1. Understanding Patient Motivation and Barriers to Self-Management of Type 2 Diabetes Anisha Patel MSIII, Christine Payne MD, Martha Seagrave PA-C University of Vermont College of Medicine IntroductionConclusions References Results Objectives Methods 1. 2013 Vermont Behavioral Risk Factor Surveillance System. Rep. Vermont Department of Health, September 2013. Web. http://healthvermont.gov/prevent/diabetes/documents/diabetes_data_pages_2012.pdf 2. Stellefson M, Dipnarine K, Stopka C. The chronic care model and diabetes management in US primary care settings: a systematic review. Prev Chronic Dis. 2013;10:E26. 3. Wagner EH, Davis C, Schaefer J, Vonkorff M, Austin B. A survey of leading chronic disease management programs: are they consistent with the literature?. Manag Care Q. 1999;7(3):56-66.. J. Photo credits: Rajan Chawla Understand patient perspective on self- management support. Understand challenges of living with diabetes. Improve self-management support by promoting strategies most utilized by patients. Designed a survey to assess patient perspective on: o ‘My Health Diary’: a folder including patient goals, lab results, logs for daily blood sugars, and upcoming appointments o Meetings with a Certified Diabetes Educator (CDE) o Follow-up phone monitoring Interviewed 20 patients with a documented diagnosis of Type 2 Diabetes Presented results at the Patient Centered Medical Home meeting of Waterbury Medical Associates. Type 2 Diabetes is a major cause of cardiovascular disease in the United States. In Vermont, diabetes affects 7% of the adult population 1. This project focuses on patient experiences with self-management support, one of six components of the Chronic Care Model shown to improve diabetes outcomes nationwide 2. In conjunction with Waterbury Medical Associates, a primary care clinic in rural Vermont, we assessed patient perspectives on self-management of diabetes and barriers to making lifestyle changes required of diabetes. Maximize use of self-management tools already implemented in the clinic: o “My Health Diary” for all diabetes patients. o Annual meetings with the CDE o Follow-up phone monitoring at regular weekly or bimonthly intervals. Implement other components of Chronic Care Model to optimize care: o Delivery system design: organize “Diabetes Days” to coordinate office visits with PCPs and CDEs 1. o Health system— organization of health care: evaluate clinical outcomes of patients treated using the Chronic Care Model. Patient responses to living with Type 2 Diabetes: “I bet I could eat nothing all day and my sugar would be high” “I just don’t eat when I’m hungry” “I don’t have time to exercise” “Not being able to eat what I want” “My grandchildren are my motivation” Recommendations Most patients consider self-management support to be helpful in managing diabetes. “My Health Diary” and CDE meetings are the most utilized strategies. Most patients do not recall receiving a phone call due to the irregular nature of monitoring. Patients have many misconceptions about healthy diabetes diets. Most patients do not incorporate exercise into diabetes management. Patient responses to self- management tools: Project Sponsored by HRSA Grant Award D56HP23280-01-00