic family medicine practice The practice is geared towards weight management and the achievement of treatment goals of Hob AIC, blood pressure and Low density lipoprotein blood concentration after several months of the program implementation.
METHODS
Participants in the group visit and comparison group were obtained from the family medicine practice. Study participants were included based on the following criteria: age above 18 years having type 2 diabetes mellitus and should have had at least one visit to the practice between July 2008 and June 2009. Participants in the intervention group were patients who had participated in the group at least once between July and September 2009 and were obtained from available health records. Data on a total of 288 participants, (52 from the visit program and 236 from the comparison group patients) was available for analysis. Most of the participants from both groups were female, at least 45 years of age, African American and obese. Participants were matched on gender, 5 age groups with an interval of 5 years, 3 race categories and 3 residential zip code groups as the baseline variables. Data on Height, smoking history, diagnosis of hypertension, hyperlipidemia and depression, albumin- Creatinine ratio and type of treatment for DM was recorded. The variables collected from both the groups before and after the program were weight, BMI, number of office visits, Hb AIC concentration, LDL concentration and BP. The baseline variables for each group and the deviations from the baseline, with adjustment for baseline values during the 7 months period as well as the number of office visits were compared to the CMH static. The level of significance for group comparisons was set at an alpha value of less than 0.05.
The data got collected using self-reports. The self-reports provided details of the participants concerning their diabetic condition. The scales that got used in the study were the baseline demographics, measured characteristics and co- morbidities of the patients in the group visit program. The demographic data that got captured during the data collection were age, ethnic/race, gender, zip code and the surrogate marker for the social economic status of the patients. The co-morbidities involved were the prevalence for depression, coronary artery disease, hyperlipidemia, hypertension, proteinuria and micro-albuminemia. They are the medical instruments used to collect data. Specific parameters such as blood pressure got measured using the blood pressure machines and the weight of the patients got measures using the body weight measuring machines. Computers got utilized in the storage of the data that gets collected from the medical reports of the patients. Data analysis got done also using the computer programs. Laboratory analysis of the blood lipoprotein was done during the follow up of the participants.
RESULTS
The data available for the research involved 52 participants of the in the 64 group visit. The participants were organized in 27 strata. There were 236 comparison group patients in 26 strata. Majority of the participants were of female gender, African American race and were obese. The prevalence of the comorbid conditions such as the depression, hypertension, coronary artery disease, hyperlipidemia, micro-albuminemia and proteinuria were similar across the study groups.
Most of the participants were under medical therapy of oral anti diabetic medications with some under the insulin therapy. Majority of the participants had more office visits from July 2009 all through the follow up period. 46% of the patients attended at least three sessions. The attendance of the individual patients during the study was also variable. The proportion of the participants in the group visit program with the hemoglobin A1C concentration less than 7% in the follow up period compared to the baseline period. The adjustment of the office visits during the follow up period did not show any major changes.
During the follow up period, the hemoglobin concentrations declined in 76% a...